Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
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Review Meta Analysis
A meta-analysis and systematic review of computed tomography angiography as a diagnostic triage tool for patients with chest pain presenting to the emergency department.
To assess clinical utility of computed tomography angiography (CTA) in the diagnosis of chest pain patients presenting to emergency departments (EDs), we conducted a meta-analysis of CTA in patients with suspected acute coronary syndromes (ACSs). ⋯ Coronary CTA demonstrates a high sensitivity and a low negative likelihood ratio of 0.06, and is effective in ruling out the presence of ACS in low to intermediate risk patients presenting to the ED with acute chest pain.
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Review Meta Analysis
Acute chest pain imaging in the emergency department with cardiac computed tomography angiography.
In practice, the determination of ischemic chest pain in the emergency department (ED) population is difficult and errors are common. Cardiac computed tomography angiography has recently emerged for accurate noninvasive evaluation of coronary artery disease, and it may offer a promising new approach to improve the triage of patients presenting to the ED with acute chest pain, in particular in terms of a faster and accurate way to determine the diagnosis, which could effectively reduce hospital admissions and costs. The focus of this article is to review the current literature on the use of cardiac computed tomography angiography in the ED setting by providing pooled sensitivity, specificity, and positive and negative predictive values of the published literature to date. Moreover, different protocols for detection of patients with cardiac and other, noncardiac causes of chest pain (triple rule-out protocol) are discussed.