Efficacy of Multislice Computed Tomography for the Detection of Acute Coronary Syndrome in the Emergency Department

Yuichi Sato; Naoya Matsumoto; Makoto Ichikawa; Taeko Kunimasa; Kiyoshi Iida; Shunichi Yoda; Tadateru Takayama; Takahisa Uchiyama; Satoshi Saito; Ken Nagao; Hiroshi Tanaka; Fumio Inoue; Satoru Furuhashi; Motoichiro Takahashi; Yasushi Koyama

doi:10.1253/circj.69.1047

Clinical Investigation

Efficacy of Multislice Computed Tomography for the Detection of Acute Coronary Syndrome in the Emergency Department

Yuichi Sato, Naoya Matsumoto, Makoto Ichikawa, Taeko Kunimasa, Kiyoshi Iida, Shunichi Yoda, Tadateru Takayama, Takahisa Uchiyama, Satoshi Saito, Ken Nagao, Hiroshi Tanaka, Fumio Inoue, Satoru Furuhashi, Motoichiro Takahashi, Yasushi Koyama

Author information

Yuichi Sato
Departments of Cardiology, Nihon University School of Medicine
Naoya Matsumoto
Departments of Cardiology, Nihon University School of Medicine
Makoto Ichikawa
Departments of Cardiology, Nihon University School of Medicine
Taeko Kunimasa
Departments of Cardiology, Nihon University School of Medicine
Kiyoshi Iida
Departments of Cardiology, Nihon University School of Medicine
Shunichi Yoda
Departments of Cardiology, Nihon University School of Medicine
Tadateru Takayama
Departments of Cardiology, Nihon University School of Medicine
Takahisa Uchiyama
Departments of Cardiology, Nihon University School of Medicine
Satoshi Saito
Departments of Cardiology, Nihon University School of Medicine
Ken Nagao
Critical Care Medicine, Nihon University School of Medicine
Hiroshi Tanaka
Radiology, Nihon University School of Medicine
Fumio Inoue
Radiology, Nihon University School of Medicine
Satoru Furuhashi
Radiology, Nihon University School of Medicine
Motoichiro Takahashi
Radiology, Nihon University School of Medicine
Yasushi Koyama
Division of Advanced Cardiac Imaging, Department of Cardiology, Cleveland Clinic Foundation

Keywords: Acute coronary syndrome, Emergency department, Multislice computed tomography

JOURNAL FREE ACCESS

2005 Volume 69 Issue 9 Pages 1047-1051

DOI https://doi.org/10.1253/circj.69.1047

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Abstract

Background The diagnosis of acute coronary syndrome (ACS), especially non-ST-elevation myocardial infarction and unstable angina in the emergency department (ED) still remains a challenge. Multislice computed tomography (MSCT) allows assessment of not only coronary artery stenoses and occlusions, but also assessment of coronary artery plaques and myocardial perfusion status. Methods and Results MSCT was performed in 31 patients who were admitted to the ED because of chest pain persisting at least 30 min and non-diagnostic ECG changes and normal serum enzyme concentrations. Using MSCT, ACS was defined by coronary artery stenosis ≥75% accompanied by computed tomography (CT)-low-density plaques, and/or by the presence of myocardial perfusion defects. ACS was confirmed by coronary stenosis ≥75% by coronary angiography and/or subsequent elevation of troponin I concentration. In total, 22 patients were diagnosed as having ACS. MSCT detected stenoses with CT-low-density plaques in 21 and non-transmural myocardial perfusion defect in 3 patients. There was 1 false-positive and 1 false-negative result. The sensitivity and specificity of MSCT to identify ACS was 95.5% and 88.9%, respectively. Conclusion MSCT provides diagnostic operating characteristics suitable for triage of patients with ACS in the ED. (Circ J 2005; 69: 1047 - 1051)

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