Journal Club - Recent Additions

July - 2012


Showing Journal 1 of 16

Coronary CT Angiography versus Standard Evaluation in Acute Chest Pain

the ROMICAT-II Investigators N Engl J Med, 2012, 367(4):299-308


Previous studies suggest CCTA (coronary computed tomographic angiography) has a very high predictive value for ruling out acute coronary syndromes. This RCT compared standard care to early CCTA in the ED in 1000  patients with acute chest pain suggestive of ACS without diagnostic...


Previous Comments

It needs to be emphasised that CCTA provided no patient-centred outcome benefit over clinical decision-making whatsoever. Given that many incidental anatomical lesions will be found by this highly sensitive technique, and that PCI may worsen outcomes for the majority of patients who are presenting for angiography, I suspect the only real benefit of CCTA would be the separation of anatomical diagnosis from the decision to perform PCI (which currently is too closely linked by a sheath in the groin and a Cardiologist who may be tempted to do something over doing nothing...)
Franno-24 Sep, 2012 12:30:57 AM