title: Efficacy of multislice computed tomography for the detection of acute coronary syndrome in the emergency department.
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.
  
  
  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 > or = 75% accompanied by computed tomography (CT)-low-density plaques, and/or by the presence of myocardial perfusion defects. ACS was confirmed by coronary stenosis > or = 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.
  
  
  CONCLUSIONS
  MSCT provides diagnostic operating characteristics suitable for triage of patients with ACS in the ED.
authors.affiliation: Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan. yuichis@med.nihon-u.ac.jp
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.forename: Naoya
authors.initials: N
authors.lastname: Matsumoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Ichikawa
authors.forename: Taeko
authors.initials: T
authors.lastname: Kunimasa
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Iida
authors.forename: Shunichi
authors.initials: S
authors.lastname: Yoda
authors.forename: Tadateru
authors.initials: T
authors.lastname: Takayama
authors.forename: Takahisa
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Saito
authors.forename: Ken
authors.initials: K
authors.lastname: Nagao
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.forename: Fumio
authors.initials: F
authors.lastname: Inoue
authors.forename: Satoru
authors.initials: S
authors.lastname: Furuhashi
authors.forename: Motoichiro
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Koyama
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D004632:Emergency Medical Services / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D036542:Tomography, Spiral Computed / Q000379:methods