P05 Acute cardiac CT pathway for troponin negative chest pain

Abstract

Introduction The acute cardiac CT pathway was set up at University hospitals of Leicester in 2017 to provide early outpatient Cardiac CT slots for patients presenting to hospital with Troponin negative chest pain to exclude coronary artery disease (CAD). A slot was created in each Cardiac CT list. Prior to this, patients would remain inpatients for up to 48 hours waiting for a scan or would have an outpatient scan after 10–20 weeks in 50% of cases. Methods Data was collected retrospectively from the radiology information system for the time period between September 2017 and August 2019 and analysed with regards to the time from request received to scan performed, degree of stenosis and management. Results Data for 116 patients was collected of which 9 were excluded due to patient cancellation or equipment failure. Of the remaining 107, the average time from request received to scan performed was 9.9 days. CT coronary angiogram (CTCA) was reported as normal in 50 cases and mild stenosis in 30 cases. There were 3 patent stents and grafts. Three patients had zero calcium but no CTCA performed. Two patients had high calcium score and no CTCA. One of these went onto have CABG. Stenosis was reported ranging from moderate to severe in 19 patients; 6 of these had stent insertions. Conclusion The acute Cardiac CT pathway demonstrated a substantial reduction in average waiting times to 9.9 days and allows earlier management of obstructive CAD in those patients presenting with Troponin negative chest pain.