Trial reportCirculation2013
Sex differences in the effectiveness of early coronary computed tomographic angiography compared with standard emergency department evaluation for acute chest pain: the rule-out myocardial infarction with Computer-Assisted Tomography (ROMICAT)-II Trial.
Trial report in Circulation, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01084239 (Rule Out Myocardial Ischemia/Infarction by Computer Assisted Tomography), which is not on this map. Cited by 20 papers.
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.
Rule Out Myocardial Ischemia/Infarction by Computer Assisted Tomography
Who cites it
20 citing papers in PubMed, 38 citations in OpenAlex.
- Utility of dual-source computed tomography in cardiac resynchronization therapy-DIRECT study.Heart rhythm · 2018Trial
- Sex Differences in Functional and CT Angiography Testing in Patients With Suspected Coronary Artery Disease.Journal of the American College of Cardiology · 2016Trial
- Coronary CT Angiography Versus Standard Emergency Department Evaluation for Acute Chest Pain and Diabetic Patients: Is There Benefit With Early Coronary CT Angiography? Results of the Randomized Comparative Effectiveness ROMICAT II Trial.Journal of the American Heart Association · 2016Trial
- Role of a Heart Center for Women in the Prevention and Diagnosis of Atherosclerotic Cardiovascular Disease in Women.Journal of the American Heart Association · 2026Review
- 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
- Coronary CT angiography for suspected acute coronary syndrome: sex-associated differences.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2021Article
- Sex-Based Considerations in the Evaluation of Chest Pain and Management of Obstructive Coronary Artery Disease.Current atherosclerosis reports · 2020Review
- Coronary Computed Tomography Angiography: Enhancing Risk Stratification and Diagnosis of Cardiovascular Disease in Women.Current treatment options in cardiovascular medicine · 2019Review
- Sex differences in coronary artery plaque composition detected by coronary computed tomography: quantitative and qualitative analysis.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2019Article
- The diagnosis of coronary plaque stability by multi-slice computed tomography coronary angiography.Journal of thoracic disease · 2018Article
- Cardiac CT in the Emergency Department: Contrasting Evidence from Registries and Randomized Controlled Trials.Current cardiology reports · 2018Review
- Age- and sex-based resource utilisation and costs in patients with acute chest pain undergoing cardiac CT angiography: pooled evidence from ROMICAT II and ACRIN-PA trials.European radiology · 2018Article
- Sex-Based Differences in the Performance of the HEART Score in Patients Presenting to the Emergency Department With Acute Chest Pain.Journal of the American Heart Association · 2017Observational
- Impact of Coronary Calcification on Clinical Management in Patients With Acute Chest Pain.Circulation. Cardiovascular imaging · 2017Observational
- Cardiovascular Disease in Women: Clinical Perspectives.Circulation research · 2016Review
- Cardiac CT angiography for evaluation of acute chest pain.The international journal of cardiovascular imaging · 2016Review
- State-of-the-Art Updates on Cardiac Computed Tomographic Angiography for Assessing Coronary Artery Disease.Current treatment options in cardiovascular medicine · 2015Article
- Gender-specific research for emergency diagnosis and management of ischemic heart disease: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2014Article
- Feasibility of prospectively ECG-triggered high-pitch coronary CT angiography with 30 mL iodinated contrast agent at 70 kVp: initial experience.European radiology · 2014Article
- Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundWe evaluate sex-based differences in the effectiveness of early cardiac computed tomographic angiography (CCTA) and standard emergency department (ED) evaluation in patients with acute chest pain. METHODS AND
resultsIn the Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II multicenter, controlled trial, we randomized 1000 patients (47% women) 40 to 74 years of age with symptoms suggestive of acute coronary syndrome to an early CCTA or standard ED evaluation. In this prespecified analysis, women in the CCTA arm had a greater reduction in length of stay, lower hospital admission rates, and lesser increased cumulative radiation dose than men in a comparison of ED strategies (P for interaction ≤0.02). Although women had lower acute coronary syndrome rates than men (3% versus 12%; P<0.0001), sex differences in length of stay persisted after adjustment for baseline differences, including acute coronary syndrome rate (P for interaction <0.03). Length of stay was similar between sexes with normal CCTA findings (P=0.11). There was no missed acute coronary syndrome for either sex. No difference was observed in major adverse cardiac events between sexes and ED strategies (P for interaction =0.39). Women had more normal CCTA examinations than men (58% versus 37%; P<0.0001), less obstructive coronary disease by CCTA (5% versus 17%; P=0.0001), but similar normalcy rates for functional testing (P=0.65). Men in the CCTA arm had the highest rate of invasive coronary angiography (18%), whereas women had comparable low 5% rates regardless of ED strategy.
conclusionsThis trial provides data supporting an early CCTA strategy as an attractive option in women presenting to the ED with symptoms suggestive of acute coronary syndrome. The findings may be explained by lower CAD prevalence and severity in women than men. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01084239.
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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.