After ruling out a myocardial infarction (MI) in patients with suspected acute coronary syndrome (ACS), routine use of CT coronary angiography to guide management did not reduce subsequent cardiac events compared with standard care, results of a randomized trial showed.
Over a median of 3 years in the TARGET-CTCA study, the primary composite outcome of MI or death from a cardiac cause occurred in 7.1% of patients randomized to CT coronary angiography and in 7.3% of those in the standard-care group (adjusted HR 0.95, 95% CI 0.73-1.23, P=0.71), reported Nicholas Mills, MD, PhD, of the University of Edinburgh in Scotland.
The findings suggest that once an MI has been ruled out, "routine CT angiography may not be required in this setting," said Mills at the European Society of Cardiology (ESC) Congress in Munich. "Implementation of these trial findings could reduce healthcare costs and simplify care for patients without compromising future outcomes."
The results were published simultaneously in the New England Journal of Medicine.
ESC discussant Christoph Grani, MD, PhD, from Bern University Hospital in Switzerland, concluded that the results don't support routine CT after MI is ruled out, but added that "CT is a diagnostic test, not a treatment."
