Coronary computed tomographic angiography for patients with low-to-intermediate risk chest pain: A systematic review and meta-analysis

Oncotarget. 2017 Jan 10;8(2):2096-2103. doi: 10.18632/oncotarget.13782.


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.

Keywords: chest pain; coronary computed tomographic angiography; coronary heart disease; functional test; meta-analysis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Chest Pain / diagnosis*
  • Chest Pain / epidemiology
  • Chest Pain / etiology*
  • Coronary Angiography / methods*
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / pathology
  • Humans
  • Patient Readmission
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Risk Factors
  • Tomography, X-Ray Computed / methods*