Bonello L, Armero S, Jacquier A, Com O, Sarran A, Sbragia P, Panuel M, Arques S, Paganelli F
Int J Cardiol. 2009 May 1;134(1):140-3. doi: 10.1016/j.ijcard.2007.12.050. Epub 2008 Mar 25.
Among patients admitted in the emergency department for acute atypical chest pain those with an acute coronary syndrome (ACS) who are mistakenly discharged home have high mortality. A recent retrospective study has demonstrated that multislice computed tomography (MSCT) coronary angiography could improve triage of these patients. We aimed to prospectively confirm these data on patients with a negative screening including maximal treadmill stress.
30 patients discharged from the emergency department after negative screening for an ACS were included. All patients underwent MSCT angiography of the coronary artery. Patients with coronary atheroma on MSCT had an invasive coronary angiography to confirm these findings.
Seven patients (23%) had obstructive coronary artery disease on MSCT. Invasive coronary angiography (ICA) confirmed the diagnosis in all patients.
In patients with no previously known coronary artery disease admitted to the emergency department with atypical acute chest pain and discharged after negative screening, including maximal treadmill stress test, MSCT coronary angiography is useful for the diagnosis of obstructive coronary artery disease.
在因急性非典型胸痛入住急诊科的患者中，那些被误诊为急性冠状动脉综合征（ACS）而被错误送回家的患者死亡率很高。最近一项回顾性研究表明，多层螺旋计算机断层扫描（MSCT）冠状动脉造影可改善这些患者的分诊。我们旨在前瞻性地证实这些关于筛查结果为阴性（包括最大运动平板试验）的患者的数据。
纳入30例急诊科对ACS筛查结果为阴性后出院的患者。所有患者均接受了冠状动脉MSCT血管造影。MSCT显示有冠状动脉粥样硬化的患者接受了有创冠状动脉造影以证实这些结果。
7例患者（23%）MSCT显示有阻塞性冠状动脉疾病。所有患者的有创冠状动脉造影（ICA）均确诊了该诊断。
对于因非典型急性胸痛入住急诊科且此前无已知冠状动脉疾病、经包括最大运动平板试验在内的筛查结果为阴性后出院的患者，MSCT冠状动脉造影对阻塞性冠状动脉疾病的诊断很有用。
