Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Johns Hopkins School of Medicine, 1800 Orleans St, Baltimore, MD, 21287, USA.
Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St., Philadelphia, PA, 19104, USA.
Curr Cardiol Rep. 2018 Mar 8;20(4):24. doi: 10.1007/s11886-018-0965-z.
To compare outcomes between registries and randomized controlled trials of coronary computed tomographic angiography (CCTA)-based versus standard of care approaches to the initial evaluation of patients with acute chest pain.
Randomized trials have demonstrated CCTA to be a safe and efficient tool for triage of low- to intermediate-risk patients presenting to the emergency department with chest pain. Recent studies demonstrate heterogeneous result using different standard of care approaches for evaluation of hard endpoints in comparison with standard evaluation. Also, there has been continued concern for increase in subsequent testing after coronary CTA. Although CCTA improves detection of coronary artery disease, it is uncertain if it will bring improvement of long-term health outcomes at this point of time. Careful analysis of the previous results and further investigation will be required to validate evaluation of hard endpoints.
比较基于冠状动脉计算机断层扫描血管造影（CCTA）的注册研究与随机对照试验与标准治疗方法在急性胸痛患者初始评估中的结果。
随机试验表明 CCTA 是一种安全有效的工具，可用于对急诊科胸痛的低至中危患者进行分诊。最近的研究表明，与标准评估相比，使用不同的标准治疗方法评估硬终点时，结果存在异质性。此外，人们一直担心冠状动脉 CTA 后会增加进一步的检查。虽然 CCTA 提高了冠状动脉疾病的检出率，但目前尚不确定它是否会改善长期健康结果。需要仔细分析以前的结果并进一步调查，以验证硬终点的评估。
