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What role does computed tomographic angiography (CTA) play in patients with acute chest pain who are at intermediate risk for acute coronary syndrome (ACS)? In this U.K. trial, investigators studied 1748 hemodynamically stable patients (mean age, 62) who presented to the emergency department with acute chest pain and suspected ACS. They were randomized to early CTA (median time, 4.2 hours after randomization) or standard care to determine if CTA identified patients with subsequent myocardial infarction (MI).
At 1 year, the primary endpoint (i.e., all-cause death or MI) was not significantly different in the two groups (5.8% and 6.1%). Invasive coronary angiography was performed significantly less often in the CTA group than in the standard-c…