title: Coronary computed tomographic angiography for patients with low-to-intermediate risk chest pain: A systematic review and meta-analysis.
abstract: Coronary computed tomographic angiography (CCTA) can image the coronary vasculature rapidly and detect the presence and severity of luminal stenosis accurately. However, whether CCTA based care strategy could gain more benefits than conventional strategy with functional tests for patients with low-to-intermediate risk chest pain remains unknown. In this study we performed a meta-analysis to compare the clinical efficacy of CCTA versus conventional strategy. Eight randomized controlled trials with 14749 patients were finally included in this review after database searching. Compared with conventional strategy, CCTA significantly increased the rates of invasive coronary angiography (RR 1.44; 95% CI 1.28 to 1.63) and revascularization (RR 1.94; 95% CI 1.65 to 2.29), but did not change the rates of major adverse cardiovascular events (RR 1.10; 95% CI 0.92 to 1.30), death (RR 0.95; 95% CI 0.64 to 1.40) and hospital readmission (RR 0.96; 95% CI 0.66 to 1.40). Consequently, compared with conventional strategy, CCTA seemed not to improve clinical outcomes for patients with low-to-intermediate risk chest pain.
authors.affiliation: Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yuqi
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Zhaofang
authors.initials: Z
authors.lastname: Yin
authors.affiliation: Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Huili
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Han
authors.affiliation: Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Changqian
authors.initials: C
authors.lastname: Wang
mesh_terms: D002637:Chest Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D010359:Patient Readmission; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: chest pain; coronary computed tomographic angiography; coronary heart disease; functional test; meta-analysis