In November 2016, the National Institute for Health and Care Excellence (NICE), the evidence-based organization that provides authoritative national guidance to improve health care quality in the United Kingdom (UK), updated its clinical guideline on the evaluation of patients with chest pain of recent onset.¹ On the basis of a thorough literature review, NICE updated the guideline to recommend coronary computed tomographic angiography (CCTA) as the initial test for all patients without known coronary artery disease (CAD) who present with atypical and typical angina, and for those with nonanginal chest pain who have an abnormal resting electrocardiogram. This dramatic change to national health care policy in the UK resonated across the Atlantic, where office-based single-photon emission computed tomography (SPECT) has served for decades as the dominant noninvasive test for CAD in the United States.

2016年11月，美国国立卫生与医疗保健研究院（NICE）以证据为基础，为英国（UK）提供权威的国家指导以改善医疗保健质量，该组织更新了其关于评估胸部疾病患者的临床指南最近发作的痛苦。^1个在全面的文献综述的基础上，NICE更新了指南，建议对所有已知且非典型性心绞痛和非心绞痛的无已知冠状动脉疾病（CAD）的患者推荐使用冠状动脉计算机断层血管造影（CCTA）作为初始检查静息心电图异常的胸痛。英国国家医疗保健政策的巨大变化在整个大西洋引起了共鸣，数十年来，基于办公室的单光子发射计算机断层扫描（SPECT）一直是美国CAD的主要非侵入性测试。