Multilayer CT technique has acquired more and more importance as a diagnostic non-invasive method for the diagnosis of coronary atheromasic plaques. In this prospective study, partially sponsored by the producer of the X-ray machinery, the usefulness of multilayer CT was evaluated in 103 patients with chest pain (average age 54 years old; 60% males) with no alterations at the ECG and with normal cardiac enzymes. The survey was performed immediately after hospitalization. Judging by hospitalization data and a 5-month follow-up, a board of experts blindly evaluated the results of CTs, finding the presence of an acute coronary syndrome in 14 patients. In 41 patients any presence of coronary plaques was excluded and in 73 patients a coronary stenosis higher than 50% was excluded. None of those subjects had had an acute coronary syndrome (negative predictive value 100%).
The use of CT in acute chest pain can be a valid help to exclude (or to confirm) the cardiac origin of pain. The study is interesting, but its generalization is probably not correct, since the sample was small, the age of the participants was relatively young, the coronary events were little frequent and patients with severe rhythm alterations were excluded. In any case, the use of multilayer CT in case of chest pain of doubtful origin is certainly proposable.
