Cardiac computed tomography angiography in a Puerto Rico population with chest pain: initial experience at HIMA-San Pablo Bayamón.

Cardiac computed tomography angiography (CCTA) is an efficient tool for the assessment of patients with chest pain and intermediate probability for coronary artery disease (CAD). Based on high negative predictive value results of CCTA, we decide to evaluate our performance at HIMA San Pablo Bayamón. For our study, 59 patients were selected based on history of chest pain having an intermediate CAD probability. Only 53 were accessible to interviewing and questioning. As exclusion criteria, patients had to be over 19 years old, without a permanent pacemaker, persistent intractable cardiac arrhythmias, history of contrast allergy, significant active COPD and having a creatinine below 1.5 mg/dl. The study was performed with the Toshiba Aquilion 64 CT scanner. We searched retrospectively for the occurrence of major adverse cardiovascular events (MACE) in this study such as unstable angina, myocardial infarction, revascularization, and death. Statistical evaluation was performed separately and as MACE. Patients were classified in three categories: normal, no significant and significant findings based on CCTA results. Statistical calculation of these results demonstrated no events in the normal category, 10% in the nonsignificant and 25% in the significant category. Our review of the efficacy of CCTA in patients in our setting in HIMA San Pablo Bayamón demonstrates an impressive negative predictive value of the test excluding significant cardiac events or MACE, which concurs with the recent literature about CCTA. The safety, ease of realization and short duration of the procedure makes this test an excellent technique to assess clinical prognosis.