Cardiac CT in the Emergency Department: Contrasting Evidence from Registries and Randomized Controlled Trials

  • Nam Ju Lee
  • Harold Litt
Cardiac PET, CT, and MRI (F Pugliese and SE Petersen, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Cardiac PET, CT, and MRI


Purpose of Review

To compare outcomes between registries and randomized controlled trials of coronary computed tomographic angiography (CCTA)-based versus standard of care approaches to the initial evaluation of patients with acute chest pain.

Recent Findings

Randomized trials have demonstrated CCTA to be a safe and efficient tool for triage of low- to intermediate-risk patients presenting to the emergency department with chest pain. Recent studies demonstrate heterogeneous result using different standard of care approaches for evaluation of hard endpoints in comparison with standard evaluation. Also, there has been continued concern for increase in subsequent testing after coronary CTA.


Although CCTA improves detection of coronary artery disease, it is uncertain if it will bring improvement of long-term health outcomes at this point of time. Careful analysis of the previous results and further investigation will be required to validate evaluation of hard endpoints.


Cardiac Coronary CT CCTA Standard of care Emergency department 


Compliance with Ethical Standards

Conflict of Interest

Nam Ju Lee declares no conflict of interest. Harold Litt reports grants from Siemens Healthineers and Heartflow LLC.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. 1.Department of Radiology and Radiological Science, The Johns Hopkins HospitalJohns Hopkins School of MedicineBaltimoreUSA
  2. 2.Department of Radiology, Perelman School of Medicine University of PennsylvaniaPhiladelphiaUSA

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