Pemeriksaan coronary computed tomography angiography (CCTA) biasa dilakukan pada nyeri dada risiko rendah untuk menyingkirkan infark miokard akut setelah hasil biomarker ditemukan dalam batas normal. Akan tetapi, berdasarkan AHA 2010 pemeriksaan nyeri dada ini dikatakan lengkap bila pemeriksaan jantung non invasif dilakukan.[1,2]
Diasumsikan, hasil pemeriksaan jantung non invasif yang positif dapat mengurangi angka kejadian major adverse cardiac events (MACEs). Selain itu tidak ada penundaan dalam rujukan ke sub spesialis jantung dan tidak adanya penundaan pada tindakan revaskularisasi.[1,2]
Sekitar tujuh juta pasien mengunjungi Instalasi Gawat Darurat (IGD) setiap tahun dengan keluhan nyeri dada. Sekitar 20% keluhan tersebut terkait penyebab kardiovaskular, namun hanya sekitar 5,5% dari kondisi tersebut merupakan kondisi yang mengancam jiwa. Sebaliknya, sebagian pasien menjalani pemeriksaan jantung akibat keluhan nyeri dada dan didiagnosis dengan penyebab non kardiak atau penyebab nyeri dada yang masih belum diketahui memiliki peningkatan risiko terhadap kejadian kardiovaskular lanjutan hingga kematian.[1,2]
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Referensi
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2. Siontis GC et al. Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: network meta-analysis of diagnostic randomised controlled trials. BMJ. 2018(21)1-14. https://www.bmj.com/content/360/bmj.k504.long
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4. European Society of Cardiology. Angina pectoris: non-invasive methods in the diagnosis and follow-up. https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Angina-pectoris-non-invasive-methods-in-the-diagnosis-and-follow-up.
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7. Roffi M et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016(14):267-315. https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehv320
8. StatPearls. Coronary CT Angiography. https://www.ncbi.nlm.nih.gov/books/NBK470279/
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13. Zaghloul A et al. Limitations of Coronary Computed Tomography Angiography in Predicting Acute Coronary Syndrome in a Low to Intermediate-risk Patient with Chest Pain. Cureus. 2018;10(5):e2649. Published 2018 May 18. doi:10.7759/cureus.2649