CT Angiography for Safe Discharge of Patients with Possible Acute Coronary Syndromes

Patients with chest pain have a high hospital admission rate, but often no cardiac cause is found. In this trial, coronary CT angiography accurately identified patients who were free from coronary disease and could be safely discharged from the emergency department. Patients who present to the emergency department with signs and symptoms consistent with a possible acute coronary syndrome pose a diagnostic dilemma. 1 – 6 Despite the introduction of clinical decision rules 6 – 15 and the improved sensitivity of cardiac markers, 15 – 17 most patients are admitted to the hospital so that an acute coronary syndrome can be ruled out, even though for most of these patients, the symptoms are ultimately found not to have a cardiac cause. The absence of evidence of coronary disease on invasive coronary angiography is associated with a low risk of future cardiac events. 18 , 19 Coronary computed tomographic angiography . . .