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Phosphoproteomic Analysis of Neonatal Regenerative Myocardium Revealed Important Roles of CHK1 via Activating mTORC1/P70S6K Pathway Timing of Oral P2Y12 Inhibitor Administration in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome Epinephrine Versus Norepinephrine for Cardiogenic Shock After Acute Myocardial Infarction Clarification of Myocardial Infarction Types Oxygen therapy in ST-elevation myocardial infarction Comparison in prevalence, predictors, and clinical outcome of VSR versus FWR after acute myocardial infarction: The prospective, multicenter registry MOODY trial-heart rupture analysis A Novel Circulating MicroRNA for the Detection of Acute Myocarditis Stent Thrombosis Risk Over Time on the Basis of Clinical Presentation and Platelet Reactivity: Analysis From ADAPT-DES The Prognostic Significance of Periprocedural Infarction in the Era of Potent Antithrombotic Therapy: The PRAGUE-18 Substudy Deficiency of GATA3-Positive Macrophages Improves Cardiac Function Following Myocardial Infarction or Pressure Overload Hypertrophy
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EditorialAugust 25, 2018

JOURNAL：NEJM. Article Link

Imaging Coronary Anatomy and Reducing Myocardial Infarction

U Hoffmann, JE Udelson.

ABSTRACT

In 1998, the Journal published one of the early studies evaluating the sensitivity and specificity of coronary computed tomographic angiography (CTA), as compared with invasive coronary angiography, for the detection of obstructive coronary artery disease. Subsequent studies have established that CTA has excellent sensitivity (95 to 99%) and high specificity (64 to 83%) for the detection of coronary stenoses of 50% or greater. An analysis from the Prospective Multicenter Imaging Study for the Evaluation of Chest Pain (PROMISE) showed that CTA predicted subsequent cardiovascular events at least as well as, and perhaps better than, functional testing (C-statistic, 0.72 vs. 0.64; P=0.04). The National Institute for Health and Care Excellence of the United Kingdom now suggests that CTA is the most appropriate test in patients with stable chest pain in whom angina pectoris cannot be excluded by means of clinical assessment alone.

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