Loading…
Sex Differences in the Effectiveness of Early Coronary Computed Tomographic Angiography Compared With Standard Emergency Department Evaluation for Acute Chest Pain: The Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II Trial
BACKGROUND—We evaluate sex-based differences in the effectiveness of early cardiac computed tomographic angiography (CCTA) and standard emergency department (ED) evaluation in patients with acute chest pain. METHODS AND RESULTS—In the Rule-Out Myocardial Infarction With Computer-Assisted Tomography...
Saved in:
| Published in: | Circulation (New York, N.Y.) N.Y.), 2013-06, Vol.127 (25), p.2494-2502 |
|---|---|
| Main Authors: | , , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | |
|---|---|
| cites | cdi_FETCH-LOGICAL-c3456-f04432a53be62ce6aa8de512e4b2c6e03dfb0fdab396252994e318bdb29fe0423 |
| container_end_page | 2502 |
| container_issue | 25 |
| container_start_page | 2494 |
| container_title | Circulation (New York, N.Y.) |
| container_volume | 127 |
| creator | Truong, Quynh A Hayden, Douglas Woodard, Pamela K Kirby, Ruth Chou, Eric T Nagurney, John T Wiviott, Stephen D Fleg, Jerome L Schoenfeld, David A Udelson, James E Hoffmann, Udo |
| description | BACKGROUND—We evaluate sex-based differences in the effectiveness of early cardiac computed tomographic angiography (CCTA) and standard emergency department (ED) evaluation in patients with acute chest pain.
METHODS AND RESULTS—In the Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II multicenter, controlled trial, we randomized 1000 patients (47% women) 40 to 74 years of age with symptoms suggestive of acute coronary syndrome to an early CCTA or standard ED evaluation. In this prespecified analysis, women in the CCTA arm had a greater reduction in length of stay, lower hospital admission rates, and lesser increased cumulative radiation dose than men in a comparison of ED strategies (P for interaction ≤0.02). Although women had lower acute coronary syndrome rates than men (3% versus 12%; P |
| doi_str_mv | 10.1161/CIRCULATIONAHA.113.001736 |
| format | article |
| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1161_CIRCULATIONAHA_113_001736</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>23685743</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3456-f04432a53be62ce6aa8de512e4b2c6e03dfb0fdab396252994e318bdb29fe0423</originalsourceid><addsrcrecordid>eNqNkU9v1DAQxSMEokvhK6DhgASHFMdOshukHqI00EhbFm1TcYwcZ7wx5M_Kdlr2u3PAbRZQb5xsj3_vzdOM570JyFkQxMGHrNhmN-u0LDZf0svU1dgZIcGSxU-8RRDR0A8jljz1FoSQxF8ySk-8F8Z8d8-YLaPn3gll8Spahmzh_brGn3ChpESNg0ADagDbIuSuIqy6xQGNgVFCznV3gGzU48D1_aXfTxYbKMd-3Gm-b5WAdNip-TEDXDvgm7ItXFs-NFw3kPeod67TAS7Q_dseBwv5Le8mbtU4gBw1pMI5Q9aisfCVq-EjlC7RdurQ30wWrg6jcFaKd1AMkmvxIHxoc0yl_dQYZR7FO8C77eaqyNLyvV8UUGqnf-k9k7wz-Op4nno3n_Iyu_TXm8-OXPuChVHsSxKGjPKI1RhTgTHnqwajgGJYUxEjYY2siWx4zZKYRjRJQmTBqm5qmkgkIWWnXjL7Cj0ao1FWe616N8YqINX9RqvHG3U1Vs0bddrXs3Y_1T02f5V_VuiAt0eAG8E7qfkglPnHLSNnFBPHnc_c3di5EZkf3XSHumqRd7b9jyC_ARrVw-o</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Sex Differences in the Effectiveness of Early Coronary Computed Tomographic Angiography Compared With Standard Emergency Department Evaluation for Acute Chest Pain: The Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II Trial</title><source>Free E-Journal (出版社公開部分のみ）</source><creator>Truong, Quynh A ; Hayden, Douglas ; Woodard, Pamela K ; Kirby, Ruth ; Chou, Eric T ; Nagurney, John T ; Wiviott, Stephen D ; Fleg, Jerome L ; Schoenfeld, David A ; Udelson, James E ; Hoffmann, Udo</creator><creatorcontrib>Truong, Quynh A ; Hayden, Douglas ; Woodard, Pamela K ; Kirby, Ruth ; Chou, Eric T ; Nagurney, John T ; Wiviott, Stephen D ; Fleg, Jerome L ; Schoenfeld, David A ; Udelson, James E ; Hoffmann, Udo</creatorcontrib><description>BACKGROUND—We evaluate sex-based differences in the effectiveness of early cardiac computed tomographic angiography (CCTA) and standard emergency department (ED) evaluation in patients with acute chest pain.
