Early coronary CTA for suspected ACS not cost effective

In this large multi center trial of patients with suspected ACS, but with non-ischemic EKG and normal troponins, they were randomized to usual evaluation or coronary CTA. The mean LOS in the hospital was reduced by 7.6 hours with CTA, but there was no difference in the overall cost of care, and there was higher radiation exposure and downstream testing in those randomized to CTA. Overall, early CTA testing for suspected ACS increased radiation exposure with no reduction in overall cost of care (abstract)