Trial reportJACC. Cardiovascular imaging2011
Prognostic value of CT angiography for major adverse cardiac events in patients with acute chest pain from the emergency department: 2-year outcomes of the ROMICAT trial.
Trial report in JACC. Cardiovascular imaging, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05845489 (Efficacy and Safety of Clopidogrel for Primary Prevention in Patients With Subclinical Coronary Atherosclerosis Identified on Imaging), which is not on this map. Cited by 58 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy and Safety of Clopidogrel for Primary Prevention in Patients With Subclinical Coronary Atherosclerosis Identified on Imaging
Who cites it
58 citing papers in PubMed, 1 synthesis or guideline pooled it, 145 citations in OpenAlex.
- Korean guidelines for the appropriate use of cardiac CT.Korean journal of radiologyGuideline
- Trial
- Use of Coronary Computed Tomographic Angiography Findings to Modify Statin and Aspirin Prescription in Patients With Acute Chest Pain.The American journal of cardiology · 2016Trial
- Trial
- Coronary CT angiography versus standard evaluation in acute chest pain.The New England journal of medicine · 2012Trial
- Interobserver agreement for the detection of atherosclerotic plaque in coronary CT angiography: comparison of two low-dose image acquisition protocols with standard retrospectively ECG-gated reconstruction.European radiology · 2012Trial
- Trial
- Potential for coronary CT angiography to tailor medical therapy beyond preventive guideline-based recommendations: insights from the ROMICAT I trial.Journal of cardiovascular computed tomographyTrial
- Denoising Multiphase Functional Cardiac CT Angiography Using Deep Learning and Synthetic Data.Radiology. Artificial intelligence · 2024Article
- Influence of heart rate and heart rate variability on the feasibility of ultra-fast, high-pitch coronary photon-counting computed tomography angiography.The international journal of cardiovascular imaging · 2023Article
- The Cost Effectiveness of Coronary CT Angiography and the Effective Utilization of CT-Fractional Flow Reserve in the Diagnosis of Coronary Artery Disease.Journal of cardiovascular development and disease · 2023Review
- Diagnostic Performance of Coronary Tomography Angiography and Serial Measurements of Sensitive Cardiac Troponin in Patients With Chest Pain and Intermediate Risk for Cardiovascular Events.Arquivos brasileiros de cardiologia · 2022Article
- Current Role of Computed Tomography in the Evaluation of Acute Coronary Syndrome.Diagnostics (Basel, Switzerland) · 2021Review
- Role of Cardiovascular Computed Tomography in Acute Coronary Syndromes During the COVID-19 Pandemic-Single Center Snapshot Study.Frontiers in cardiovascular medicine · 2021Article
- Long-term prognosis and predictors of outcomes after negative stress echocardiography.The international journal of cardiovascular imaging · 2020Article
- HEART score improves efficiency of coronary computed tomography angiography in patients suspected of acute coronary syndrome in the emergency department.European heart journal. Acute cardiovascular care · 2020Article
- Preventive Management of Nonobstructive CAD After Coronary CT Angiography in the Emergency Department.JACC. Cardiovascular imaging · 2020Article
- Prognostic value of normal and non-obstructive coronary artery disease based on CT angiography findings. A 12 month follow up study.Journal of cardiovascular and thoracic research · 2019Article
- Precision of regional wall motion estimates from ultra-low-dose cardiac CT using SQUEEZ.The international journal of cardiovascular imaging · 2018Article
- Implication of coronary CT angiography combined with four-dimensional speckle tracking echocardiography for predicting major adverse cardiac events.The international journal of cardiovascular imaging · 2018Observational
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesThe aim of this study was to determine the 2-year prognostic value of cardiac computed tomography (CT) for predicting major adverse cardiac events (MACE) in patients presenting to the emergency department (ED) with acute chest pain.
backgroundCT has high potential for early triage of acute chest pain patients. However, there is a paucity of data regarding the prognostic value of CT in this ED cohort.
methodsWe followed 368 patients from the ROMICAT (Rule Out Myocardial Infarction Using Computer Assisted Tomography) trial (age 53 ± 12 years; 61% male) who presented to the ED with acute chest pain, negative initial troponin, and a nonischemic electrocardiogram for 2 years. Contrast-enhanced 64-slice CT was obtained during index hospitalization, and caregivers and patients remained blinded to the results. CT was assessed for the presence of plaque, stenosis (>50% luminal narrowing), and left ventricular regional wall motion abnormalities (RWMA). The primary endpoint was MACE, defined as composite cardiac death, nonfatal myocardial infarction, or coronary revascularization.
resultsFollow-up was completed in 333 patients (90.5%) with a median follow-up period of 23 months. At the end of the follow-up period, 25 patients (6.8%) experienced 35 MACE (no cardiac deaths, 12 myocardial infarctions, and 23 revascularizations). Cumulative probability of 2-year MACE increased across CT strata for coronary artery disease (CAD) (no CAD 0%; nonobstructive CAD 4.6%; obstructive CAD 30.3%; log-rank p < 0.0001) and across combined CT strata for CAD and RWMA (no stenosis or RWMA 0.9%; 1 feature-either RWMA [15.0%] or stenosis [10.1%], both stenosis and RWMA 62.4%; log-rank p < 0.0001). The c statistic for predicting MACE was 0.61 for clinical Thrombolysis In Myocardial Infarction risk score and improved to 0.84 by adding CT CAD data and improved further to 0.91 by adding RWMA (both p < 0.0001).
conclusionsCT coronary and functional features predict MACE and have incremental prognostic value beyond clinical risk score in ED patients with acute chest pain. The absence of CAD on CT provides a 2-year MACE-free warranty period, whereas coronary stenosis with RWMA is associated with the highest risk of MACE.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.