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Noninvasive Cardiac Testing vs Clinical Evaluation Alone in Acute Chest Pain

The incremental benefit of noninvasive testing in addition to clinical evaluation vs clinical evaluation alone for patients who present to the emergency department (ED) with acute chest pain is unknown.

Researchers examined differences in outcomes with clinical evaluation and noninvasive testing (coronary computed tomographic angiography [CCTA] or stress testing) vs clinical evaluation alone.

This study was a retrospective analysis of data from the randomized multicenter Rule Out Myocardial Ischemia/Infarction. Data for 1000 patients who presented with chest pain to the EDs at 9 hospitals in the United States were evaluated.

In conclusion in patients presenting to the ED with acute chest pain, noninvasive cardiac testing in addition to clinical evaluation leads to longer stay, more downstream testing,more radiation exposure, and greater cost without evidence of improving clinical outcomes.

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