MedicalResearch.com Interview with:
David L. Brown, MD, FACC
Professor of Medicine
Washington University School of Medicine
St. Louis, MO 63110
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Approximately 10 million patients present to emergency rooms in the US annually for evaluation of acute chest pain.
The goal of that evaluation is to rule out the diagnosis of an acute heart attack. Imaging with coronary CT angiography and stress testing are not part of the diagnostic algorithm for acute heart attack. Nevertheless many chest pain patients undergo some form of noninvasive cardiac testing in the ER. We found that CCTA or stress testing adding nothing to the care of chest pain patients beyond what is achieved by a history, physical examination, ECG and troponin test.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Noninvasive testing of chest pain patients in the ER increases cost, length of stay, downstream testing and radiation exposure with no benefit.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: We would like to see a randomized controlled trial to definitively address this issue.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Reinhardt SW, Lin C, Novak E, Brown DL. Noninvasive Cardiac Testing vs Clinical Evaluation Alone in Acute Chest Pain A Secondary Analysis of the ROMICAT-II Randomized Clinical Trial. JAMA Intern Med. Published online November 14, 2017. doi:10.1001/jamainternmed.2017.7360
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