Trial reportJournal of cardiovascular computed tomography
Safety of coronary CT angiography and functional testing for stable chest pain in the PROMISE trial: A randomized comparison of test complications, incidental findings, and radiation dose.
Trial report in Journal of cardiovascular computed tomography. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01174550 (PROspective Multicenter Imaging Study for Evaluation of Chest Pain - The PROMISE Trial), which is not on this map. Cited by 13 papers, 1 of them a synthesis 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.
PROspective Multicenter Imaging Study for Evaluation of Chest Pain - The PROMISE Trial
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Pooled it
- Cardiac magnetic resonance imaging reduces radiation exposure in emergency department patients with chest pain: A secondary analysis from the CMR IMPACT trial.The American journal of emergency medicine · 2026Trial
- Evaluating Radiation Exposure in Patients with Stable Chest Pain in the SCOT-HEART Trial.Radiology · 2023Trial
- Clinical significance of incidental findings on coronary CT angiography: Insights from a randomized controlled trial.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Trial
- Recent clinical trials support continued emphasis on patient-first over modality-first approaches to initial test selection in patients with stable ischemic heart disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- 2023 Guidelines of the Taiwan Society of Cardiology on the Diagnosis and Management of Chronic Coronary Syndrome.Acta Cardiologica Sinica · 2023Article
- Multimodality Imaging in the Detection of Ischemic Heart Disease in Women.Journal of cardiovascular development and disease · 2022Review
- Factors influencing the safety of outpatient coronary CT angiography: a clinical registry study.BMJ open · 2022Article
- Quality and safety of coronary computed tomography angiography at academic and non-academic sites: insights from a large European registry (ESCR MR/CT Registry).European radiology · 2022Article
- Cost-effectiveness in diagnosis of stable angina patients: a decision-analytical modelling approach.Open heart · 2022Article
- Strategies to Reduce Low-Value Cardiovascular Care: A Scientific Statement From the American Heart Association.Circulation. Cardiovascular quality and outcomes · 2022Review
- Coronary Computed Tomography Angiography: Enhancing Risk Stratification and Diagnosis of Cardiovascular Disease in Women.Current treatment options in cardiovascular medicine · 2019Review
- Cardiac-Specific Conversion Factors to Estimate Radiation Effective Dose From Dose-Length Product in Computed Tomography.JACC. Cardiovascular imaging · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundCoronary computed tomography angiography (CTA) and functional testing strategies for stable chest pain yield similar outcomes; one aspect that may guide test choice is safety.
methodsWe compared test safety (test complications, incidental findings, and effective radiation dose) between CTA and functional testing as-tested in PROMISE (PROspective Multicenter Imaging Study for Evaluation of Chest Pain). In the subgroup whose physicians intended nuclear stress over other functional tests if randomized to the functional arm, we compared radiation dose of CTA versus nuclear stress and identified characteristics associated with dose.
resultsOf 9470 patients, none had major and <1% had minor complications (CTA: 0.8% [37/4633] vs. functional: 0.6% [27/4837]). CTA identified more incidental findings (11.6% [539/4633] vs. 0.7% [34/4837], p < 0.001), most commonly pulmonary nodules (9.4%, 437/4633). CTA had similar 90-day cumulative radiation dose to functional testing. However, in the subgroup whose physicians intended nuclear stress (CTA 3147; nuclear 3203), CTA had lower median index test (8.8 vs. 12.6 mSv, p < 0.001) and 90-day cumulative (11.6 vs. 13.1 mSv, p < 0.001) dose, independent of patient characteristics. The lowest nuclear doses employed 1-day Tc-99m protocols (12.2 mSv). The lowest CTA doses were at sites performing ≥500 CTAs/year (6.9 mSv) and with advanced (latest available) CT scanners (5.5 mSv).
conclusionComplications were negligibly rare for both CTA and functional testing. CTA detects more incidental findings. Compared to nuclear stress testing, CTA's lower radiation dose, independent of patient characteristics, makes it an attractive test choice. Radiation dose varies with imaging protocol, indicating opportunities to further reduce dose. (ClinicalTrials.gov number, NCT01174550).
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.