Abstract 16182: Diabetics With Acute Chest Pain Have Similar Length of ED Stay From Early CCTA Compared to Standard Evaluation but More Downstream Testing and Radiation Exposure: The ROMICAT II Trial

• Published in: Circulation (New York, N.Y.) N.Y.), 2014-11, Vol.130 (suppl_2)
• Main Authors: Truong, Quynh, Schulman-Marcus, Joshua, Zakroysky, Pearl, Chou, Eric T, Nagurney, John T, Wiviott, Stephen D, Fleg, Jerome L, Schoenfeld, David A, Udelson, James E, Hoffman, Udo, Woodard, Pamela K
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.130.suppl_2.16182

Abstract only Objective: In the evaluation of acute chest pain (ACP), early cardiac computed tomographic angiography reduces emergency department (ED) length of stay (LOS) compared with standard evaluation. It is unknown whether patients with diabetes mellitus (DM) have similar benefits. Methods: In the ROMICAT II multicenter trial, we randomized 1000 patients (17.3% DM) 40-74 years old with symptoms suggestive of acute coronary syndrome (ACS) but without ischemic ECG changes or initial positive troponin to early CCTA or standard ED evaluation. In this pre-specified analysis, we compared differences between the two strategies for the primary endpoint of LOS in DM and non-DM patients. Secondary endpoints were examined in Table 1. Results: ACS rate was similar between DM and non-DM (both 7.5%, p=1.0). DM (70% on oral hypoglycemics, 25% insulin) were older (57 vs 54 years) with more cardiac risk factors, though more frequently female (56%) and on cardiac medications than non-DM (all p