Randomized Evaluation of Coronary Computed Tomographic Angiography in Intermediate-risk Patients Presenting to the Emergency Department With Chest Pain

Status: Recruiting
Location: See location...
Intervention Type: Diagnostic test
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

The aim is to determine whether a diagnostic strategy including early coronary computed tomographic angiography in intermediate-risk patients presenting to the Emergency Department with chest pain reduces the composite endpoint of death, readmission because of myocardial infarction or unstable angina requiring revascularization.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Age≥18 years.

• Within 24 hours from presenting to the ED with chest pain or other symptoms suggestive of coronary artery disease (CAD)

• HEART-score \>3 (according to http://www.heartscore.nl/)

• Written informed consent obtained

Locations
Other Locations
Sweden
Danderyd Hospital
RECRUITING
Stockholm
Contact Information
Primary
Liselotte Persson, RN
Liselotte.Persson@sll.se
+46812355000
Backup
Henrik Löfmark, MD
Henrik.Lofmark@sll.se
Time Frame
Start Date: 2021-01-21
Estimated Completion Date: 2025-12
Participants
Target number of participants: 1600
Treatments
Experimental: Coronary computed tomopraphic angiography
Patients randomized to strategy including early CCTA will receive standard care according to responsible physician and referred to a CCTA as soon as possible, preferably within 24 hours, but not later than within 21 days. Local scanning protocols can be used on ≥64-slice multi-detector CT scanners able to perform ECG-gated coronary angiography.~The coronary angiography will be classified as normal (or near normal) or as having atherosclerosis (CAD). The report will also classify each vessel (left main, prox LAD, mid or distal LAD, LCX and RCA regarding degree of stenosis (no stenosis, 0-49%, ≥50%, or not possible to estimate because of calcification or technical reason).~The result will be presented to the responsible physician as soon as possible and who will plan further care of the patients.
No_intervention: No Coronary computed tomopraphic angiography
Patients randomized to a strategy not including early CCTA will receive further care (including examinations) according to responsible physician but not include early CCTA. These patients will often undergo a non-invasive functional test, such as Exercise-ECG, stress echocardiography or nuclear imaging according to local routines, but not always.~Regardless of diagnostic strategy, the responsible physician is encouraged to initiate secondary prevention measures if the investigations indicate signs of CAD, including medication with aspirin and statins.
Sponsors
Leads: Karolinska Institutet

This content was sourced from clinicaltrials.gov