Coronary CT angiography versus standard of care for assessment of chest pain in the emergency department. [Review]

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Citation: Journal of cardiovascular computed tomography. 7(2):79-82, 2013 Mar-Apr.PMID: 23538167Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal Article | ReviewSubject headings: *Chest Pain/di [Diagnosis] | *Chest Pain/mo [Mortality] | *Coronary Angiography/sn [Statistics & Numerical Data] | *Coronary Artery Disease/di [Diagnosis] | *Coronary Artery Disease/mo [Mortality] | *Emergency Service, Hospital/ut [Utilization] | *Tomography, X-Ray Computed/sn [Statistics & Numerical Data] | Comorbidity | Coronary Angiography/st [Standards] | Evidence-Based Medicine | Humans | Length of Stay | Practice Guidelines as Topic | Prevalence | Reproducibility of Results | Risk Assessment | Sensitivity and Specificity | Standard of Care | Tomography, X-Ray Computed/st [Standards] | United StatesYear: 2013ISSN:
  • 1876-861X
Name of journal: Journal of cardiovascular computed tomographyAbstract: Use of coronary CT angiography (CTA) in the early evaluation of low-intermediate risk chest pain in the emergency department represents a common, appropriate application of CTA in the community. Three large randomized trials (CT-STAT, ACRIN-PA, and ROMICAT II) have compared a coronary CTA strategy with current standard of care evaluations in >3000 patients. These trials consistently show the safety of a negative coronary CT angiogram to identify patients for discharge from the emergency department with low rates of major adverse cardiovascular events, at significantly lower cost, and greater efficiency in terms of time to discharge. Together, these trials provide definitive evidence for the use of coronary CTA in the emergency department in patients with a low-to-intermediate pretest probability of coronary artery disease. Clinical practice guidelines that recommend the use of coronary CTA in the emergency department are warranted. Copyright 2013 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.All authors: Budoff M, Cury RC, Taylor AJFiscal year: FY2013Digital Object Identifier: Date added to catalog: 2013-12-24
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Journal Article MedStar Authors Catalog Article 23538167 Available 23538167

Use of coronary CT angiography (CTA) in the early evaluation of low-intermediate risk chest pain in the emergency department represents a common, appropriate application of CTA in the community. Three large randomized trials (CT-STAT, ACRIN-PA, and ROMICAT II) have compared a coronary CTA strategy with current standard of care evaluations in >3000 patients. These trials consistently show the safety of a negative coronary CT angiogram to identify patients for discharge from the emergency department with low rates of major adverse cardiovascular events, at significantly lower cost, and greater efficiency in terms of time to discharge. Together, these trials provide definitive evidence for the use of coronary CTA in the emergency department in patients with a low-to-intermediate pretest probability of coronary artery disease. Clinical practice guidelines that recommend the use of coronary CTA in the emergency department are warranted. Copyright 2013 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

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