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Predicting Major Adverse Events in Patients With Acute Myocardial Infarction Positive remodelling of coronary arteries on computed tomography coronary angiogram: an observational study Inflammatory Bowel Disease and Acute Coronary Syndromes: From Pathogenesis to the Fine Line Between Bleeding and Ischemic Risk Long-Term Outcomes of Patients With Late Presentation of ST-Segment Elevation Myocardial Infarction Association Between Haptoglobin Phenotype and Microvascular Obstruction in Patients With STEMI: A Cardiac Magnetic Resonance Study Unloading the Left Ventricle Before Reperfusion in Patients With Anterior ST-Segment-Elevation Myocardial Infarction Macrophage MST1/2 Disruption Impairs Post-Infarction Cardiac Repair via LTB4 Mortality in STEMI patients without standard modifiable risk factors: a sex-disaggregated analysis of SWEDEHEART registry data Prognostic and Practical Validation of Current Definitions of Myocardial Infarction Associated With Percutaneous Coronary Intervention Epidemiology and Clinical Outcomes of Patients With Inflammatory Bowel Disease Presenting With Acute Coronary Syndrome
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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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