AIMS: To compare the effectiveness and safety of a cardiac computed tomography (CT) algorithm with functional testing in @entity1 with symptoms suggestive of @entity453 ( @entity453 ). METHODS AND RESULTS: Between April 2011 and July 2013, 350 @entity1 with @entity5749 , referred to the outpatient clinic of four Dutch hospitals, were prospectively randomized between cardiac CT and functional testing (2 : 1 ratio). The tiered cardiac CT protocol included a @entity460 scan followed by CT angiography if the Agatston @entity460 score was between 1 and 400. @entity1 with test-specific contraindications were not excluded from study participation. By 1 year, fewer @entity1 randomized to @entity299 (P = 0.012). The cumulative radiation dose was slightly higher in the CT group (6.6    8.7 vs. 6.1    9.3 @entity2073 ; P < 0.0001). After 1.2 years, event-free survival was 96.7% for @entity1 randomized to CT and 89.8% for @entity1 randomized to functional testing (P = 0.011). After CT, the final diagnosis was established sooner (P < 0.0001), and additional downstream testing was required less frequently (25 vs. 53%, P < 0.0001), resulting in lower cumulative diagnostic costs (   369 vs.    440; P < 0.0001). CONCLUSION: For @entity1 with suspected stable @entity453 , a tiered cardiac CT protocol offers an effective and safe alternative to functional testing. Incorporating the @entity460 scan into the diagnostic workup was safe and lowered diagnostic expenses and radiation exposure.

XXXX imaging and selective computed tomography angiography in comparison to functional testing for suspected @entity453 : the multicentre, randomized CRESCENT trial.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity5749 :: ('MESH:D060050', 'Disease') :: ['stable angina'] @entity2073 :: ('10821', 'Species') :: ['mSv'] @entity460 :: ('MESH:D002118', 'Chemical') :: ['calcium'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac CT reported anginal complaints'] @entity453 :: ('MESH:D003324', 'Disease') :: ['CAD', 'coronary artery disease']
@entity460 :: (MESH:D002118,Chemical) :: ['Calcium']
