Coronary CT angiography outperforms calcium imaging in the triage of acute coronary syndrome

Abstract

Coronary CTA outperforms calcium imaging in the triage of patients suspected of developing ACS. Absence of plaque on coronary CTA allows safe discharge. Coronary CTA has incremental value to clinical risk scores and has the potential to reduce unnecessary hospital admissions.

Accuracy of multidetector computed tomography for detection of coronary artery stenosis in acute coronary syndrome compared with stable coronary disease: A CORE64 multicenter trial substudy

“…Our data are in line with Henneman at al [35], which demonstrated that 39% of ACS patients had no coronary calcification and 46% of patients with CS b100 had obstructive coronary disease. These findings suggest that in this higher-risk population, a low CS might underestimate the overall plaque burden and cannot exclude safely the presence of significant CAD [36], especially in suspected ACS patients [37].…”

Copeptin in acute chest pain: identification of acute coronary syndrome and obstructive coronary artery disease on coronary CT angiography

“…Patients with chest pain in the last 24 h were enrolled consecutively at the ED of Erasmus University Medical Centre from November 2009 to February 2011 10. Eligible for participation were patients older than 40 years, without ST segment elevation, haemodynamic instability or highly elevated cardiac troponin T (>0.15 μg/l).…”

Cardiac CTA in the Emergency Department

“…Calcium scoring in acute chest pain is debatable. Although a calcium score of 0 in low risk patients implies a low probability of ACS, it is generally not seen as reliable to rule out ACS in patients with acute chest pain [8]. CT calcium scoring is a non-contrast, non-invasive, relatively low radiation (approximately 1mSv) method where coronary artery calcium (CAC) is quantified.…”