64-Slice CT coronary angiography in patients with non-ST elevation acute coronary syndrome.
BACKGROUND
A high diagnostic accuracy of 64-slice CT coronary angiography (CTCA) has been reported in selected patients with stable angina pectoris, but only scant information is available in patients with non-ST elevation acute coronary syndrome (ACS).


OBJECTIVE
To study the diagnostic performance of 64-slice CTCA in patients with non-ST elevation ACS.


METHODS
64-slice CTCA was performed in 104 patients (mean (SD) age 59 (9) years) with non-ST elevation ACS. Two independent, blinded observers assessed all coronary arteries for stenosis, using conventional quantitative angiography as a reference. Coronary lesions with >or=50% luminal narrowing were classified as significant.


RESULTS
Conventional coronary angiography demonstrated the absence of significant disease in 15% (16/104) of patients, and the presence of single-vessel disease in 40% (42/104) and multivessel disease in 44% (46/104) of patients. Sensitivity for detecting significant coronary stenoses on a patient-by-patient analysis was 100% (88/88; 95% CI 95 to 100), specificity 75% (12/16; 95% CI 47 to 92), and positive and negative predictive values were 96% (88/92; 95% CI 89 to 99) and 100% (12/12; 95% CI 70 to 100), respectively.


CONCLUSIONS
64-slice CTCA has a high sensitivity to detect significant coronary stenoses, and is reliable to exclude the presence of significant coronary artery disease in patients who present with a non-ST elevation ACS.
Meijboom
Willem B
WB
Department of Cardiology, Thoraxcenter, and Radiology, Rotterdam, The Netherlands.
Mollet
Nico R
NR
Van Mieghem
Carlos A
CA
Weustink
Annick C
AC
Pugliese
Francesca
F
van Pelt
Niels
N
Cademartiri
Filippo
F
Vourvouri
Eleni
E
de Jaegere
Peter
P
Krestin
Gabriel P
GP
de Feyter
Pim J
PJ
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D004562:Electrocardiography; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed