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High-Tech CT Scan May Get People With Chest Pain Home Faster
Date:7/26/2012

troponin test missed. A doctor can also choose to discharge a patient with instructions to follow up with their own physician and get a stress test within three days of discharge, according to Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.

"These are difficult cases. It's these low-to-intermediate risk patients that we're most concerned about, and a lot of doctors are hesitant to send patients home without imaging or stress testing, because you don't want to miss a potential heart attack," Glatter said. He added that doctors may also choose to just send patients home, because most of this group won't have heart disease.

A more recent option is CCTA. This test uses advanced CT scanning technology combined with the use of an intravenously administered contrast material to provide doctors with detailed images of the blood vessels supplying the heart. Using this technology allows doctors to see if there is any plaque buildup in the blood vessels leading to the heart that could be limiting the supply of blood reaching the heart.

In the current study, Hoffmann and his colleagues randomly assigned 1,000 people to receive either early CCTA testing or to a standard evaluation. All participants were being seen in an emergency department for chest pain. None had EKG changes or elevated troponin levels. All were between the ages of 40 and 74, with an average age of 54. Forty-seven percent were women.

For those who had CCTA as part of their initial evaluation, the average length of their hospital stay was reduced by 7.6 hours. The study also found that more patients -- 47 percent -- were discharged from the emergency department compared with 12 percent of the group who received a standard evaluation.

The researchers followed up with participants from each group at 28 days and found no differences in the rate of major adverse heart events between the groups.

Not surprisingly, the CCTA group had higher
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