Table 4.
Most relevant single-centre studies evaluating the performance of cardiac CT in the triage of patients with acute chest pain
| Study | Number of patients | Risk | Inclusion criteria | ACS definition (rate) | Outcome (last follow-up) | CT criteria | SE | SP | PPV | NPV |
|---|---|---|---|---|---|---|---|---|---|---|
| Gallagher et al67 | 85 | Low risk (Reilly/Goldman criteria) | Negative troponin; normal ECG | AMI, UA + CAG >70% (8%) | Cardiac death or ACS (30 days) | Stenosis >50% CS>400 |
86 | 92 | 50 | 99 |
| Beigel et al68 | 340 | High risk excluded | Negative troponin; non-ischaemic ECG | CAG significant stenosis (4.4%) | MACE (5 months) | Stenosis >50% | 100 | 97 | 65 | 100 |
| Rubinshtein et al69 | 58 | Intermediate risk | Negative troponin; normal ECG | CAG ≥50% or positive troponins or positive stress test (34%) | MACE (15 months) | Stenosis ≥50% | 100 | 92 | 87 | 100 |
| ROMICAT I70 | 368 | Low risk | Negative troponin; non-ischaemic ECG | AMI, UA (8.4%) | MACE (6 months) | Plaque | 100 | 54 | 17 | 100 |
| Stenosis >50% | 77 | 87 | 35 | 98 | ||||||
| Johnson et al71 | 109 | Any risk | Negative troponin; non-ischaemic ECG | CAG >50% (14%) | CAG (6 months) | Stenosis >50% (per segment) | 100 | 99 | 79 | 100 |
| Dedic et al72 | 111 | Any risk | Troponine ≤0.15 μg l−1 | AMI, UA (17%) | AMI or revascularization (3 months) | Calcium | 89 | 41 | 24 | 95 |
| Any plaque | 100 | 40 | 26 | 100 | ||||||
| Stenosis>50% | 89 | 79 | 47 | 97 |
ACS, acute coronary syndrome; AMI, acute myocardial infarction; CAG, invasive coronary angiography; CS, calcium score; ECG, electrocardiogram; MACE, major adverse cardiac events including cardiac deaths, acute myocardial infarction, unstable angina and revascularization; NPV, negative-predictive value; PPV, positive-predictive value; SE, sensitivity; SP, specificity; UA, unstable angina.