PT  - JOURNAL ARTICLE
AU  - Khaled Alfakih
AU  - John P Greenwood
AU  - Sven Plein
TI  - The 2016 update to NICE CG95 guideline for the ­investigation of new onset stable chest pain: more ­innovation, but at a cost?
AID  - 10.7861/clinmedicine.17-3-209
DP  - 2017 Jun 01
TA  - Clinical Medicine
PG  - 209--211
VI  - 17
IP  - 3
4099  - http://www.rcpjournals.org/content/17/3/209.short
4100  - http://www.rcpjournals.org/content/17/3/209.full
SO  - Clin Med2017 Jun 01; 17
AB  - The 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.