{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:49:35Z","timestamp":1753890575669,"version":"3.41.2"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> In clinical practice, cardiac computed tomography (CCT) has a limited role in acute coronary syndromes (ACS). Several trials evaluated CCT in low and intermediate risk patients presenting to the emergency room (ER) and noted that it was both safe and feasible. During the COVID19 pandemic, it is imperative to adopt a pathway for the evaluation of ACS that permits early discharge, reduces invasive coronary angiography and limits exposure of healthcare workers. Here, we present a single center experience by which CCT was incorporated in the clinical pathway of patients presenting to the ER with chest pain and ACS.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This is a snapshot study of the first 27 patients who underwent CCT immediately after the lockdown in the city of Jeddah. ST elevation myocardial infarctions and hemodynamically unstable patients were excluded. Those with unstable angina or a Non-ST elevation myocardial infarction were screened for COVID19. The patients' COVID19 status and the results of the CCT were then used to determine the treatment strategy. Patient predisposition, hospital stay and exposure of staff are collected and reported.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> All CCT images were interpretable with no limitations or significant artifact. CCT identified critical disease in 7 patients (26%), normal epicardial coronary arteries in 11 (41%) and mild to moderate disease in 9 (33%). All patients with normal or mild to moderate disease were assigned to a conservative strategy and discharged within 24 h. Those with a NSTEMI and critical anatomy were assigned to an additional invasive evaluation with subsequent revascularization. During the course of this study, no transmission to healthcare workers occurred.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> CCT enabled 80% of patients to be discharged within the first 24 h, the majority of whom were discharged from the emergency room. It was able to identify critical anatomy facilitating appropriate revascularization. This snapshot study warrants exploration of the role of CCT in ACS further particularly since the latest European Society of Cardiology's Non-STEACS guidelines suggest a role for CCT in the evaluation of low risk ACS.<\/jats:p>","DOI":"10.3389\/fcvm.2021.665735","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T04:14:39Z","timestamp":1620706479000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Role of Cardiovascular Computed Tomography in Acute Coronary Syndromes During the COVID-19 Pandemic-Single Center Snapshot Study"],"prefix":"10.3389","volume":"8","author":[{"given":"Mirvat","family":"Alasnag","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waqar","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Al-Nasser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Al-Shaibi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1724","DOI":"10.1016\/j.jacc.2008.07.031","article-title":"Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (assessment by coronary computed tomographic angiography of individuals undergoing invasive coronary angiography) trial","volume":"52","author":"Budoff","year":"2008","journal-title":"J Am Coll Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1016\/j.jacc.2011.02.074","article-title":"Age- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the international multicenter CONFIRM (coronary CT angiography evaluation for clinical outcomes: an international multicenter registry) of 23, 854 patients without known coronary artery disease","volume":"58","author":"Min","year":"2011","journal-title":"J Am Coll Cardiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e88","DOI":"10.1093\/cvr\/cvz173","article-title":"The SCOT-HEART trial: cardiac CT to guide patient management and improve outcomes","volume":"115","author":"Nazir","year":"2019","journal-title":"Cardiov 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trial","volume":"4","author":"Schlett","year":"2011","journal-title":"JACC Cardiovasc Imaging."},{"key":"B7","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.ahj.2012.01.028","article-title":"Design of the rule out myocardial ischemia\/infarction using computer assisted tomography: a multicenter randomized comparative effectiveness trial of cardiac computed tomography versus alternative triage strategies in patients with acute chest pain in the emergency department","volume":"163","author":"Hoffmann","year":"2012","journal-title":"Am Heart J."},{"key":"B8","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.jcct.2020.03.002","article-title":"Society of cardiovascular computed tomography guidance for use of cardiac computed tomography amidst the COVID-19 pandemic","volume":"14","author":"Choi","year":"2020","journal-title":"J Cardiov Comp Tomog."},{"key":"B9","unstructured":""},{"key":"B10","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/j.jacc.2019.12.012","article-title":"Coronary CT angiography in patients with non-ST-segment elevation acute coronary syndrome","volume":"75","author":"Linde","year":"2020","journal-title":"J Am Coll Cardiol."},{"key":"B11","doi-asserted-by":"crossref","DOI":"10.1093\/eurheartj\/ehaa624","article-title":"ESC scientific document group, 2020 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: the task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European society of cardiology (ESC)","author":"Collet","year":"2020","journal-title":"Eur Heart J"}],"container-title":["Frontiers in Cardiovascular 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