Trial reportJACC. Cardiovascular imaging2013
Stress CMR reduces revascularization, hospital readmission, and recurrent cardiac testing in intermediate-risk patients with acute chest pain.
Trial report in JACC. Cardiovascular imaging, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01035047 (Randomized Investigation of Chest Pain Diagnostic Strategies), which is not on this map. Cited by 22 papers, 6 of them syntheses 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.
Randomized Investigation of Chest Pain Diagnostic Strategies
Who cites it
22 citing papers in PubMed, 6 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Representation of Older Adults and Women in Randomized Trials of Noninvasive Imaging for Chest Pain.Circulation. Cardiovascular imaging · 2025Pooled it
- SCMR Position Paper (2020) on clinical indications for cardiovascular magnetic resonance.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2020Guideline
- Interventions to Promote Early Discharge and Avoid Inappropriate Hospital (Re)Admission: A Systematic Review.International journal of environmental research and public health · 2019Pooled it
- Hospitalisation in short-stay units for adults with internal medicine diseases and conditions.The Cochrane database of systematic reviews · 2018Pooled it
- Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: network meta-analysis of diagnostic randomised controlled trials.BMJ (Clinical research ed.) · 2018Pooled it
- 2014 Korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.Korean journal of radiologyGuideline
- Cardiac Magnetic Resonance Imaging Versus Invasive-Based Strategies in Patients With Chest Pain and Detectable to Mildly Elevated Serum Troponin: A Randomized Clinical Trial.Circulation. Cardiovascular imaging · 2023Trial
- ACES (Accelerated Chest Pain Evaluation With Stress Imaging) Protocols Eliminate Testing Disparities in Patients With Chest Pain.Critical pathways in cardiology · 2019Trial
- Stress cardiovascular magnetic resonance imaging in intermediate-risk emergency department patients with abnormal high-sensitivity troponin.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2025Article
- Are Short-Stay Units Safe and Effective in the Treatment of Non-Variceal Upper Gastrointestinal Bleeding?Medicina (Kaunas, Lithuania) · 2023Observational
- [Ischemic heart disease : More than just chronic CAD].Radiologie (Heidelberg, Germany) · 2022Review
- Appropriateness of Cardiovascular Imaging in the Initial Assessment of Possible Acute Coronary Syndrome in the Emergency Department.Reviews in cardiovascular medicine · 2022Review
- Defining Delayed Discharges of Inpatients and Their Impact in Acute Hospital Care: A Scoping Review.International journal of health policy and management · 2022Article
- Using Cardiac Magnetic Resonance Imaging to Evaluate Patients with Chest Pain in the Emergency Department.Journal of cardiovascular imaging · 2021Review
- Factors associated with unplanned readmissions within 1 day of acute care discharge: a retrospective cohort study.BMC health services research · 2018Article
- Monocyte Chemoattractant Protein-1 as a Predictor of Coronary Atherosclerosis in Patients Receiving Coronary Angiography.Critical pathways in cardiology · 2018Article
- Myocardial deformation by strain echocardiography identifies patients with acute coronary syndrome and non-diagnostic ECG presenting in a chest pain unit: a prospective study of diagnostic accuracy.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Article
- Risk stratification in non-ST elevation acute coronary syndromes: Risk scores, biomarkers and clinical judgment.International journal of cardiology. Heart & vasculature · 2015Review
- Incremental cost-effectiveness of dobutamine stress cardiac magnetic resonance imaging in patients at intermediate risk for coronary artery disease.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Article
- 2014 korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: a joint report of the korean society of cardiology and the korean society of radiology.Korean circulation journal · 2014Review
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
objectivesThe aim of this study was to determine the effect of stress cardiac magnetic resonance (CMR) imaging in an observation unit (OU) on revascularization, hospital readmission, and recurrent cardiac testing in intermediate-risk patients with possible acute coronary syndromes (ACS).
backgroundIntermediate-risk patients commonly undergo hospital admission with high rates of coronary revascularization. It is unknown whether OU-based care with CMR is a more efficient alternative.
methodsA total of 105 intermediate-risk participants with symptoms of ACS but without definite ACS on the basis of the first electrocardiogram and troponin were randomized to usual care provided by cardiologists and internists (n = 53) or to OU care with stress CMR (n = 52). The primary composite endpoint of coronary artery revascularization, hospital readmission, and recurrent cardiac testing at 90 days was determined. The secondary endpoint was length of stay from randomization to index visit discharge; safety was measured as ACS after discharge.
resultsThe median age of participants was 56 years (range 35 to 91 years), 54% were men, and 20% had pre-existing coronary disease. Index hospital admission was avoided in 85% of the OU CMR participants. The primary outcome occurred in 20 usual care participants (38%) versus 7 OU CMR participants (13%) (hazard ratio: 3.4; 95% confidence interval: 1.4 to 8.0, p = 0.006). The OU CMR group experienced significant reductions in all components: revascularizations (15% vs. 2%, p = 0.03), hospital readmissions (23% vs. 8%, p = 0.03), and recurrent cardiac testing (17% vs. 4%, p = 0.03). Median length of stay was 26 h (interquartile range: 23 to 45 h) in the usual care group and 21 h (interquartile range: 15 to 25 h) in the OU CMR group (p < 0.001). ACS after discharge occurred in 3 usual care participants (6%) and no OU CMR participants.
conclusionsIn this single-center trial, management of intermediate-risk patients with possible ACS in an OU with stress CMR reduced coronary artery revascularization, hospital readmissions, and recurrent cardiac testing, without an increase in post-discharge ACS at 90 days. (Randomized Investigation of Chest Pain Diagnostic Strategies; NCT01035047).
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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.