METHODS AND RESULTS—In the Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II multicenter, controlled trial, we randomized 1000 patients (47% women) 40 to 74 years of age with symptoms suggestive of acute coronary syndrome to an early CCTA or standard ED evaluation. In this prespecified analysis, women in the CCTA arm had a greater reduction in length of stay, lower hospital admission rates, and lesser increased cumulative radiation dose than men in a comparison of ED strategies (P for interaction ≤0.02). Although women had lower acute coronary syndrome rates than men (3% versus 12%; P<0.0001), sex differences in length of stay persisted after adjustment for baseline differences, including acute coronary syndrome rate (P for interaction <0.03). Length of stay was similar between sexes with normal CCTA findings (P=0.11). There was no missed acute coronary syndrome for either sex. No difference was observed in major adverse cardiac events between sexes and ED strategies (P for interaction =0.39). Women had more normal CCTA examinations than men (58% versus 37%; P<0.0001), less obstructive coronary disease by CCTA (5% versus 17%; P=0.0001), but similar normalcy rates for functional testing (P=0.65). Men in the CCTA arm had the highest rate of invasive coronary angiography (18%), whereas women had comparable low 5% rates regardless of ED strategy.
CONCLUSIONS—This trial provides data supporting an early CCTA strategy as an attractive option in women presenting to the ED with symptoms suggestive of acute coronary syndrome. The findings may be explained by lower CAD prevalence and severity in women than men.
CLINICAL TRIAL REGISTRATION—URLhttp://www.clinicaltrials.gov. Unique identifierNCT01084239.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.113.001736</identifier><identifier>PMID: 23685743</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: American Heart Association, Inc</publisher><subject>Acute Coronary Syndrome - diagnosis ; Acute Coronary Syndrome - diagnostic imaging ; Acute Coronary Syndrome - epidemiology ; Acute Disease ; Adult ; Aged ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cardiovascular system ; Chest Pain - diagnosis ; Chest Pain - diagnostic imaging ; Chest Pain - epidemiology ; Coronary Angiography ; Coronary heart disease ; Diagnosis, Differential ; Diagnostic Tests, Routine ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Emergency Service, Hospital ; Female ; Heart ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - diagnosis ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - epidemiology ; Myocarditis. Cardiomyopathies ; Prevalence ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Severity of Illness Index ; Tomography, X-Ray Computed</subject><ispartof>Circulation (New York, N.Y.), 2013-06, Vol.127 (25), p.2494-2502</ispartof><rights>2013 American Heart Association, Inc.</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3456-f04432a53be62ce6aa8de512e4b2c6e03dfb0fdab396252994e318bdb29fe0423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27501760$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23685743$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Truong, Quynh A</creatorcontrib><creatorcontrib>Hayden, Douglas</creatorcontrib><creatorcontrib>Woodard, Pamela K</creatorcontrib><creatorcontrib>Kirby, Ruth</creatorcontrib><creatorcontrib>Chou, Eric T</creatorcontrib><creatorcontrib>Nagurney, John T</creatorcontrib><creatorcontrib>Wiviott, Stephen D</creatorcontrib><creatorcontrib>Fleg, Jerome L</creatorcontrib><creatorcontrib>Schoenfeld, David A</creatorcontrib><creatorcontrib>Udelson, James E</creatorcontrib><creatorcontrib>Hoffmann, Udo</creatorcontrib><title>Sex Differences in the Effectiveness of Early Coronary Computed Tomographic Angiography Compared With Standard Emergency Department Evaluation for Acute Chest Pain: The Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II Trial</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>BACKGROUND—We evaluate sex-based differences in the effectiveness of early cardiac computed tomographic angiography (CCTA) and standard emergency department (ED) evaluation in patients with acute chest pain.
