Initial CT Perfusion-Guided Strategy for Suspected NSTEMI

Summary

Non-ST elevation myocardial infarction (NSTEMI) is a relatively complex type of myocardial infarction, characterized by chest pain symptoms and elevated troponin levels. However, some patients initially diagnosed with suspected NSTEMI are found not to have severe stenosis upon coronary angiography. Recent studies have shown that initial imaging examinations (including CTA and CMR) in suspected NSTEMI patients can help reduce the need for coronary angiography. The diagnostic value of CT perfusion (CTP) has been established in patients with stable coronary artery disease, but relevant studies have not yet been conducted in suspected NSTEMI patients. This study aims to explore the diagnostic and therapeutic value of an initial CTP strategy for suspected NSTEMI patients. Additionally, we will conduct a cardiovascular health questionnaire to investigate the impact and prognostic value of factors such as adverse lifestyle and inflammation levels in these patients.

Eligibility

Inclusion Criteria:

1. Patients with stable chest tightness or chest pain, aged ≥18 years
2. No ST elevation or dynamic ST-T changes on the ECG
3. Elevated TNT (greater than 14 ng/L three hours after symptom onset)

Exclusion Criteria:

1. Persistent chest pain or ECG indicating dynamic ST-T changes,
2. Hemodynamic instability
3. Known history of coronary artery disease
4. Contraindications for CT perfusion or coronary angiography
5. Coexisting conditions such as pregnancy, cancer, severe valvular heart disease, or liver/kidney dysfunction
6. Other diseases with a life expectancy of less than one year
7. Inability to sign informed consent or, in the researcher's judgment, poor compliance, making it unlikely the patient can complete the study as required.

Conditions2

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