Coronary Computed Tomography Angiography to Exclude Acute Coronary Syndrome in Low-Risk Chest Pain Patients

22 articles (13,617 patients) were retrieved. CCTA had strong diagnostic performance, with an excellent negative predictive value (99.8-100%) and sensitivity (94-100%) for ACS diagnosis and prediction of major adverse cardiovascular events. Specificity and positive predictive values were lower and less consistent. When combined with hs-cTn, the diagnostic accuracy of CCTA for ACS was improved significantly. CCTA was associated with low rates of ACS at follow-up (0-3.5%), which were lower than or comparable to the safety outcomes of standard care and stress testing.