The evolving role of coronary CT angiography in Acute Coronary Syndromes |
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| Institution: | 1. Division of Cardiology, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA;2. Division of Cardiology, Interventional Cardiology Laboratory, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA;3. National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA;4. Weill Cornell Medical Center, New York, NY, USA;5. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA;1. Division of Nuclear Medicine, Department of Medical Imaging, London Health Sciences Centre/St. Joseph’s Health Care London, University of Western Ontario, London, Ontario, Canada;2. Division of Radiology, Department of Medical Imaging, London Health Sciences Centre/St. Joseph’s Health Care London, University of Western Ontario, London, Ontario, Canada;1. Department of Cardiology - The Heart Center, University Hospital of Copenhagen - Rigshospitalet, Blegdamsvej 9, 2100-CPH, Denmark;2. Department of Radiology, University Hospital of Copenhagen - Rigshospitalet, Blegdamsvej 9, 2100-CPH, Denmark;1. Centro Cardiologico Monzino, IRCCS, Milan, Italy;2. Division of Radiotherapy IEO, European Institute of Oncology, IRCCS, Milan, Italy;3. Unit of Medical Physics, IEO European Institute of Oncology, IRCCS, Milan, Italy;4. Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy;5. Scientific Directorate, IEO European Institute of Oncology, IRCCS, Milan, Italy;6. Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy |
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| Abstract: | In the United States, non-obstructive coronary disease has been on the rise, and each year, nearly one million adults suffer myocardial infarction, 70% of which are non-ST-segment elevation myocardial infarction (NSTEMI). In addition, approximately 15% of patients suffering NSTEMI will have subsequent readmission for a recurrent acute coronary syndrome (ACS). While invasive angiography remains the standard of care in the diagnostic and therapeutic approach to these patients, these methods have limitations that include procedural complications, uncertain specificity in diagnosis of the culprit lesion in patients with multi-vessel coronary artery disease (CAD), and challenges in following coronary disease over time. The role of coronary computed tomography angiography (CCTA) for evaluating patients with both stable and acute chest pain has seen a paramount upshift in the last decade. This paper reviews the established role of CCTA for the rapid exclusion of obstructive plaque in troponin negative acute chest pain, while exploring opportunities to address challenges in the current approach to evaluating NSTEMI. |
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| Keywords: | Cardiac computed tomography Non-ST-Segment elevation myocardial infarction Coronary artery disease Heart attack |
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