| Title |
Coronary Computed Tomography Angiography Versus Stress Echocardiography in Acute Chest Pain A Randomized Controlled Trial
|
|---|---|
| Published in |
JACC: Cardiovascular Imaging, June 2018
|
| DOI | 10.1016/j.jcmg.2018.03.024 |
| Pubmed ID | |
| Authors |
Jeffrey M Levsky, Linda B Haramati, Daniel M Spevack, Mark A Menegus, Terence Chen, Sarah Mizrachi, Durline Brown-Manhertz, Samantha Selesny, Rikah Lerer, Deborah J White, Jonathan N Tobin, Cynthia C Taub, Mario J Garcia |
| Abstract |
This study sought to compare early emergency department (ED) use of coronary computed tomography angiography (CTA) and stress echocardiography (SE) head-to-head. Coronary CTA has been promoted as the early ED chest pain triage imaging method of choice, whereas SE is often overlooked in this setting and involves no ionizing radiation. The authors randomized 400 consecutive low- to intermediate-risk ED acute chest pain patients without known coronary artery disease and a negative initial serum troponin level to immediate coronary CTA (n = 201) or SE (n = 199). The primary endpoint was hospitalization rate. Secondary endpoints were ED and hospital length of stay. Safety endpoints included cardiovascular events and radiation exposure. Mean patient age was 55 years, with 43% women and predominantly ethnic minorities (46% Hispanics, 32% African Americans). Thirty-nine coronary CTA patients (19%) and 22 SE patients (11%) were hospitalized at presentation (difference 8%; 95% confidence interval: 1% to 15%; p = 0.026). Median ED length of stay for discharged patients was 5.4 h (interquartile range [IQR]: 4.2 to 6.4 h) for coronary CTA and 4.7 h (IQR: 3.5 to 6.0 h) for SE (p < 0.001). Median hospital length of stay was 58 h (IQR: 50 to 102 h) for coronary CTA and 34 h (IQR: 31 to 54 h) for SE (p = 0.002). There were 11 and 7 major adverse cardiovascular events for coronary CTA and SE, respectively (p = 0.47), over a median 24 months of follow-up. Median/mean complete initial work-up radiation exposure was 6.5/7.7 mSv for coronary CTA and 0/0.96 mSv for SE (p < 0.001). The use of SE resulted in the hospitalization of a smaller proportion of patients with a shorter length of stay than coronary CTA and was safe. SE should be considered an appropriate option for ED chest pain triage (Stress Echocardiography and Heart Computed Tomography [CT] Scan in Emergency Department Patients With Chest Pain; NCT01384448). |
X Demographics
The data shown below were collected from the profiles of 132 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 27 | 20% |
| Spain | 10 | 8% |
| Mexico | 7 | 5% |
| United Kingdom | 7 | 5% |
| Argentina | 5 | 4% |
| Colombia | 3 | 2% |
| India | 3 | 2% |
| Netherlands | 3 | 2% |
| Italy | 3 | 2% |
| Other | 19 | 14% |
| Unknown | 45 | 34% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 85 | 64% |
| Scientists | 20 | 15% |
| Practitioners (doctors, other healthcare professionals) | 19 | 14% |
| Science communicators (journalists, bloggers, editors) | 8 | 6% |
Mendeley readers
The data shown below were compiled from readership statistics for 119 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 119 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 14 | 12% |
| Student > Bachelor | 11 | 9% |
| Other | 10 | 8% |
| Researcher | 10 | 8% |
| Student > Postgraduate | 7 | 6% |
| Other | 15 | 13% |
| Unknown | 52 | 44% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 38 | 32% |
| Nursing and Health Professions | 11 | 9% |
| Biochemistry, Genetics and Molecular Biology | 2 | 2% |
| Social Sciences | 2 | 2% |
| Economics, Econometrics and Finance | 2 | 2% |
| Other | 5 | 4% |
| Unknown | 59 | 50% |
Attention Score in Context
This research output has an Altmetric Attention Score of 109. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 January 2019.
All research outputs
#384,219
of 25,382,440 outputs
Outputs from JACC: Cardiovascular Imaging
#71
of 2,700 outputs
Outputs of similar age
#8,444
of 341,533 outputs
Outputs of similar age from JACC: Cardiovascular Imaging
#2
of 52 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,700 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.1. This one has done particularly well, scoring higher than 97% of its peers.
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We're also able to compare this research output to 52 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 96% of its contemporaries.