CCTA vs Standard of Care: Which Is Best For Acute Chest Pain?

Coronary computed tomography angiography (CCTA) is associated with higher rates revascularization vs standard-of-care (SOC) approaches in patients with acute chest pain, according to a recent systematic review and meta-analysis.

However, both methods are associated with similar rates of major adverse cardiovascular events (MACE).
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For their review, the researchers identified 6285 patients with acute chest pain in 10 trials through a systematic search of various electronic databases. Follow-up in each trial ranged from 1 to 19 months.

Various endpoints (mortality, MACE, myocardial infarction [MI], invasive coronary angiography [ICA] and revascularization) were evaluated. Random-effects models were used to calculate pooled risk ratios (RR) and their 95% confidence intervals.

Results indicated that significantly higher rates of ICA (RR 1.32) and revascularization (RR 1.77) occurred in the CCTA group compared with the SOC group. However, the researchers observed no significant between-group differences in all-cause mortality (RR 0.48), MI (RR 0.82), or MACE (RR 0.98).

“Compared with other SOC approaches, use of CCTA is associated with similar major adverse cardiac events but higher rates of revascularization in patients with acute chest pain,” the researchers concluded.

—Christina Vogt

Reference:

Gongora CA, Bavishi C, Uretsky S, Argulian E. Acute chest pain evaluation using coronary computed tomography angiography compared with standard of care: a meta-analysis of randomized clinical trials [Published online January 18, 2018]. Heart. http://dx.doi.org/10.1136/heartjnl-2017-311647.