Observational studyBMC medical imaging2026
Comparison of coronary artery calcium score-based and all-coronary computed tomography angiography strategies in patients with stable chest pain and risk factor-weighted clinical likelihood of 5-15.
Observational study in BMC medical imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04691037 (Improving the Clinical Management of Stable Chest Pain Based on Imaging), which is not on this map. Not yet cited in PubMed.
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.
Improving the Clinical Management of Stable Chest Pain Based on Imaging: a Registry of Computed Tomography Coronary Angiography
Who cites it
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Authors and funding
8 authors.
Funding
Abstract
backgroundFor patients with stable chest pain (SCP) and risk factor-weighted clinical likelihood (RF-CL) of 5–15%, the most appropriate strategy to defer or refer further testing is important but remains debatable. This study aimed to compare two coronary artery calcium score (CACS)-based strategies and all-coronary computed tomography angiography (CCTA) strategy in these patients.
methods19682 patients with RF-CL of 5%-15% referred to CCTA for SCP were classified into referral and deferral groups according to CACS strategy and CACS-weighted clinical likelihood model-based strategy (CACS-CL strategy), respectively. The associations of coronary artery disease (CAD), major adverse cardiovascular event (MACE) and subsequent clinical management with groups, as well as net reclassification improvement (NRI) and number needed to test (NNT) with CACS were evaluated to compare the performance of strategies.
resultsCompared to CACS strategy, CACS-CL strategy indicated stronger associations between groups and CAD, MACE (hazard ratios: 5.30 versus 4.09), more intensive subsequent clinical management and positive NRIs (varying between 6.72% and 18.69%). When comparing CACS-CL to all-CCTA strategy, all metrics (such as diagnostic yield of CCTA) significantly (p < 0.001) improved, except rate of omission diagnosis, leading to an NNT to reduce one CCTA of 2.10 and to miss one necessary CCTA of 16.27, respectively.
conclusionIn patients with SCP and RF-CL of 5%-15%, CACS-CL strategy was associated with greater effectiveness and safety than CACS strategy did. Compared to all-CCTA strategy, CACS-CL strategy dramatically improved the classification of patients to deferral group but slightly compromised safety, which should be investigated in further study.
trial registrationClinicalTrials.gov Identifier: NCT04691037; Registration Date: 12/29/2020.
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