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KMID : 0385920150260010112
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Journal of the Korean Society of Emergency Medicine
2015 Volume.26 No. 1 p.112 ~ p.117
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Analysis of Coronary CT Angiography Findings Using Triple Rule-Out Protocol in Patients with Suspected Acute Coronary Syndrome in Emergency Department
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Lee Hyung-Joo
Seo Dong-Woo
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Abstract
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Purpose: The aim of this study is to analyze target and inci-dental findings of the Triple rule-out (TRO) protocol in patients with intermediate or high likelihood of acute coro-nary syndrome (ACS) in the emergency department (ED).
Methods: This study was a retrospective analysis. All patients having chest pain or angina equivalent within 24 hours who underwent TRO coronary CT angiography (CCTA) in the ED or emergency intensive care unit were included. Patients aged 20 years and older with an interme-diate or high likelihood of ACS were included. Target find-ings were defined as significant coronary artery stenosis, acute aortic syndrome and pulmonary embolism. Incidental findings were defined as all findings except target findings. Significant incidental findings were defined as those require-ing immediate treatment or follow-up within 3 months.
Results: Of the 106 included patients, 72 had intermediate and 34 had high likelihood of ACS. Target findings were observed in 11 (15.3%) and 12 (35.3%) patients in each likelihood group (p<0.05), and incidental findings were observed in 54 (75%) and 24 (70.6%) patients, respectively (p>0.05). Of total patients, significant findings, including cancer, were observed in 28 patients (26.4%).
Conclusion: TRO CCTA may be useful in patients with intermediate or high likelihood of ACS in the ED.
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KEYWORD
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Chest pain, Emergency medical services, Acute coronary syndrome, Pulmonary embolism, Aortic diseases, Multidetector computed tomography
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