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Clinical decision aids and computed tomography coronary angiography in patients with suspected acute coronary syndrome

Title: Clinical decision aids and computed tomography coronary angiography in patients with suspected acute coronary syndrome
Authors: Wang, K.-L.; Taggart, C.; McDermott, M.; O'Brien, R.; Oatey, K.; Keating, L.; Storey, R.F.; Felmeden, D.; Curzen, N.; Kardos, A.; Roobottom, C.; Smith, J.; Goodacre, S.; Newby, D.E.; Gray, A.J.
Publisher Information: BMJ
Publication Year: 2024
Collection: White Rose Research Online (Universities of Leeds, Sheffield & York)
Description: Background The HEART score, the T-MACS model and the GRACE score support early decision-making for acute chest pain, which could be complemented by CT coronary angiography (CTCA). However, their performance has not been directly compared. Methods In this secondary analysis of a multicentre randomised controlled trial of early CTCA in intermediate-risk patients with suspected acute coronary syndrome, C-statistics and performance metrics (using the predefined cut-offs) of clinical decision aids and CTCA, alone and then in combination, for the index hospital diagnosis of acute coronary syndrome and for 30-day coronary revascularisation were assessed in those who underwent CTCA and had complete data. Results Among 699 patients, 358 (51%) had an index hospital diagnosis of acute coronary syndrome, for which the C-statistic was higher for CTCA (0.80), followed by the T-MACS model (0.78), the HEART score (0.74) and the GRACE score (0.60). The negative predictive value was higher for the absence of coronary artery disease on CTCA (0.90) or a T-MACS estimate of
Document Type: article in journal/newspaper
File Description: text
Language: English
ISSN: 1472-0205
Relation: https://eprints.whiterose.ac.uk/id/eprint/214262/1/emermed-2024-213904.pdf; Wang, K.-L. orcid.org/0000-0001-8563-9089 , Taggart, C., McDermott, M. et al. (12 more authors) (2024) Clinical decision aids and computed tomography coronary angiography in patients with suspected acute coronary syndrome. Emergency Medicine Journal, 41 (8). pp. 488-494. ISSN: 1472-0205
Availability: https://eprints.whiterose.ac.uk/id/eprint/214262/
Rights: cc_by_4
Accession Number: edsbas.AB244C61
Database: BASE