Department of Radiology, Prince Charles Hospital, Brisbane, Australia.
Heart Lung Circ. 2010 Apr;19(4):213-8. doi: 10.1016/j.hlc.2010.01.004. Epub 2010 Feb 10.
The absence of radiological evidence of plaque on computed tomographic coronary angiography (CTCA) reliably excludes obstructive coronary artery disease.
We studied patients who presented to our emergency department with chest pain and were admitted to our chest pain assessment service. If they were free of pain and without high-risk features of myocardial ischaemia including elevation of serum biomarkers they underwent CTCA and performed a standard treadmill exercise test.
Eighty-nine patients aged 56.3+/-8.6 years were admitted. Eleven of them had selective angiography; CTCA identified all who had obstructive disease. More than half of the 85 patients who had normal values of cardiac troponin and of the 75 with a negative exercise test had radiological evidence of disease. During follow-up for 355+/-72 days none died, suffered myocardial infarction or required coronary artery surgery: two with obstructive disease underwent percutaneous coronary intervention 1 and 7 days after the index study.
The CTCA findings were significantly correlated with those of selective angiography and with troponin status and increased the ascertainment of coronary artery disease in a cohort of patients at low risk for clinically significant ischaemic heart disease.
计算机断层扫描冠状动脉造影（CTCA）未见斑块的影像学证据可可靠排除阻塞性冠状动脉疾病。
我们研究了因胸痛就诊于我院急诊科并收入胸痛评估服务中心的患者。如果他们没有胸痛且没有心肌缺血的高危特征，包括血清标志物升高，他们就会接受 CTCA 和标准跑步机运动试验。
共收治 89 名年龄 56.3±8.6 岁的患者。其中 11 名患者进行了选择性血管造影术；CTCA 确定了所有存在阻塞性疾病的患者。在心脏肌钙蛋白值正常的 85 名患者和运动试验阴性的 75 名患者中，超过一半的患者有影像学疾病证据。在 355±72 天的随访中，没有患者死亡、发生心肌梗死或需要冠状动脉手术：两名有阻塞性疾病的患者在指数研究后 1 天和 7 天分别接受了经皮冠状动脉介入治疗。
CTCA 的结果与选择性血管造影术以及肌钙蛋白状态显著相关，并增加了对低危有临床显著缺血性心脏病风险的患者群体中冠状动脉疾病的确定。
