Utilization of coronary computed tomography angiography for rapid risk stratification in emergency chest pain units

Mehrdad Esmailian, Amirreza Sajjadieh Khajouei, Neda Eghtedari, Mohammad Azarian, Golnaz Vaseghi


Background: Coronary computed tomography angiography (CCTA) is a well-known method for evaluating anatomic coronary stenosis, but the reliability of CCTA to predict cardiovascular events is an issue of controversy. Materials and Methods: In this prospective observational study, 58 patients with acute chest pain and low-to-moderate risk were selected and CCTA was performed on them. During follow up, the occurrence of major adverse cardiac events (MACE), defined as, cardiac death, myocardial infarction or coronary revascularization, were evaluated. Sensitivity, specificity, and positive and negative predictive values of CCTA for the occurrence of MACE, at the six-month follow up, were also evaluated. Results: A total of nine (15.5 %) were positive in terms of the MACE criteria and they all had positive CCTA results. It seemed that there was 100% sensitivity for CCTA in predicting the occurrence of MACE. Forty-nine patients had no MACE, among whom 48 patients had negative CCTA. The specificity of CCTA in predicting the occurrence of MACE was 98%. All patients with positive CCTA showed significant stenosis in angiography. Conclusion: It appears that CCTA allows us to predict the prognosis of patients with acute chest pain and low-to moderate-risk in terms of MACE occurrence.

Key words: Computed coronary tomography angiography, major adverse cardiac events, prognosis

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