Pagidipati NJ, et al. - Among the participants of the PROMISE trial, including 4,720 women and 4,246 men randomized to CT angiography vs stress testing, researchers analyzed sex-based variations in noninvasive testing (NIT) results and subsequent clinical management. They used logistic regression models and Cox regression models for this purpose. Normal NITs were detected more frequently in women vs men. Also, referral to catheterization or to receive statin therapy was less likely to be reported for women with abnormalities on NIT. Obstructive coronary artery disease (40.8% vs 60.9%) was detected among fewer women than men, of those who had catheterization within 90 days of randomization (358 women, 534 men). When indicated, women vs men were remarkably less likely to report statin use but were similarly likely to report aspirin use at a 60-day visit. On account of high rates of negative NIT observed in women plus better outcomes compared with men, a sex-specific algorithm to guide NIT and chest pain management is required.