Curie Brief
Turn on cookies to sign in
Signing in saves your progress to your Curie account. We can only do that with cookies on — turn them on to continue.
News
Routine coronary CT angiography (CCTA) doesn't move the needle for chest pain patients already cleared of a heart attack. The TARGET-CTCA trial, published in the NEJM, found no significant difference in cardiovascular death or MI rates between patients who got CCTA and those who received standard care over 3 years. Skipping routine scans in this group could cut costs and simplify care without compromising outcomes.
For patients who show up to the ER with chest pain but are cleared of a heart attack, the next step has long been debated — should they get a coronary CT angiography (CCTA) scan just to be safe? The TARGET-CTCA trial, presented at the European Society of Cardiology Congress and published in the New England Journal of Medicine, now has a clear answer: probably not.
The randomized trial enrolled 3,170 intermediate-risk patients from 14 U.K. hospitals. Half were assigned to CCTA-guided outpatient care; the other half received standard care. After a median follow-up of 3 years, rates of cardiovascular death or MI were nearly identical — 7.1% in the CCTA group vs. 7.3% in the standard care group — a difference that was not statistically significant.
Notably, CCTA did reveal coronary artery disease in many patients (23% had severe CAD, 42% had mild-to-moderate CAD), and it led to modestly higher use of statins and antiplatelets. But those medication upticks didn't translate into better outcomes.
Key Takeaways:
Why it matters: Millions of chest pain patients are evaluated in emergency departments each year. This trial suggests that once MI is confidently ruled out, routine coronary imaging may be unnecessary — potentially saving significant healthcare costs and streamlining care without putting patients at risk.
