期刊
JOURNAL OF CLINICAL MEDICINE
卷 10, 期 22, 页码 -出版社
MDPI
DOI: 10.3390/jcm10225442
关键词
chest pain; emergency department; acute coronary syndrome; coronary computed tomography angiography
资金
- National Research Foundation of Korea (NRF) - Korea government Ministry of Science and ICT [NRF-2021R1G1A1010567 11]
This retrospective observational cohort study aimed to develop a prediction model for rapidly determining the occurrence of significant stenosis in coronary computed tomography angiography (CCTA) among chest pain patients without troponin elevation and ST-segment changes. A new prediction model was developed with independent associated factors for significant stenosis, and a score of >= 5 was chosen as cut-off values with 86.6% sensitivity and 56.4% specificity.
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.
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