PMC

Areas under the receiver-operating characteristic curves (AUC) for the detection of acute coronary syndrome (ACS) during index hospitalization. AUC were higher for both plaque and stenosis as compared to the TIMI risk score (AUC: 0.88, 0.82 vs. 0.63; respectively).

A–C: 40-year old male who presented 3 hours after the onset of substernal chest pain and who had an inconclusive initial evaluation in the emergency department (ED) with non-diagnostic ECG and negative initial biomarkers. The patient was determined to have acute coronary syndrome (ACS) after troponin became positive (8 hours after ED presentation). The patient subsequently underwent invasive coronary angiography, where an 80% mid left anterior descending coronary artery (LAD) stenosis was detected, and subsequently a stent was placed. Coronary computed tomography angiography (CTA) was performed prior to hospital admission. This patient was classified as positive for the presence of significant coronary stenosis. A: Volume rendered 3-dimensional CT image of the heart depicting the right coronary artery (RCA, arrow) and the LAD (arrowhead). B: Maximum intensity projection (MIP) image of the RCA (arrowheads) demonstrating calcified and non-calcified plaque without the presence of a significant coronary stenosis and the LCX (arrows) demonstrating calcified and non-calcified plaque with proximal luminal narrowing. C: Curved multiplanar reformatted image of the LAD reveals a significant coronary stenosis (arrow) in the mid portion of the vessel. Proximal and distal portion demonstrate good luminal contrast enhancement with minimal coronary plaque.