Coronary Computed Tomography Angiography in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome

Background: Patients often report to the emergency room complaining of sudden chest pain; 50% of these patients are admitted for further examination of what is likely acute coronary syndrome. Aim: The goals of this study are to decide whether early invasive coronary evaluation improves clinical outcomes in comparison to subacute strategies and also to evaluate the efficacy of coronary computed tomography angiography(CCTA) in identifying patients for invasive investigation and treatment, excluding those with coronary artery stenosis below 50%. Patients and methods: This prospective, non-randomized cohort study involved three hundred patients who attended the emergency department of Al-Azhar University and the police academy hospital between December 2021 and January 2024. Two groups of patients were identified: one that underwent an invasive coronary angiography as soon as possible (Group A) and another that waited 72 hours. Results: With an overall accuracy of 86.67%, CCTA demonstrated a sensitivity of 97.41%, specificity of 50%, PPV of 86.72%, and NPV of 85% in group A. Overall accuracy for group B's CCTA was 92.67%, with sensitivity at 92.94%, specificity at 92.31%, PPV at 94.05%, and NPV at 90.91%. Conclusion: Coronary CT angiography can be used to rule out significant coronary artery disease in patients with unstable angina or low-risk non-ST-myocardial infarct acute coronary syndrome, which may help guide patient therapy.