Coronary CT and the coronary calcium score, the future of ED risk stratification?
Accurate and efficient evaluation of acute chest pain remains clinically challenging because traditional diagnostic modalities have many limitations. Recent improvement in non-invasive imaging technologies could potentially improve both diagnostic efficiency and clinical outcomes of patients with acute chest pain while reducing unnecessary hospitalizations. However, there is still controversy regarding much of the evidence for these technologies. This article reviews the role of coronary artery calcium score and the coronary computed tomography in the assessment of individual coronary risk and their usefulness in the emergency department in facilitating appropriate disposition decisions. The evidence base and clinical applications for both techniques are also described, together with cost- effectiveness and radiation exposure considerations.
Departamento de Cardiologia, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Leticia
L
Fernandez-Friera
Ana
A
Garcia-Alvarez
Gabriela
G
Guzman
Mario J
MJ
Garcia
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging*; D002118:Calcium / Q000032:analysis*; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000378:metabolism*; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D019317:Evidence-Based Medicine; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging; D018579:Patient Selection; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014218:Triage
D002118:Calcium