Chronic stable angina electron beam tomography

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor(s)-In-Chief: ; Smita Kohli, M.D.; Lakshmi Gopalakrishnan, M.B.B.S.

Synonyms and keywords: Ultrafast Computed Tomography; EBCT

Overview
The extent of coronary artery calcification directly correlates to the area of atheromatous plaque. Hence in patients with chest pain, coronary artery calcium (CAC) scoring is one of the factor to be considered in the risk assessment for coronary artery disease. The methods used for detection and quantification of CAC include electron beam computed tomography (EBCT) and multi-detector computed tomography (MDCT). Agatston score is a computed software that is commonly used to measure CAC based on the density and area of calcified plaques.

Indications

 * Ultrafast computed tomography can be used to detect coronary calcifications, which often precede symptomatic coronary artery stenosis. However, coronary calcification is also observed in patients without important coronary artery disease at angiography.


 * CT angiography used for the detection of CAD, has a negative predictive value of 93-99%, sensitivity of 90-94% and specificity of 95-97%.


 * CT angiography is indicated in patients with a low pretest probability of CAD (less than 10%) or in patients with non conclusive exercise ECG or stress test.


 * Although this test has generated substantial interest and publicity, the current lack of information from large scale assessments make it premature to recommend its use in routine clinical care.

==ACC / AHA Guidelines- Electron Beam Tomography (DO NOT EDIT) == {{cquote|

Class IIb
1. Electron beam computed tomography. (Level of Evidence:B)}}

==ESC Guidelines- Computed tomography in patients with chronic stable angina (DO NOT EDIT) == {{cquote|

Class IIb
1. Patients with a low pre-test probability of CAD, with a non-conclusive exercise ECG or stress imaging test. (Level of Evidence: C)}}

Vote on and Suggest Revisions to the Current Guidelines

 * The Chronic Stable Angina Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines

Guidelines Resources

 * The ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina


 * Guidelines on the management of stable angina pectoris: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology


 * TheACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina


 * The 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina