SynthesisJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2012
A meta-analysis and systematic review of computed tomography angiography as a diagnostic triage tool for patients with chest pain presenting to the emergency department.
Synthesis in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Korean guidelines for the appropriate use of cardiac CT.Korean journal of radiologyGuideline
- Diagnostic performance between computed tomography angiography and high-sensitivity troponin for acute coronary syndrome in the emergency department: a systematic review and meta-analysis.Journal of thoracic disease · 2026Article
- Usefulness of FFR-CT to exclude haemodynamically significant lesions in high-risk NSTE-ACS.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
- Trends in non-focal neurological chief complaints and CT angiography utilization among adults in the emergency department.Internal and emergency medicine · 2024Observational
- Computed Tomography Evaluation of Coronary Atherosclerosis: The Road Travelled, and What Lies Ahead.Diagnostics (Basel, Switzerland) · 2024Review
- Coronary computed tomography angiography in the evaluation of acute chest pain in patients with elevated high sensitive cardiac troponin I (hs-cTn) level.American heart journal plus : cardiology research and practice · 2023Article
- Inter-observer agreement and image quality of model-based algorithm applied to the Coronary Artery Disease-Reporting and Data System score.Insights into imaging · 2022Article
- Advances in Clinical Cardiology 2020: A Summary of Key Clinical Trials.Advances in therapy · 2021Review
- Ability of FFR-CT to detect the absence of hemodynamically significant lesions in patients with high-risk NSTE-ACS admitted in the emergency department with chest pain, study design and rationale.International journal of cardiology. Heart & vasculature · 2020Article
- High-sensitivity troponin allows accurate rapid diagnosis and discharge but it is not a substitute for a comprehensive patient evaluation.Internal and emergency medicine · 2019Article
- ANMCO-SIMEU Consensus Document: in-hospital management of patients presenting with chest pain.European heart journal supplements : journal of the European Society of Cardiology · 2017Article
- [Cardiac causes of chest pain].Der Internist · 2017Review
- Coronary CT angiography in acute chest pain.F1000Research · 2017Review
- Coronary CT Angiography in the Emergency Department: Current Status.Current treatment options in cardiovascular medicine · 2016Review
- Independent evaluation of a simple clinical prediction rule to identify right ventricular dysfunction in patients with shortness of breath.The American journal of emergency medicine · 2015Observational
- NIH workshop on clinical translation of molecular imaging probes and technology--meeting report.Molecular imaging and biology · 2014Article
- A comparison of coronary CTA and stress testing using high-efficiency SPECT MPI for the evaluation of chest pain in the emergency department.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014Article
- Use of multi-slice computed tomography in patients with chest-pain submitted to the emergency department.The international journal of cardiovascular imaging · 2014Article
- Coronary Artery Calcium Testing in Symptomatic Patients: An Issue of Diagnostic Efficiency.Current cardiovascular imaging reports · 2013Article
- Coronary CT angiography after stress testing: an efficient use of resources? Implications of the Advanced Cardiovascular Imaging Consortium (ACIC) results.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2012Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo assess clinical utility of computed tomography angiography (CTA) in the diagnosis of chest pain patients presenting to emergency departments (EDs), we conducted a meta-analysis of CTA in patients with suspected acute coronary syndromes (ACSs).
methods386 studies were identified on initial review of literature. Inclusion criteria were: (1) prospective study with ≥1 month follow-up, (2) use of CTA in the ED setting, (3) use of ACC/AHA definitions for ACS and robust assessment of major adverse cardiac events, (4) ≥30 patients, and (5) study population with initial non-diagnostic ECGs and negative biomarkers.
resultsNine studies (N = 1349) formed the data set. The pooled patient population was 52 ± 2 years of age, 51% male, with low to intermediate pretest probability for ACS. Risk factors included 12% diabetes, 42% hypertension, 35% smokers, 29% had hyperlipidemia, and 7% known CAD. ACS was subsequently diagnosed in 10% of patients. The bivariate summary estimate of sensitivity of CTA for ACS diagnosis was 95% (95% CI 88-100) and specificity was 87% (95% CI 83-92), yielding a negative likelihood ratio of 0.06 (95% CI 0-0.14) and positive likelihood ratio of 7.4 (95% CI 4.8-10). The 30-day event rate included no deaths and no additional MIs.
conclusionCoronary CTA demonstrates a high sensitivity and a low negative likelihood ratio of 0.06, and is effective in ruling out the presence of ACS in low to intermediate risk patients presenting to the ED with acute chest pain.
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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.