Key result
Cardiac computed tomography angiography is a viable, safe, and potentially more efficient alternative to functional testing for evaluating patients with acute chest pain.
Why the study?
Does coronary computed tomography angiography improve the evaluation and triage of patients with acute chest pain compared to functional testing?
Does coronary computed tomography angiography improve the evaluation and triage of patients with acute chest pain compared to functional testing?
Coronary CT angiography is a safe and efficient strategy for ruling out coronary artery disease in patients presenting with acute chest pain, with emerging advanced assessments likely to further expand its clinical utility.
Supports CT angiography for acute chest pain triage; leaves open need for randomized outcome trials.
The efficient and reliable evaluation of patients with acute chest pain is one of the most challenging tasks in the emergency department. Coronary computed tomography (CT) angiography may play a major role, since it permits ruling out coronary artery disease with high accuracy if performed with expertise in properly selected and prepared patients. Several randomized trials have established early cardiac CT as a viable safe and potentially more efficient alternative to functional testing in the evaluation of acute chest pain. Ongoing investigations explore whether advanced anatomic and functional assessments such as high-risk coronary plaque, resting myocardial perfusion, and left ventricular function, or the simulation of the fractional coronary flow reserve will add information to the anatomic assessment for stenosis, which would allow expanding the benefits of cardiac CT from triage to treatment decisions. Especially, the combination of high-sensitive troponins and coronary computed tomography angiography may play a valuable role in future strategies for the management of patients presenting with acute chest pain.
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Nieman et al. (2015) conducted a review in Acute chest pain. Cardiac computed tomography (CT) angiography vs. Functional testing was evaluated. Cardiac computed tomography angiography is a viable, safe, and potentially more efficient alternative to functional testing for evaluating patients with acute chest pain.
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