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

  • Cardiac PET, CT, and MRI (F Pugliese and SE Petersen, Section Editors)
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Abstract

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.

Summary

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.

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

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Authors and Affiliations

  1. Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Johns Hopkins School of Medicine, 1800 Orleans St, Baltimore, MD, 21287, USA

    Nam Ju Lee

  2. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St., Philadelphia, PA, 19104, USA

    Harold Litt

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Correspondence to Harold Litt.

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

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

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This article is part of the Topical Collection on Cardiac PET, CT, and MRI

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Lee, N.J., Litt, H. Cardiac CT in the Emergency Department: Contrasting Evidence from Registries and Randomized Controlled Trials. Curr Cardiol Rep 20, 24 (2018). https://doi.org/10.1007/s11886-018-0965-z

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