TY - JOUR
AU - Padley, S.
AB - Background: Cardiac computed tomography (CCT) is a well-validated investigation for the non-invasive assessment of coronary artery disease (CAD). The National Institute for Clinical Excellence (NICE) have recently released guidelines incorporating CCT into the diagnostic algorithm for chest pain of recent onset.Aim: To assess the frequency of eligibility for CCT in medical admissions with suspected cardiac chest pain using criteria defined by NICE.Design: A retrospective, observational study, set in a teaching hospital acute medical unit.Methods: A total of 198 consecutive patients admitted over a 4-month period with suspected cardiac chest pain (57 male; mean age 63.5 years) were assessed for eligibility for CCT based on NICE guideline criteria.Results: Of the 198 patients admitted, 65 (33) patients were excluded by a raised troponin I or ischaemic ECG changes; 100 (51) patients were excluded by pain categorized as non-anginal and 171 (86) patients were excluded by a modified Diamond Forrester score outside the range 1029. Applying NICE criteria to this population ultimately resulted in 2 (1) patients recommended for CCT, 12 (6) for functional cardiac testing and 17 (9) for invasive angiography.Conclusions: Applying current NICE guidelines for chest pain of recent onset to medical admissions results in a lesser uptake of CCT than functional testing and invasive angiography. If the NICE guidelines are revised to include patients with an intermediate pre-test probability of CAD, CCT may have a greater role.
TI - The consequences of applying NICE chest pain guidelines to an acute medical population: a role for cardiac computed tomography
JO - QJM: An International Journal of Medicine
DO - 10.1093/qjmed/hcq146
DA - 2010-12-23
UR - https://www.deepdyve.com/lp/oxford-university-press/the-consequences-of-applying-nice-chest-pain-guidelines-to-an-acute-KE2ZF6MU9I
SP - 959
EP - 963
VL - 103
IS - 12
DP - DeepDyve
ER -