Early resting myocardial computed tomography perfusion for the detection of acute coronary syndrome in patients with coronary artery disease

Circulation. Cardiovascular Imaging
Amit PursnaniBrian Ghoshhajra

Abstract

Acute rest single-photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI) has high predictive value for acute coronary syndrome (ACS) in emergency department patients. Prior studies have shown excellent agreement between rest/stress computed tomography perfusion (CTP) and SPECT-MPI, but the value of resting CTP (rCTP) in acute chest pain triage remains unclear. We sought to determine the diagnostic accuracy of early rCTP, incremental value beyond obstructive coronary artery disease (CAD; ≥50% stenosis), and compared early rCTP to late stress SPECT-MPI in patients with CAD presenting with suspicion of ACS to the emergency department. In this prespecified subanalysis of 183 patients (58.1±10.2 years; 33% women), we included patients with any CAD by coronary computed tomography angiography (CCTA) from Rule Out Myocardial Infarction Using Computer-Assisted Tomography I. rCTP was assessed semiquantitatively, blinded to CAD interpretation. Overall, 31 had ACS and 48 had abnormal rCTP. Sensitivity and specificity of rCTP for ACS were 48% (95% confidence interval [CI], 30%-67%) and 78% (95% CI, 71%-85%), respectively. rCTP predicted ACS (adjusted odds ratio, 3.40 [95% CI, 1.37-8.42]; P=0.008) independently of obstr...Continue Reading

References

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Citations

Feb 13, 2016·The British Journal of Radiology·Erica MaffeiFilippo Cademartiri
Nov 14, 2015·JACC. Cardiovascular Imaging·Pedro de Araújo GonçalvesHector M Garcia-Garcia
Jun 14, 2015·Clinical Imaging·Netanel S BerkoJeffrey M Levsky
Jun 15, 2016·American Heart Journal·Martijn W SmuldersSebastiaan C A M Bekkers
Mar 18, 2017·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Donghee HanJames K Min
Oct 27, 2017·Current Cardiology Reports·Klaus F KofoedJesper J Linde

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