Computed Tomography Coronary Angiogram (CTCA) Versus Traditional Care in Emergency Department Assessment of Potential Acute Coronary Syndromes (ACS)

Completed · Not applicable

Conditions studied: Chest Pain, Acute Coronary Syndrome, Acute Myocardial Infarction, Coronary Artery Disease

In brief

This multi-center, randomized, controlled trial conducted in Emergency Departments (ED) compares computed tomography (CT) coronary angiography with the traditional approach (usual care) for low- to intermediate-risk chest pain patients. The primary objective is to estimate the rate of major cardiac events (heart attack or cardiac death) within 30 days in trial participants in Group B who were not found to have significant coronary artery disease by CT coronary angiography. Additional evaluations will comprise health care utilization assessments, including length of hospital stay and re-admissions, cost analysis, and 1-year post-triage/presentation major cardiac event rates.

Key facts

Study ID

NCT00933400

Run by

American College of Radiology

People needed

1392

Starts

2009-07-01

Expected to finish

2012-04-01

Last updated by the study team

2024-03-06

Who can join

Age: 30 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Participant is 30 years of age or older
• Participant presents with complaints consistent with potential ACS (e.g., chest pain, shortness of breath, other)
• Participant requires admission or objective testing to exclude ACS
• Participant with initial ECG result without acute ischemia
• Participant with an initial Thrombolysis in Myocardial Infarction (TIMI) Risk Score of 0 to 2
• Participant is willing to provide a written informed consent

You may not qualify if…

• Patients who present with symptoms that are clearly not cardiac in origin (e.g., chest pain secondary to herpes zoster, obvious pneumonia, or recent trauma);
• Patients with no initial ECG performed in the ED
• Patients with ST-elevation myocardial infarction (STEMI)
• Patients with existing co-morbidity that requires admission regardless of presence of ACS (e.g., uncontrolled diabetes)
• Patients with known contraindications to CT coronary angiography: Iodinated contrast allergic-like reaction
• Patients who are known to have had CT coronary angiography in the year prior to presentation
• Patients who are known to have normal catheterization results (no or minimal, < 25%, stenosis) in the year prior to presentation
• Patients who are pregnant
• Patients with known renal insufficiency (e.g., creatinine clearance < 60 mL/min/1.73 m2)
• Patients with no telephone or cell phone numbers (preventing follow up)
• Patients unwilling to provide a written informed consent

Where it is running

• Wake Forest University Baptist Medical Center — Winston-Salem, North Carolina, United States
• Penn State Hershey - Milton S. Hershey Medical Center — Hershey, Pennsylvania, United States
• Penn-Presbyterian Medical Center — Philadelphia, Pennsylvania, United States
• University of Pennsylvania Health System — Philadelphia, