title: 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.
abstract: 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.
authors.affiliation: Department of Radiology, Taichung Veterans General Hospital, Medical College of Chung Shang Medical University, Taiwan, Republic of China.
authors.forename: I-Chen
authors.initials: IC
authors.lastname: Tsai
authors.forename: Tain
authors.initials: T
authors.lastname: Lee
authors.forename: Wen-Lieng
authors.initials: WL
authors.lastname: Lee
authors.forename: Chen-Rong
authors.initials: CR
authors.lastname: Tsao
authors.forename: Wei-Lin
authors.initials: WL
authors.lastname: Tsai
authors.forename: Min-Chi
authors.initials: MC
authors.lastname: Chen
authors.forename: Chih-Tai
authors.initials: CT
authors.lastname: Ting
mesh_terms: 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*
chemical_list: D003287:Contrast Media; D007472:Iohexol