Impact of non-gated computed tomography on the timing of invasive strategy of patients with non-ST-elevation acute coronary syndrome

Masatsugu Miyagawa, Riku Arai, Kurara Takahashi, Yuki Nakajima, Shohei Migita, Saki Mizobuchi, Yudai Tanaka, Katsunori Fukumoto, Tomoyuki Morikawa, Takashi Mineki, Keisuke Kojima, Nobuhiro Murata, Mitsumasa Sudo, Yasuo Okumura

Research output: Contribution to journalArticlepeer-review


Background: This study aimed to examine the clinical role of non-gated computed tomography (CT) in ruling out fatal chest pain in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), with a focus on the time of arrival at the hospital to coronary angiography (CAG) and peak creatine kinase (CK) levels. Methods: We retrospectively examined 196 NSTE-ACS patients who were admitted with urgently diagnosed NSTE-ACS and underwent percutaneous coronary intervention between March 2019 and October 2022. The patients were divided into three groups, namely, non-CT group, CT and defect− group, and CT and defect+ group, based on whether they underwent a CT scan and the presence or absence of perfusion defects on the CT image. Results: After the initial admission for NSTE-ACS, 40 patients (20.4%) underwent non-gated CT prior to CAG. Among these 40 patients, 27 had a perfusion defect on the CT scan. The incidence of contrast-induced nephropathy was not different among the three groups. The CT and defect+ group had a shorter arrival-to-CAG time than that of the non-CT group. In NSTE-ACS patients with elevated CK levels, the CT and defect+ group had lower peak CK levels than those in the non-CT group. Conclusion: NSTE-ACS patients with perfusion defects on non-gated CT had a shorter time from arrival to CAG, which might be associated with a lower peak CK. Non-gated CT might be useful for early diagnosis and early revascularization in the clinical setting of NSTE-ACS.

Original languageEnglish
Article number1266767
JournalFrontiers in Cardiovascular Medicine
Publication statusPublished - 2023


  • coronary angiography
  • creatine kinase
  • non-ST-elevation acute coronary syndrome (NSTE-ACS)
  • non-ST-elevation myocardial infarction (NSTEMI)
  • non-gated computed tomography
  • perfusion defect


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