Use of 40-detector row computed tomography before catheter coronary angiography to select early conservative versus early invasive treatment for patients with low-risk acute coronary syndrome.
OBJECTIVE
Using catheter coronary angiography (CAG) as reference standard, we examined the agreement of 40-detector row computed tomography (MDCT) in triaging patients into the 2 controversial strategies of managing low-risk acute coronary syndrome (ACS).


METHODS
Seventy-eight patients with low-risk ACS received both MDCT and CAG. Early invasive strategy was assigned for the patient if there was significant stenosis (> or =50% diameter stenosis) in any of the coronary artery segments with diameter larger than 1.5 mm. The results of MDCT were compared with the CAG for agreement.


RESULTS
The overall agreement of the early conservative/early invasive strategy assignment was 92.3%, with kappa value of 0.82 between MDCT and CAG. Only 1 patient needing early invasive strategy was missed by MDCT.


CONCLUSIONS
Forty-detector row computed tomography is reliable in triaging patients into the 2 strategies of managing low-risk ACS.
Tsai
I-Chen
IC
Department of Radiology, Taichung Veterans General Hospital, Medical College of Chung Shang Medical University, Taiwan, Republic of China.
Lee
Tain
T
Lee
Wen-Lieng
WL
Tsao
Chen-Rong
CR
Tsai
Wei-Lin
WL
Chen
Min-Chi
MC
Ting
Chih-Tai
CT
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology / Q000628:therapy; D002404:Catheterization; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000295:instrumentation / Q000379:methods*; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol