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Computed Tomography May Help Early Chest Pain Triage

Last Updated: April 28, 2009.

Early use of coronary computed tomography angiography in the early triage of patients presenting with acute chest pain can play an important role in improving emergency department patient management, according to a study published in the May 5 issue of the Journal of the American College of Cardiology.

TUESDAY, April 28 (HealthDay News) -- Early use of coronary computed tomography angiography in the early triage of patients presenting with acute chest pain can play an important role in improving emergency department patient management, according to a study published in the May 5 issue of the Journal of the American College of Cardiology.

Udo Hoffmann, M.D., of Harvard Medical School in Boston, and colleagues conducted a study of 368 patients, of whom 61 percent were men with a mean age of 53 years, who presented at a hospital emergency department with chest pain.

When the patients were examined using coronary computed tomography angiography, 50 percent were free of coronary artery disease, 31 percent had nonobstructive disease, and 19 percent had inconclusive or positive test results, the investigators found. The test was able to completely and accurately diagnose patients without coronary artery disease and was 77 percent sensitive in diagnosing those with significant stenosis, the researchers discovered.

"Both plaque and stenosis by computed tomography predict acute coronary syndrome independent of cardiovascular risk factors or thrombolysis in myocardial infarction risk score," the authors write. "Given the large number of such patients, early coronary computed tomography angiography may significantly improve patient management in the emergency department."

The study was supported by Siemens Medical Solutions and GE Healthcare. Several authors report financial relationships with both companies.

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