Use of 40-Detector Row Computed Tomography Before Catheter Coronary Angiography to Select Early Conservative Versus Early Invasive Treatment for Patients with Low-risk Acute Coronary Syndrome

Using catheter coronary angiography (CAG) as reference standard, we examined the agreement of 40-detector row computed tomography (MDCT) in triaging patients into the 2 controversial strategies of managing low-risk acute coronary syndrome (ACS).Seventy-eight patients with low-risk ACS received both MDCT and CAG. Early invasive strategy was assigned for the patient if there was significant stenosis (or =50% diameter stenosis) in any of the coronary artery segments with diameter larger than 1.5 mm. The results of MDCT were compared with the CAG for agreement.The overall agreement of the early conservative/early invasive strategy assignment was 92.3%, with kappa value of 0.82 between MDCT and CAG. Only 1 patient needing early invasive strategy was missed by MDCT.Forty-detector row computed tomography is reliable in triaging patients into the 2 strategies of managing low-risk ACS.