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Multislice
CT Scan Diagnoses Chest Pain in ER
Third Published Study This Year Shows High Accuracy in Ruling Out Disease |
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| March 20, 2007 -- A new study in Circulation shows that Multislice CT scanning in the Emergency Department can accurately diagnose chest pain of unknown origin. Published online yesterday, this study, the third such reported in as many months, adds more evidence that 64-slice CT scans are a major diagnostic tool for establishing the presence of coronary narrowing. Physicians at the Technion-Israel Institute of Technology in Haifa, studied 58 patients who presented in the ER with chest pain, but whose EKG and enzyme tests did not indicate they were having a heart attack. The question has always been what to do with such patients, whose chest pain would indicate further testing -- usually a stress test, often one with a radio-isotope. In this study, patients were given a 64-slice CT scan, and of the 58 patients, 15 showed normal coronary arteries, 20 showed some plaque, but not enough to be obstructive, while the remaining 23 patients had blockages of 50% or more. These patients were tested further, using invasive angiography or nuclear stress tests and 20 were found to fall into the category of ACS or acute coronary syndrome -- and these patients were referred for further treatment. Most importantly, the 35 patients who were found to have no coronary disease using the CT scan were discharged from the ER and then followed for 15 months. None suffered death or heart attack, making the case for multislice CT heart scans having a high negative predictability. The Circulation study study mirrors two others, published earlier this year (see "related stories" in the sidebar) and adds to the growing evidence that multislice CT angiography in the Emergency Department may provide a fast, safe and accurate alternative to other forms of testing for the presence of coronary artery disease as a cause for chest pain. This evidence will no doubt be impacted by the publication later this year of the CorE 64 trial, in which 64 slice CT was compared to invasive coronary angiography in a very large multi-center trial. |
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