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Randomised controlled trial
Coronary CT angiography reduces unnecessary admissions and allows safe discharge of emergency department patients with low-to-intermediate risk chest pain
  1. Adam J Singer1,
  2. Michael Poon2
  1. 1Department of Emergency Medicine, Stony Brook University, Stony Brook, New York, USA
  2. 2Departments of Radiology and Cardiology, Stony Brook University, Stony Brook, New York, USA
  1. Correspondence to: Dr Adam J Singer
    Department of Emergency Medicine, Stony Brook University, Nicolls Road, Stony Brook, NY 11794-8350, USA; adam.singer{at}stonybrook.edu

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Context

Chest pain is the second-most common reason for visiting the emergency department (ED). Due to diagnostic uncertainty and medicolegal concerns, many such patients are admitted to undergo diagnostic evaluation to exclude acute coronary syndromes (ACS). The availability of a safe, rapid, non-invasive and highly accurate diagnostic test to exclude ACS has remained a holy grail in the ED.

Methods

A total of 1370 low-to-intermediate risk adult patients presenting to one of five EDs in the USA with chest pain and suspected ACS were randomised to coronary CT angiography (CCTA) or to standard care. Patients with …

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