[Interest of emergency coronary computed tomography for exclusion of coronary artery disease in patients with acute chest pain and low to intermediate risk].

Purpose: To demonstrate the usefulness of the multislice computer tomography coronary angiography (CCTA) in patients with suspected acute chest pain without electrical changes or enzyme rise, and with low cardiovascular risk.

Patients And Methods: Fifty-three patients at low or intermediate risk for coronary artery disease, who were admitted in the emergency department for an acute chest pain, and who underwent a CCTA, were included in the study. Results of the CCTA were classified as normal, non-obstructive stenosis (≤ 50% stenosis in diameter), obstructive stenosis (> 50% stenosis in diameter). The mortality was assessed during a 4-years follow-up period.

Results: Mean age was 61 years (36-86), 43% of patients were women. The CCTA was normal in 35 patients (66%), seven patients (13%) had non-obstructive stenosis and 11 (21%) had obstructive stenosis. In the group of normal CCTA, 8.5% of patients were admitted in cardiac intensive care unit, 57.1% in the non-obstructive stenosis and 90.9% in the group of obstructive stenosis. No deaths occurred during the 4-year follow up in the group of patients with normal CCTA.

Conclusion: This study confirms the negative predictive value of CCTA for the diagnosis of coronary artery disease and for further clinical events in patients at low or intermediate risk referred to emergency department for an acute chest pain.