METHODS AND RESULTS—In the Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II multicenter, controlled trial, we randomized 1000 patients (47% women) 40 to 74 years of age with symptoms suggestive of acute coronary syndrome to an early CCTA or standard ED evaluation. In this prespecified analysis, women in the CCTA arm had a greater reduction in length of stay, lower hospital admission rates, and lesser increased cumulative radiation dose than men in a comparison of ED strategies (P for interaction ≤0.02). Although women had lower acute coronary syndrome rates than men (3% versus 12%; P<0.0001), sex differences in length of stay persisted after adjustment for baseline differences, including acute coronary syndrome rate (P for interaction <0.03). Length of stay was similar between sexes with normal CCTA findings (P=0.11). There was no missed acute coronary syndrome for either sex. No difference was observed in major adverse cardiac events between sexes and ED strategies (P for interaction =0.39). Women had more normal CCTA examinations than men (58% versus 37%; P<0.0001), less obstructive coronary disease by CCTA (5% versus 17%; P=0.0001), but similar normalcy rates for functional testing (P=0.65). Men in the CCTA arm had the highest rate of invasive coronary angiography (18%), whereas women had comparable low 5% rates regardless of ED strategy.
CONCLUSIONS—This trial provides data supporting an early CCTA strategy as an attractive option in women presenting to the ED with symptoms suggestive of acute coronary syndrome. The findings may be explained by lower CAD prevalence and severity in women than men.
CLINICAL TRIAL REGISTRATION—URLhttp://www.clinicaltrials.gov. Unique identifierNCT01084239.</description><subject>Acute Coronary Syndrome - diagnosis</subject><subject>Acute Coronary Syndrome - diagnostic imaging</subject><subject>Acute Coronary Syndrome - epidemiology</subject><subject>Acute Disease</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular system</subject><subject>Chest Pain - diagnosis</subject><subject>Chest Pain - diagnostic imaging</subject><subject>Chest Pain - epidemiology</subject><subject>Coronary Angiography</subject><subject>Coronary heart disease</subject><subject>Diagnosis, Differential</subject><subject>Diagnostic Tests, Routine</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Emergency Service, Hospital</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Prevalence</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Severity of Illness Index</subject><subject>Tomography, X-Ray Computed</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNqNkU9v1DAQxSMEokvhK6DhgASHFMdOshukHqI00EhbFm1TcYwcZ7wx5M_Kdlr2u3PAbRZQb5xsj3_vzdOM570JyFkQxMGHrNhmN-u0LDZf0svU1dgZIcGSxU-8RRDR0A8jljz1FoSQxF8ySk-8F8Z8d8-YLaPn3gll8Spahmzh_brGn3ChpESNg0ADagDbIuSuIqy6xQGNgVFCznV3gGzU48D1_aXfTxYbKMd-3Gm-b5WAdNip-TEDXDvgm7ItXFs-NFw3kPeod67TAS7Q_dseBwv5Le8mbtU4gBw1pMI5Q9aisfCVq-EjlC7RdurQ30wWrg6jcFaKd1AMkmvxIHxoc0yl_dQYZR7FO8C77eaqyNLyvV8UUGqnf-k9k7wz-Op4nno3n_Iyu_TXm8-OXPuChVHsSxKGjPKI1RhTgTHnqwajgGJYUxEjYY2siWx4zZKYRjRJQmTBqm5qmkgkIWWnXjL7Cj0ao1FWe616N8YqINX9RqvHG3U1Vs0bddrXs3Y_1T02f5V_VuiAt0eAG8E7qfkglPnHLSNnFBPHnc_c3di5EZkf3XSHumqRd7b9jyC_ARrVw-o</recordid><startdate>20130625</startdate><enddate>20130625</enddate><creator>Truong, Quynh A</creator><creator>Hayden, Douglas</creator><creator>Woodard, Pamela