Key result
Multislice computed tomography identified acute coronary syndrome with a sensitivity of 95.5% and a specificity of 88.9% in emergency department patients with chest pain and non-diagnostic ECGs.
Why the study?
Does multislice computed tomography accurately detect acute coronary syndrome in emergency department patients with chest pain and non-diagnostic initial tests?
Observational (n=31)
No
Does multislice computed tomography accurately detect acute coronary syndrome in emergency department patients with chest pain and non-diagnostic initial tests?
Effect estimate: Sensitivity 95.5%, Specificity 88.9%
MSCT demonstrates high sensitivity and specificity for detecting acute coronary syndrome in ED patients with chest pain and non-diagnostic initial tests, suggesting utility for triage.
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. METHODS AND 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. CONCLUSION: MSCT provides diagnostic operating characteristics suitable for triage of patients with ACS in the ED.
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Sato et al. (2005) conducted an observational in Suspected acute coronary syndrome (n=31). Multislice computed tomography (MSCT) vs. Coronary angiography and/or cardiac enzymes (reference standard) was evaluated on Identification of acute coronary syndrome (Sensitivity 95.5%, Specificity 88.9%). Multislice computed tomography identified acute coronary syndrome with a sensitivity of 95.5% and a specificity of 88.9% in emergency department patients with chest pain and non-diagnostic ECGs.
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