Choosing Wisely:

Don’t use coronary CT angiography in high-risk emergency department patients presenting with acute chest pain. note: Risk defined by the Thrombolysis In Myocardial Infarction risk score for unstable angina/acute coronary syndromes.

Rationale and Comments: To date, randomized control trials evaluating use of coronary CT angiography for individuals presenting with acute chest pain in the emergency department have been limited to low- or low-intermediate­­–risk individuals.
Sponsoring Organizations:
  • Society of Cardiovascular Computed Tomography
  • Sources:
  • Randomized controlled trials
  • Disciplines:
  • Cardiovascular
  • Emergency medicine
  • References: • Goldstein JA, et al. The CT-STAT (Coronary Computed Tomographic Angiography for Systematic Triage of Acute Chest Pain Patients to Treatment) trial. J Amer Coll Cardiol. 2011;58(14):1414-22.
    • Hoffmann U, et al. Coronary CT angiography versus standard evaluation in acute chest pain. N Engl J Med. 2012;367(4):299-308.
    • Litt HI, et al. CT angiography for s afe discharge of patients with possible acute coronary syndromes. N Engl J Med. 2012;366(15):1393-403.

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