Diagnostic accuracy of 64-slice computed tomography coronary angiography in a large population of patients without revascularisation: registry data in NSTEMI acute coronary syndrome and influence of gender and risk factors

Maffei, Erica; Martini, Chiara; Tedeschi, Carlo; Spagnolo, Pietro; Zuccarelli, Alessandra; Arcadi, Teresa; Guaricci, Andrea Igoren; Seitun, Sara; Weustink, Annick C.; Mollet, Nico R.; Cademartiri, Filippo

doi:10.1007/s11547-011-0696-3

Cited by 3 publications

(1 citation statement)

References 41 publications

(25 reference statements)

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“…In the last two years a great debate occurs about the value of anatomical information by coronary computed tomographic angiography (CTA) in comparison to functional imaging tests on the evaluation of patients with new onset chest pain and unknown coronary artery disease (CAD) [1–5]. Stable chest pain is a common clinical presentation that often requires further investigation using noninvasive or invasive testing [6–8].…”

Section: Introductionmentioning

confidence: 99%

Old and New NICE Guidelines for the Evaluation of New Onset Stable Chest Pain: A Real World Perspective

Carrabba

Migliorini

Pradella

et al. 2018

BioMed Research International

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Stable chest pain is a common clinical presentation that often requires further investigation using noninvasive or invasive testing, resulting in a resource-consuming problem worldwide. At onset of 2016, the National Institute for Health and Care Excellence (NICE) published an update on its guideline on chest pain. Three key changes to the 2010 version were provided by the new NICE guideline. First, the new guideline recommends that the previously proposed pretest probability risk score should no longer be used. Second, they also recommend that a calcium score of zero should no longer be used to rule out coronary artery disease (CAD) in patients with low pretest probability. Third, the new guideline recommends that all patients with new onset chest pain should be investigated with a coronary computed tomographic angiography (CTA) as a first-line investigation. However, in real world the impact of implementation of CTA for the evaluation of new onset chest pain remains to be evaluated, especially regarding its cost effectiveness. The aim of the present report was to discuss the results of the studies supporting new NICE guideline and its comparison with European and US guidelines.

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Section: Introductionmentioning

confidence: 99%

Old and New NICE Guidelines for the Evaluation of New Onset Stable Chest Pain: A Real World Perspective

Carrabba

Migliorini

Pradella

et al. 2018

BioMed Research International

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Role of MDCT coronary angiography in the clinical setting: economic implications

et al. 2013

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Prognostic Value and Therapeutic Perspectives of Coronary CT Angiography: A Literature Review

Carità

Guaricci

Muscogiuri

et al. 2018

BioMed Research International

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Coronary stenosis severity is both a powerful and a still debated predictor of prognosis in coronary artery disease. Coronary computed tomographic angiography (CCTA) has emerged as a noninvasive technique that enables anatomic visualization of coronary artery disease (CAD). CCTA with newer applications, plaque characterization and physiologic/functional evaluation, allows a comprehensive diagnostic and prognostic assessment of otherwise low-intermediate subjects for primary prevention. CCTA measures the overall plaque burden, differentiates plaque subtypes, and identifies high-risk plaque with good reproducibility. Research in this field may also advance towards an era of personalized risk prediction and individualized medical therapy. It has been demonstrated that statins may delay plaque progression and change some plaque features. The potential effects on plaque modifications induced by other medical therapies have also been investigated. Although it is not currently possible to recommend routinely serial scans to monitor the therapeutic efficacy of medical interventions, the plaque modulation, as a part of risk modification, appears a feasible strategy. In this review we summarize the current evidence regarding vulnerable plaque and effects of lipid lowering therapy on morphological features of CAD. We also discuss the potential ability of CCTA to characterize coronary atherosclerosis, stratify prognosis of asymptomatic subjects, and guide medical therapy.

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Diagnostic accuracy of 64-slice computed tomography coronary angiography in a large population of patients without revascularisation: registry data in NSTEMI acute coronary syndrome and influence of gender and risk factors

Abstract: CTCA is a reliable diagnostic modality with high sensitivity and NPV in NSTEMI-ACS patients who are not candidates for early revascularisation, regardless of gender and number of risk factors.

Cited by 3 publications

References 41 publications

Old and New NICE Guidelines for the Evaluation of New Onset Stable Chest Pain: A Real World Perspective

Old and New NICE Guidelines for the Evaluation of New Onset Stable Chest Pain: A Real World Perspective

Role of MDCT coronary angiography in the clinical setting: economic implications

Prognostic Value and Therapeutic Perspectives of Coronary CT Angiography: A Literature Review

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