Trial reportJACC. Cardiovascular imaging2015
hs-Troponin I Followed by CT Angiography Improves Acute Coronary Syndrome Risk Stratification Accuracy and Work-Up in Acute Chest Pain Patients: Results From ROMICAT II Trial.
Trial report in JACC. Cardiovascular imaging, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 22 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.
Rule Out Myocardial Ischemia/Infarction by Computer Assisted Tomography
Prospective RandOmised Trial of Emergency Cardiac CT
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Serial high-sensitivity cardiac troponin T measurements to rule out acute myocardial infarction and a single high baseline measurement for swift rule-in: A systematic review and meta-analysis.European heart journal. Acute cardiovascular care · 2020Pooled it
- Cardiovascular magnetic resonance accurately detects obstructive coronary artery disease in suspected non-ST elevation myocardial infarction: a sub-analysis of the CARMENTA Trial.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2021Trial
- Biomarkers of Cardiovascular Stress: A Historical Review.Journal of cardiovascular development and disease · 2026Review
- Validation and comparison of five chronic total occlusion scores to predict difficulty of percutaneous coronary intervention.BMC cardiovascular disorders · 2026Article
- Coronary Computed Tomography Angiography to Exclude Acute Coronary Syndrome in Low-Risk Chest Pain Patients.Journal of cardiovascular development and disease · 2025Review
- Developing an ML-Based Pretest Probability Model of Obstructive CAD in Patients With Stable Chest Pain.JACC. Asia · 2025Article
- Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives.Journal of cardiovascular development and disease · 2025Review
- Utility of Cardiovascular CT in Ischemic Heart Disease.Echocardiography (Mount Kisco, N.Y.) · 2025Review
- Acute dyspnea in the emergency department: a clinical review.Internal and emergency medicine · 2023Review
- Coronary allograft vasculopathy in post-heart transplant patients: pathogenesis and role of cardiac computed tomography in diagnosis-a comprehensive review.Annals of medicine and surgery (2012) · 2023Article
- The value of quantitative plaque analysis based on coronary computed tomography angiography in predicting the percutaneous coronary intervention outcome of chronic total occlusion lesions.Quantitative imaging in medicine and surgery · 2023Article
- Vascular-specific epicardial adipose tissue in predicting functional myocardial ischemia for patients with stable chest pain.Journal of thrombosis and thrombolysis · 2021Article
- Discordance of High-Sensitivity Troponin Assays in Patients With Suspected Acute Coronary Syndromes.Journal of the American College of Cardiology · 2021Article
- CCTA in the diagnosis of coronary artery disease.La Radiologia medica · 2020Review
- Machine learning of clinical variables and coronary artery calcium scoring for the prediction of obstructive coronary artery disease on coronary computed tomography angiography: analysis from the CONFIRM registry.European heart journal · 2020Observational
- Quantification of plaque characteristics detected by dual source computed tomography angiography to predict myocardial ischemia as assessed by single photon emission computed tomography myocardial perfusion imaging.Quantitative imaging in medicine and surgery · 2019Article
- Differences in the association of total versus local coronary artery calcium with acute coronary syndrome and culprit lesions in patients with acute chest pain: The coronary calcium paradox.Atherosclerosis · 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
- High-Sensitivity Cardiac Troponin I as a Gatekeeper for Coronary Computed Tomography Angiography and Stress Testing in Patients with Acute Chest Pain.Clinical chemistry · 2017Article
Corrections and comments
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Authors and funding
16 authors at 9 institutions in 4 countries.
Funding
Abstract
objectivesThis study compared diagnostic accuracy of conventional troponin/traditional coronary artery disease (CAD) assessment and highly sensitive troponin (hsTn) I/advanced CAD assessment for acute coronary syndrome (ACS) during the index hospitalization.
backgroundhsTnI and advanced assessment of CAD using coronary computed tomography angiography (CTA) are promising candidates to improve the accuracy of emergency department evaluation of patients with suspected ACS.
methodsWe performed an observational cohort study in patients with suspected ACS enrolled in the ROMICAT II (Rule Out Myocardial Infarction/Ischemia using Computer Assisted Tomography) trial and randomized to coronary CTA who also had hsTnI measurement at the time of the emergency department presentation. We assessed coronary CTA for traditional (no CAD, nonobstructive CAD, ≥50% stenosis) and advanced features of CAD (≥50% stenosis, high-risk plaque features: positive remodeling, low <30-Hounsfield units plaque, napkin-ring sign, spotty calcium).
resultsOf 160 patients (mean age: 53 ± 8 years, 40% women) 10.6% were diagnosed with ACS. The ACS rate in patients with hsTnI below the limit of detection (n = 9, 5.6%), intermediate (n = 139, 86.9%), and above the 99th percentile (n = 12, 7.5%) was 0%, 8.6%, and 58.3%, respectively. Absence of ≥50% stenosis and high-risk plaque ruled out ACS in patients with intermediate hsTnI (n = 87, 54.4%; ACS rate 0%), whereas patients with both ≥50% stenosis and high-risk plaque were at high risk (n = 13, 8.1%; ACS rate 69.2%) and patients with either ≥50% stenosis or high-risk plaque were at intermediate risk for ACS (n = 39, 24.4%; ACS rate 7.7%). hsTnI/advanced coronary CTA assessment significantly improved the diagnostic accuracy for ACS as compared to conventional troponin/traditional coronary CTA (area under the curve 0.84, 95% confidence interval [CI]: 0.80 to .88 vs. 0.74, 95% CI: 0.70 to 0.78; p < 0.001).
conclusionshsTnI at the time of presentation followed by early advanced coronary CTA assessment improves the risk stratification and diagnostic accuracy for ACS as compared to conventional troponin and traditional coronary CTA assessment. (Multicenter Study to Rule Out Myocardial Infarction/Ischemia by Cardiac Computed Tomography [ROMICAT-II]; 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.