CTA seeks niche triage role in unstable angina patients

January 22, 2008 Diagnostic Imaging. CTA seeks niche triage role in unstable angina patients If multislice CT can rule out obstructive coronary artery disease, time and cost of care would be reduced and risk stratification improved Francesca Pugliese, M.D., and Gabriel P. Krestin, M.D., Ph.D. -------------------------------------------------------------------------------- Coronary CT angiography has been found to be a powerful tool to evaluate patients suspected of coronary artery disease who are at low to intermediate risk. The task now for many researchers is to further refine specific patient populations for whom coronary CTA can be beneficial. One such patient niche being explored is the group with unstable angina and/or non-ST-segment elevation myocardial infarction. Persistent ST-segment elevation generally reflects transmural ischemia by total coronary occlusion and characterizes evolving myocardial infarction (STEMI). This occurs in a relatively small population of patients with acute coronary syndrome. In these settings, the therapeutic objective is either primary angioplasty or fibrinolytic treatment to achieve rapid and complete recanalization (Figure 1).1

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