Trial reportJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2013
Stress myocardial perfusion imaging for the evaluation and triage of chest pain in the emergency department: a randomized controlled trial.
Trial report in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Representation of Older Adults and Women in Randomized Trials of Noninvasive Imaging for Chest Pain.Circulation. Cardiovascular imaging · 2025Pooled 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
- Multimodality Non-Invasive Imaging Approach in Acute Coronary Syndrome: Diagnostic and Prognostic Assessment.Current cardiology reports · 2025Review
- Role of cardiac imaging in acute chest pain.The British journal of radiology · 2023Review
- Appropriateness of Cardiovascular Imaging in the Initial Assessment of Possible Acute Coronary Syndrome in the Emergency Department.Reviews in cardiovascular medicine · 2022Review
- Guidelines for reasonable and appropriate care in the emergency department (GRACE): Recurrent, low-risk chest pain in the emergency department.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2021Article
- High-sensitivity troponin T and long-term adverse cardiac events among patients presenting with suspected acute coronary syndrome in Singapore.Singapore medical journal · 2019Observational
- Fragmented QRS on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imaging.Indian heart journal · 2018Article
- Getting it right the first time: Stress-only MPI in the ER.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Imaging for chest pain in the emergency room: Finding the right gate not the right gatekeeper.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Article
- 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
- Chest pain: coronary CT in the ER.The British journal of radiology · 2016Review
- An online tool for nurse triage to evaluate risk for acute coronary syndrome at emergency department.Emergency medicine international · 2015Article
- Imaging techniques for the assessment of suspected acute coronary syndromes in the emergency department.Current problems in cardiology · 2014Review
- Acute chest pain evaluation: is there too much stress on the system?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2013Article
- Article
Corrections and comments
- Commented on by
Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with acute coronary syndrome (ACS) often present atypically. In a randomized controlled trial, we studied whether adding stress myocardial perfusion imaging (SMPI) to an evaluation strategy for emergency department (ED) patients presenting with chest pain more effectively identifies patients with ACS.
methodsParticipants were randomized to standard ED chest pain protocol (clinical assessment) or standard protocol supplemented with SMPI results. During 6 hours of electrocardiogram (ECG) monitoring and serial cardiac markers (creatine kinase-MB isoenzyme, troponin), participants developing ST segment changes or elevated cardiac markers were admitted. Those with a negative observation period underwent SMPI (N = 1,004) or clinical assessment (N = 504) based on randomization, and admitted if their SMPI scan was abnormal or senior clinicians found a high or intermediate risk for ACS.
resultsSMPI participants had a significantly lower admission rate than clinical assessment participants (10.16% vs 18.45%), with no significant between-group differences in risk of cardiac events (CEs) after 30 days (0.40% vs 0.79%) or 1 year (0.70% vs 0.99%).
conclusionsWhen added to a standard triage strategy incorporating clinical evaluation, serial ECGs, and cardiac markers, SMPI improved clinical decision making for chest pain patients, significantly reducing the need for hospitalization without an increase in adverse CE rates at 30 days or 1 year.
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.