K</creator><creator>Kirby, Ruth</creator><creator>Chou, Eric T</creator><creator>Nagurney, John T</creator><creator>Wiviott, Stephen D</creator><creator>Fleg, Jerome L</creator><creator>Schoenfeld, David A</creator><creator>Udelson, James E</creator><creator>Hoffmann, Udo</creator><general>American Heart Association, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20130625</creationdate><title>Sex Differences in the Effectiveness of Early Coronary Computed Tomographic Angiography Compared With Standard Emergency Department Evaluation for Acute Chest Pain: The Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II Trial</title><author>Truong, Quynh A ; Hayden, Douglas ; Woodard, Pamela K ; Kirby, Ruth ; Chou, Eric T ; Nagurney, John T ; Wiviott, Stephen D ; Fleg, Jerome L ; Schoenfeld, David A ; Udelson, James E ; Hoffmann, Udo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3456-f04432a53be62ce6aa8de512e4b2c6e03dfb0fdab396252994e318bdb29fe0423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Acute Coronary Syndrome - diagnosis</topic><topic>Acute Coronary Syndrome - diagnostic imaging</topic><topic>Acute Coronary Syndrome - epidemiology</topic><topic>Acute Disease</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular system</topic><topic>Chest Pain - diagnosis</topic><topic>Chest Pain - diagnostic imaging</topic><topic>Chest Pain - epidemiology</topic><topic>Coronary Angiography</topic><topic>Coronary heart disease</topic><topic>Diagnosis, Differential</topic><topic>Diagnostic Tests, Routine</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Emergency Service, Hospital</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial Infarction - epidemiology</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Prevalence</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Severity of Illness Index</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Truong, Quynh A</creatorcontrib><creatorcontrib>Hayden, Douglas</creatorcontrib><creatorcontrib>Woodard, Pamela K</creatorcontrib><creatorcontrib>Kirby, Ruth</creatorcontrib><creatorcontrib>Chou, Eric T</creatorcontrib><creatorcontrib>Nagurney, John T</creatorcontrib><creatorcontrib>Wiviott, Stephen D</creatorcontrib><creatorcontrib>Fleg, Jerome L</creatorcontrib><creatorcontrib>Schoenfeld, David A</creatorcontrib><creatorcontrib>Udelson, James E</creatorcontrib><creatorcontrib>Hoffmann, Udo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Truong, Quynh A</au><au>Hayden, Douglas</au><au>Woodard, Pamela K</au><au>Kirby, Ruth</au><au>Chou, Eric T</au><au>Nagurney, John T</au><au>Wiviott, Stephen D</au><au>Fleg, Jerome L</au><au>Schoenfeld, David A</au><au>Udelson, James E</au><au>Hoffmann, Udo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex Differences in the Effectiveness of Early Coronary Computed Tomographic Angiography Compared With Standard Emergency Department Evaluation for Acute Chest Pain: The Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II Trial</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2013-06-25</date><risdate>2013</risdate><volume>127</volume><issue>25</issue><spage>2494</spage><epage>2502</epage><pages>2494-2502</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>BACKGROUND—We evaluate sex-based differences in the effectiveness of early cardiac computed tomographic angiography (CCTA) and standard emergency department (ED) evaluation in patients with acute chest pain.
