The role of coronary CT angiography for acute chest pain in the era of high-sensitivity troponins

Yang, Shengwen; Manjunath, L.; Willemink, Martin J.; Nieman, Koen

doi:10.1016/j.jcct.2019.05.007

Cited by 14 publications

(12 citation statements)

References 54 publications

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“…However, with the development of multiatrial spiral, the tube ball rotation time is decreasing, the scan time is getting faster, and the rapid development of techniques such as cardiac gating makes it possible to evaluate coronary artery, aorta, and pulmonary artery simultaneously by one examination, and this technique which is called chest pain triple one-stop imaging examination can reduce the number of single examinations used to evaluate coronary artery disease, aortic disease, and pulmonary artery disease, as Figure 1 shows. Derived from cardiac gated coronary artery examination [17], the difference compared to the coronary artery is the longer scan range, usually from the thoracic inlet to the level of the diaphragm. Using a conventional retrospective ECG gated scan, data from all phases of several cardiac cycles need to be acquired in the breath-hold state and then the best phase is selected for data reconstruction, which has a lower pitch, usually and can be used in the emergency department to assess the etiology of acute chest pain and has potential applications for early diagnosis [18].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Multislice Spiral CT Cardiothoracic Combined with Angiography in Acute Chest Pain

Yang

2021

Journal of Healthcare Engineering

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Acute chest pain is a common clinical emergency condition with a variety of causes, including acute coronary syndrome, pulmonary embolism, aortic coarctation, and pneumothorax. It is essential for emergency physicians to quickly and accurately understand the cause of acute chest pain. 64-slice spiral CT combined cardiothoracic angiography is an accurate and rapid way to diagnose and differentiate the cause of acute chest pain. 64-slice combined cardiothoracic angiography can accurately and rapidly display the thoracic aorta, both pulmonary arteries, the main trunk of the coronary artery and its major branches, and also provide a comprehensive view of both lungs and mediastinum, which is an effective test for the diagnosis and differential diagnosis of acute chest pain. Based on this, this study further investigated the value of 64-slice spiral CT triplex examination in the diagnosis of acute chest pain. The results showed that 64-slice spiral CT has the advantages of fast scanning speed, high resolution, and advanced postprocessing technology, and combined cardiothoracic angiography can quickly and accurately help emergency physicians analyze the cause of acute chest pain, which plays a very important role in formulating the correct treatment plan in a timely manner. At the same time, with the continuous development of CT technology, the temporal and spatial resolution has improved the quality of CT images, giving us more options to reduce the effective radiation dose and reduce the total amount of contrast, making the 64-row spiral CT cardiothoracic imaging more perfect.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Multislice Spiral CT Cardiothoracic Combined with Angiography in Acute Chest Pain

Yang

2021

Journal of Healthcare Engineering

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“…However, owing to the delayed rise in measurable cardiac troponin from the onset of symptoms, the value of conventional troponin is limited for early detection of NSTE-ACS. High-sensitivity troponin can be detected within 1 hour after the onset of chest pain, but the low specificity and availability limits its value in clinical practice (26).…”

Section: Discussionmentioning

confidence: 99%

Nomogram to differentiate between aortic dissection and non-ST segment elevation acute coronary syndrome: a retrospective cohort study

Zhang¹,

Wang²,

Guo³

et al. 2021

Cardiovasc Diagn Ther

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Background: Aortic dissection (AD) and non-ST segment elevation acute coronary syndrome (ACS) are two of the most life-threatening diseases encountered in the emergency department (ED), but there are no rapid and reliable tools for differentiation. The purpose of this study is to develop and validate a nomogram that incorporates both the clinical characteristics and bedside laboratory tests available to differentiate between AD and non-ST segment elevation ACS (NSTE-ACS). Methods: Between January 2016 and July 2018, patients with AD and NSTE-ACS were enrolled and divided into training and validation groups. The least absolute shrinkage and selection operator (LASSO) regression model was used to select the factors with significant value of predicting the diagnosis of AD. A nomogram was built on the basis of multivariable logistic regression analysis. Area under the curve (AUC) of receiver operating characteristic (ROC) curve and the calibration curve were used to assess the performance of the nomogram. Decision curve analysis was performed to assess the clinical utility of the nomogram. Results: A final cohort of 263 patients (94 patients with AD and 169 patients with NSTE-ACS) were enrolled. Six variables were incorporated in the nomogram: pain severity, tearing pain, pulse asymmetry, electrocardiogram (ECG), D-dimer level and troponin I level. The AUC of the nomogram to predict the probability of AD was 0.919 (95% CI, 0.876-0.962) in the training group and 0.938 (95% CI, 0.888-0.989) in the validation group. The calibration curve demonstrated a good consistency between the actual clinical results and the predicted outcomes. The decision curve analysis indicated that the nomogram had higher overall net benefits in predicting AD in both the training group and the validation group. Conclusions:We developed and validated a predictive nomogram that could be used as a tool to differentiate AD from NSTE-ACS rapidly and accurately.

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“…Se deben considerar 2 recomendaciones encaminadas a disminuir el riesgo de contagio. La primera, limitar el acercamiento y el contacto con los pacientes al realizar la exploración física o un ecocardiograma transtorácico, con la intención de obtener el máximo de información con el mínimo contacto físico con el paciente; la segunda, considerar el uso de la angiotomografía coronaria como una herramienta rápida y no invasiva para confirmar o excluir la presencia de enfermedad coronaria como causa de los síntomas cuando se considere adecuado 3 . Los elementos fundamentales para el diagnóstico son:…”

Section: Diagnósticounclassified

Atención de la cardiopatía isquémica en salas de cateterismo durante la contingencia sanitaria por pandemia de COVID-19. Recomendaciones de la Sociedad de Cardiología Intervencionista de México (SOCIME)

Piña-Reyna¹,

García-Rincón²,

Ortiz-Fernández³

et al. 2021

RECIC

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The role of coronary CT angiography for acute chest pain in the era of high-sensitivity troponins

Cited by 14 publications

References 54 publications

Diagnostic Value of Multislice Spiral CT Cardiothoracic Combined with Angiography in Acute Chest Pain

Diagnostic Value of Multislice Spiral CT Cardiothoracic Combined with Angiography in Acute Chest Pain

Nomogram to differentiate between aortic dissection and non-ST segment elevation acute coronary syndrome: a retrospective cohort study

Atención de la cardiopatía isquémica en salas de cateterismo durante la contingencia sanitaria por pandemia de COVID-19. Recomendaciones de la Sociedad de Cardiología Intervencionista de México (SOCIME)

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