Hjertecomputertomografi til udredning for atypiske brystsmerter

Kristian Altern Ovrehus, Jesper Khédri Jensen, Jesper Møller Jensen, Henrik Munkholm, Bjarne Linde Nørgaard

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Abstract

INTRODUCTION: Coronary CT angiography (CTA) is a promising method used for diagnostic evaluation of patients suspected of coronary artery disease (CAD). CTA is increasingly used as an alternative to conventional coronary angiography. Information on the diagnostic and therapeutic consequences of using CTA in the diagnostic work-up of patients suspected of CAD is sparse.

MATERIAL AND METHODS: Out-clinic patients (n = 215) with chest pain and an intermediate pre-test probability of CAD were referred to diagnostic evaluation by CTA.

RESULTS: CTA was not performed in 5% (11/215) due to extensive coronary calcification or arrhythmia, was non-conclusive in 7% (15/215) and was diagnostic in 88% (189/215) of the patients. CTA excluded CAD in 46% (99/215) of the patients. No further diagnostic or hospital follow-up after CTA was necessary in 73% (156/215) of the patients. CTA identified non-significant CAD in 27% (57/215) and significant CAD (>or= 50% stenosis) in 15% (33/215) of the patients. The proportion of patients with CAD in relevant antithrombotic and lipid-lowering medication increased following CTA. Further diagnostic evaluation with coronary angiography following CTA was indicated in 18% (39/215) of the patients due to obstructive CAD (n = 21), non-diagnostic examination (n = 7), or the presence of extensive coronary calcification or arrhythmia (n = 11).

CONCLUSION: CTA ruled-out CAD in 46% of the patients. No further diagnostic testing or hospital follow-up after CTA was necessary in 73% of the patients. CTA seems valuable in excluding CAD, and may prevent unnecessary invasive angiography in patients without CAD.

Bidragets oversatte titelCardiac computer tomography in the investigation of atypical chest pain
OriginalsprogDansk
TidsskriftUgeskrift for Læger
Vol/bind171
Nummer38
Sider (fra-til)2728-32
Antal sider5
ISSN0041-5782
StatusUdgivet - 14 sep. 2009

Emneord

  • Adult
  • Aged
  • Aged, 80 and over
  • Angina Pectoris
  • Chest Pain
  • Coronary Angiography
  • Coronary Artery Disease
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Outpatients
  • Predictive Value of Tests
  • Tomography, X-Ray Computed

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