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- W2316671117 abstract "Background: Computed tomography angiography (CTA) is a non-invasive modality for coronary atherosclerotic plaque and significant stenosis and therefore improve early and accurate triage of patients presenting with acute chest pain to the emergency department (ED). However, it remains unclear whether chest pain patients with non-significant stenosis assessed by CTA is truly associated with a low risk of cardiac events, especially in Japanese population, who exhibited a greater incidence of coronary vasospasm than Caucasians. Objective: We conducted a prospective study of patients presenting to the ED between 2010 and 2012 with acute chest pain, no ischemic ECG changes and negative initial cardiac biomarkers. Out of 482 consecutive patients (mean age, 63 years; 75% male) with a low-to-intermediate risk score, 386 patients who revealed non-significant coronary artery stenosis (n=155) or no plaques (n=231) in CTA were finally enrolled in this study. Results: During the median follow-up period of 2.0 years, 89 (23%) patients returned to the ED due to recurrent chest pain and were diagnosed as vasospastic angina pectoris (VSA) by intracoronary ergometrine provocation test results. Importantly, 68 (77%) out of 89 patients were admitted within the first 3 months. Those particular patients included one patient who had syncope leading to brain trauma and one patient who developed cardiopulmonary arrest. Both of them was documented coronary vasospasm in cardiac catheterization. Conclusion: VSA is a potential confounder in acute chest pain patients with no significant coronary artery stenosis or plaque assessed by CTA. The present finding indicates that the diagnostic ability of CTA seems to be limited to functional impairment." @default.
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- W2316671117 date "2013-08-02" @default.
- W2316671117 modified "2023-09-23" @default.
- W2316671117 title "Are they really not guilty who present to the emergency department with acute chest pain, no obstructive coronary artery disease by CT angiography?" @default.
- W2316671117 doi "https://doi.org/10.1093/eurheartj/eht310.p4708" @default.
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