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- Khaled Alfakih, John P Greenwood, and Sven Plein.
- Department of Cardiology, University Hospital Lewisham, London, UK; khaled.alfakih@nhs.net.
- Clin Med (Lond). 2017 Jun 1; 17 (3): 209211209-211.
AbstractThe National Institute for Health and Care Excellence (NICE) published an update on its guideline on chest pain of recent onset in 2016. The new guideline makes three key changes to the 2010 version. NICE recommend that the previously proposed pre-test probability risk score should no longer be used. They also recommend that a calcium score of zero should no longer be used to rule out coronary artery disease in patients with low pre-test probability. However, the most radical change is that NICE now recommend that all patients with new onset chest pain should be investigated with a computerised tomography coronary angiogram as a first-ine investigation. We discuss the recent trial evidence that has informed the NICE update and consider the impact of the new guidelines.© Royal College of Physicians 2017. All rights reserved.
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