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Evid Based Med doi:10.1136/eb-2012-101011
  • Therapeutics
  • Randomised controlled trial

Coronary CT angiography decreases the length of stay in emergency department versus standard therapy in patients presenting with acute chest pain, but results in increased downstream testing and radiation exposure

  1. Reza Arsanjani
  1. Department of Medicine, Cedars-Sinai Medical Center, Cedars-Sinai Heart Institute, Cardiac Imaging Research, Los Angeles, California, USA
  1. Correspondence to James K Min
    Department of Medicine, Cedars-Sinai Medical Center, Cedars-Sinai Heart Institute, Cardiac Imaging Research, Los Angeles, CA 90048, USA; james.min{at}cshs.org

Commentary on: Hoffmann U, Truong QA, Schoenfeld DA, et al. ROMICAT-II Investigators. Coronary CT angiography versus standard evaluation in acute chest pain. N Engl J Med 2012;367:299–308.

Context

Chest pain is the second leading reason for presenting to the emergency department (ED); however, the majority of these patients do not have an acute cardiac diagnosis at the time of discharge.1 ,2 Coronary CT angiography (CCTA) has been shown to have a very high negative predictive value (NPV) and an excellent intermediate-term prognosis.3 In this new study, Hoffmann and colleagues investigated the effectiveness of CCTA versus the standard therapy for the evaluation of patients presenting with chest pain to ED as well as downstream testing, radiation exposure and overall cost of care.

Methods

This study was a prospective, multicentre, randomised, strategy-controlled trial …

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