Coronary disease & ACSRandomised controlled trial
Targeted Use of Computed Tomographic Coronary Angiography in Acute Chest Pain
- Randomised controlled trial
- multicentre
- 14 UK hospitals
Authors' conclusion
In patients with suspected acute coronary syndrome in whom myocardial infarction had been ruled out, routine CT coronary angiography-guided management did not result in a lower incidence of subsequent myocardial infarction or death from a cardiac cause than standard care.
Study context
- Population
- ED patients with suspected ACS, MI ruled out, intermediate risk by high-sensitivity cardiac troponin (maximum I or T >5 ng per liter)
- Participants
- 3,170 patients
- Comparison
- Outpatient computed tomographic (CT) coronary angiography-guided care vs standard care
- CT coronary angiographyn = 1,587
- Standard caren = 1,583reference
- Primary endpoint
- MI or death from a cardiac cause
- Follow-up
- Median 3.0 years
Primary result
MI or cardiac death
Adjusted hazard ratio
0.95
95% CI 0.73–1.23
P = 0.71
Events by treatment group
CT coronary angiography vs Standard care
adjusted HR 0.95 (95% CI 0.73–1.23); P = 0.71
As reported in the abstract
Further findings
CT coronary angiography performed · 90 days after randomisation
Safety
CT coronary angiography-related adverse event
- Overall
- 7 (0.4%)
Original publication
Targeted Use of Computed Tomographic Coronary Angiography in Acute Chest Pain. N Engl J Med. Published 29 August 2026. doi:10.1056/nejmoa2608903
Summarised from the published abstract; every number is checked against it