METHODS AND RESULTS—In the Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II multicenter, controlled trial, we randomized 1000 patients (47% women) 40 to 74 years of age with symptoms suggestive of acute coronary syndrome to an early CCTA or standard ED evaluation. In this prespecified analysis, women in the CCTA arm had a greater reduction in length of stay, lower hospital admission rates, and lesser increased cumulative radiation dose than men in a comparison of ED strategies (P for interaction ≤0.02). Although women had lower acute coronary syndrome rates than men (3% versus 12%; P<0.0001), sex differences in length of stay persisted after adjustment for baseline differences, including acute coronary syndrome rate (P for interaction <0.03). Length of stay was similar between sexes with normal CCTA findings (P=0.11). There was no missed acute coronary syndrome for either sex. No difference was observed in major adverse cardiac events between sexes and ED strategies (P for interaction =0.39). Women had more normal CCTA examinations than men (58% versus 37%; P<0.0001), less obstructive coronary disease by CCTA (5% versus 17%; P=0.0001), but similar normalcy rates for functional testing (P=0.65). Men in the CCTA arm had the highest rate of invasive coronary angiography (18%), whereas women had comparable low 5% rates regardless of ED strategy.
CONCLUSIONS—This trial provides data supporting an early CCTA strategy as an attractive option in women presenting to the ED with symptoms suggestive of acute coronary syndrome. The findings may be explained by lower CAD prevalence and severity in women than men.
CLINICAL TRIAL REGISTRATION—URLhttp://www.clinicaltrials.gov. Unique identifierNCT01084239.</abstract><cop>Hagerstown, MD</cop><pub>American Heart Association, Inc</pub><pmid>23685743</pmid><doi>10.1161/CIRCULATIONAHA.113.001736</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0009-7322 |
| ispartof | Circulation (New York, N.Y.), 2013-06, Vol.127 (25), p.2494-2502 |
| issn | 0009-7322 1524-4539 |
| language | eng |
| recordid | cdi_crossref_primary_10_1161_CIRCULATIONAHA_113_001736 |
| source | Free E-Journal (出版社公開部分のみ） |
| subjects | Acute Coronary Syndrome - diagnosis Acute Coronary Syndrome - diagnostic imaging Acute Coronary Syndrome - epidemiology Acute Disease Adult Aged Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Cardiovascular system Chest Pain - diagnosis Chest Pain - diagnostic imaging Chest Pain - epidemiology Coronary Angiography Coronary heart disease Diagnosis, Differential Diagnostic Tests, Routine Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Emergency Service, Hospital Female Heart Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Myocardial Infarction - diagnosis Myocardial Infarction - diagnostic imaging Myocardial Infarction - epidemiology Myocarditis. Cardiomyopathies Prevalence Radiodiagnosis. Nmr imagery. Nmr spectrometry Severity of Illness Index Tomography, X-Ray Computed |
| title | Sex Differences in the Effectiveness of Early Coronary Computed Tomographic Angiography Compared With Standard Emergency Department Evaluation for Acute Chest Pain: The Rule-Out Myocardial Infarction With Computer-Assisted Tomography (ROMICAT)-II Trial |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T05%3A39%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-pubmed_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Sex%20Differences%20in%20the%20Effectiveness%20of%20Early%20Coronary%20Computed%20Tomographic%20Angiography%20Compared%20With%20Standard%20Emergency%20Department%20Evaluation%20for%20Acute%20Chest%20Pain:%20The%20Rule-Out%20Myocardial%20Infarction%20With%20Computer-Assisted%20Tomography%20(ROMICAT)-II%20Trial&rft.jtitle=Circulation%20(New%20York,%20N.Y.)&rft.au=Truong,%20Quynh%20A&rft.date=2013-06-25&rft.volume=127&rft.issue=25&rft.spage=2494&rft.epage=2502&rft.pages=2494-2502&rft.issn=0009-7322&rft.eissn=1524-4539&rft.coden=CIRCAZ&rft_id=info:doi/10.1161/CIRCULATIONAHA.113.001736&rft_dat=%3Cpubmed_cross%3E23685743%3C/pubmed_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3456-f04432a53be62ce6aa8de512e4b2c6e03dfb0fdab396252994e318bdb29fe0423%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_id=info:pmid/23685743&rfr_iscdi=true |