Efficacy Evaluation of Observation Unit Cardiac Magnetic Resonance Imaging (MRI) in Patients With Intermediate Risk Acute Chest Pain

Completed · Not applicable

Conditions studied: Acute Coronary Syndrome, Chest Pain

In brief

The purpose of this study is to investigate the best way to evaluate patients with chest pain in the emergency department. It compares types of cardiac tests performed while receiving treatment in an observation unit. Patients will either undergo cardiac MRI testing or conventional care testing. Patients treated in the conventional care testing group will undergo the testing their doctor determines is best for them. All patients will undergo follow up to find out if they have had any heart related events.

Key facts

Study ID

NCT00869245

Run by

Wake Forest University Health Sciences

People needed

124

Starts

2009-03-01

Expected to finish

2011-10-01

Last updated by the study team

2017-11-08

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age greater than or equal to 18 years
• Chest discomfort or other symptoms consistent with possible ACS
• TIMI risk score ≥ 1 or physician impression* of intermediate or high likelihood symptoms represent ACS
• Patient requires an inpatient or observation unit evaluation for their chest pain
• The treating physician feels the patient could be discharged home if cardiac disease was excluded
• ED attending feels patient is safe for observation unit care**

You may not qualify if…

• Initial troponin I > 1.0 ng/ml
• New ST-segment elevation (≥1mV) or depression (≥2 mV)
• Contra-indications to MRI (listed below)
• Unable to lie flat
• Hypotension (systolic < 90 mm Hg)
• Renal insufficiency (estimated GFR < 45 cc/min) or end stage renal disease
• Life expectancy less than 3 months
• Patient refusal of medical record review and follow-up at 30 days
• Pregnancy
• Liver, heart, or kidney transplant
• Chronic liver disease
• Unable to speak English or Spanish
• The ED attending feels that cardiac catheterization is indicated
• The ED care provider intends to order a CT coronary angiogram
• (*)Physicians are encouraged to use the 2007 ACC/AHA guidelines for the management of patients with NSTE ACS as a framework for this assessment.(1)
• (**)These patients should generally not be considered for observation unit care: PCI / CAGB in past 6 months, multiple stents, multiple prior MIs
• Contraindications to MRI: (Pacemaker, defibrillator, cerebral aneurysm clips, metallic ocular foreign body, implanted devices, claustrophobia)

Where it is running

• Wake Forest University Baptist Medical Center - Emergency Department — Winston-Salem, North Carolina, United States

Full record on ClinicalTrials.gov

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