Among Low-Risk Patients, Does Functional Testing Decrease Referrals for Invasive Coronary Angiography Compared With Coronary Computed Tomographic Angiography?

Of 19,674 potentially relevant studies identified, authors included 18 trials (11,329 patients) evaluating patients at low risk for acute coronary syndrome. The meta-analysis included 6 different imaging modalities. In patients with low risk of acute coronary syndrome, several diagnostic tests were associated with fewer invasive referrals for angiography compared with coronary CT angiography, including stress echocardiography (OR 0.28; 95% CI 0.14 to 0.57), cardiovascular MRI (OR 0.32; 95% CI 0.15 to 0.71), and exercise ECG (OR 0.53; 95% CI 0.28 to 1.00).

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