TY - BOOK AU - Taylor, Allen J TI - Coronary CT angiography versus standard of care for assessment of chest pain in the emergency department. [Review] SN - 1876-861X PY - 2013/// KW - *Chest Pain/di [Diagnosis] KW - *Chest Pain/mo [Mortality] KW - *Coronary Angiography/sn [Statistics & Numerical Data] KW - *Coronary Artery Disease/di [Diagnosis] KW - *Coronary Artery Disease/mo [Mortality] KW - *Emergency Service, Hospital/ut [Utilization] KW - *Tomography, X-Ray Computed/sn [Statistics & Numerical Data] KW - Comorbidity KW - Coronary Angiography/st [Standards] KW - Evidence-Based Medicine KW - Humans KW - Length of Stay KW - Practice Guidelines as Topic KW - Prevalence KW - Reproducibility of Results KW - Risk Assessment KW - Sensitivity and Specificity KW - Standard of Care KW - Tomography, X-Ray Computed/st [Standards] KW - United States KW - MedStar Heart & Vascular Institute KW - Comparative Study KW - Journal Article KW - Review N2 - 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 UR - http://dx.doi.org/10.1016/j.jcct.2013.01.009 ER -