Randomized controlled trials of imaging strategies for chest pain
Our recently completed multicenter randomized controlled trials have established the efficacy of a coronary CT angiography-based diagnostic strategy for chest pain. The ROMICAT II trial (n=1,000) found that a CT for acute chest pain resulted in improved efficiency of clinical decision making. The PROMISE trial (n=10,000) found that a CT diagnostic strategy resulted in similar outcomes to functional testing for stable chest pain. Our current efforts focus on whether coronary plaque morphology can predict which patients are at greatest risk.
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- Douglas PS, Hoffmann U, Patel MR, Mark DB, Al-Khalidi HR, Cavanaugh B, Cole J, Dolor RJ, Fordyce CB, Huang M, Khan MA, Kosinski AS, Krucoff MW, Malhotra V, Picard MH, Udelson JE, Velazquez EJ, Yow E, Cooper LS, Lee KL, PROMISE Investigators. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med 2015;372:1291–1300.
- Hoffmann U, Truong QA, Schoenfeld DA, Chou ET, Woodard PK, Nagurney JT, Pope JH, Hauser TH, White CS, Weiner SG, Kalanjian S, Mullins ME, Mikati I, Peacock WF, Zakroysky P, Hayden D, Goehler A, Lee H, Gazelle GS, Wiviott SD, Fleg JL, Udelson JE, ROMICAT-II Investigators. Coronary CT angiography versus standard evaluation in acute chest pain. N Engl J Med 2012;367:299–308.