In which patients with chest pain is cardiac CT angiography useful for ruling out obstructive coronary artery disease?

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Abstract

EVIDENCE-BASED ANSWER

Cardiac computed tomography angiography (CCTA) is useful for ruling out obstructive coronary artery disease (negative likelihood ratio [LR-] ≤0.07) in outpatients with typical or atypical chest pain and no history of coronary artery disease (CAD). In the emergency department setting, CCTA can determine which patients with acute chest pain but low-to-intermediate risk for CAD can safely avoid hospitalization without increasing 30-day complications or resource use (SOR: B, single diagnostic cohort study and single RCT).

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