422 Impact Of The 2021 Chest Pain Guideline On Coronary CTA Vs SPECT MPI Trends From A Multi-center Community Healthcare System

      Introduction: The 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain is a first for the AHA and ACC, intended for the diagnosis & evaluation of acute & stable chest pain. The guideline heralded a paradigm shift in the evaluation of chest pain, putting equal emphasis on anatomic diagnosis as well as functional testing. The use of coronary CT angiography received multiple Class I recommendations especially for the intermediate risk population. Our objective was to see if the publication of these guidelines impacted local practice in a multi-center community healthcare system.
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