Use of Coronary CT Angiography to Predict Obstructive Lesions in Patients with Chest Pain without Enzyme and ST-Segment Elevation

It is challenging to rule out acute coronary syndrome among chest pain patients without both ST-segment elevation in electrocardiography and troponin elevation at emergency departments (ED). The purpose of this study was to develop a prediction model for rapidly determining the occurrence of signifi...

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Autores principales:	June-sung Kim, Youn-Jung Kim, Yo Sep Shin, Shin Ahn, Won Young Kim
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	chest pain emergency department acute coronary syndrome coronary computed tomography angiography Medicine R
Acceso en línea:	https://doaj.org/article/7c1b2f6b3731492f84f8d675c8293f5e
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spelling	oai:doaj.org-article:7c1b2f6b3731492f84f8d675c8293f5e2021-11-25T18:02:52ZUse of Coronary CT Angiography to Predict Obstructive Lesions in Patients with Chest Pain without Enzyme and ST-Segment Elevation10.3390/jcm102254422077-0383https://doaj.org/article/7c1b2f6b3731492f84f8d675c8293f5e2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5442https://doaj.org/toc/2077-0383It is challenging to rule out acute coronary syndrome among chest pain patients without both ST-segment elevation in electrocardiography and troponin elevation at emergency departments (ED). The purpose of this study was to develop a prediction model for rapidly determining the occurrence of significant stenosis in coronary computed tomography angiography (CCTA). Retrospective observational cohort study was conducted with 904 patients who had presented with chest pain without troponin elevation and ST-segment changes and underwent CCTA between January 2017 and December 2018. The primary endpoint was the presence of significant stenosis on CCTA, defined as narrowing above 70% diameter. The logistic regression model was used for development a new predictive model. One hundred and thirty-four patients (14.8%) were shown severe stenosis. The independent associated factors for significant stenosis were age ≥65 years, male, diabetes, history of acute coronary syndrome, and typical chest pain. Based these results, we developed a new prediction model. The area under the curve was 0.782 (95% confidence interval 0.742–0.822). Moreover, score of ≥5 was chosen as cut-off values with 86.6% sensitivity and 56.4% specificity. In conclusion, among chest pain patients without ST changes and troponin elevation, the new score will be helpful to identify potential candidate for CCTA such as patients with significant stenosis.June-sung KimYoun-Jung KimYo Sep ShinShin AhnWon Young KimMDPI AGarticlechest painemergency departmentacute coronary syndromecoronary computed tomography angiographyMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5442, p 5442 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chest pain emergency department acute coronary syndrome coronary computed tomography angiography Medicine R
spellingShingle	chest pain emergency department acute coronary syndrome coronary computed tomography angiography Medicine R June-sung Kim Youn-Jung Kim Yo Sep Shin Shin Ahn Won Young Kim Use of Coronary CT Angiography to Predict Obstructive Lesions in Patients with Chest Pain without Enzyme and ST-Segment Elevation
description	It is challenging to rule out acute coronary syndrome among chest pain patients without both ST-segment elevation in electrocardiography and troponin elevation at emergency departments (ED). The purpose of this study was to develop a prediction model for rapidly determining the occurrence of significant stenosis in coronary computed tomography angiography (CCTA). Retrospective observational cohort study was conducted with 904 patients who had presented with chest pain without troponin elevation and ST-segment changes and underwent CCTA between January 2017 and December 2018. The primary endpoint was the presence of significant stenosis on CCTA, defined as narrowing above 70% diameter. The logistic regression model was used for development a new predictive model. One hundred and thirty-four patients (14.8%) were shown severe stenosis. The independent associated factors for significant stenosis were age ≥65 years, male, diabetes, history of acute coronary syndrome, and typical chest pain. Based these results, we developed a new prediction model. The area under the curve was 0.782 (95% confidence interval 0.742–0.822). Moreover, score of ≥5 was chosen as cut-off values with 86.6% sensitivity and 56.4% specificity. In conclusion, among chest pain patients without ST changes and troponin elevation, the new score will be helpful to identify potential candidate for CCTA such as patients with significant stenosis.
format	article
author	June-sung Kim Youn-Jung Kim Yo Sep Shin Shin Ahn Won Young Kim
author_facet	June-sung Kim Youn-Jung Kim Yo Sep Shin Shin Ahn Won Young Kim
author_sort	June-sung Kim
title	Use of Coronary CT Angiography to Predict Obstructive Lesions in Patients with Chest Pain without Enzyme and ST-Segment Elevation
title_short	Use of Coronary CT Angiography to Predict Obstructive Lesions in Patients with Chest Pain without Enzyme and ST-Segment Elevation
title_full	Use of Coronary CT Angiography to Predict Obstructive Lesions in Patients with Chest Pain without Enzyme and ST-Segment Elevation
title_fullStr	Use of Coronary CT Angiography to Predict Obstructive Lesions in Patients with Chest Pain without Enzyme and ST-Segment Elevation
title_full_unstemmed	Use of Coronary CT Angiography to Predict Obstructive Lesions in Patients with Chest Pain without Enzyme and ST-Segment Elevation
title_sort	use of coronary ct angiography to predict obstructive lesions in patients with chest pain without enzyme and st-segment elevation
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/7c1b2f6b3731492f84f8d675c8293f5e
work_keys_str_mv	AT junesungkim useofcoronaryctangiographytopredictobstructivelesionsinpatientswithchestpainwithoutenzymeandstsegmentelevation AT younjungkim useofcoronaryctangiographytopredictobstructivelesionsinpatientswithchestpainwithoutenzymeandstsegmentelevation AT yosepshin useofcoronaryctangiographytopredictobstructivelesionsinpatientswithchestpainwithoutenzymeandstsegmentelevation AT shinahn useofcoronaryctangiographytopredictobstructivelesionsinpatientswithchestpainwithoutenzymeandstsegmentelevation AT wonyoungkim useofcoronaryctangiographytopredictobstructivelesionsinpatientswithchestpainwithoutenzymeandstsegmentelevation
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Use of Coronary CT Angiography to Predict Obstructive Lesions in Patients with Chest Pain without Enzyme and ST-Segment Elevation

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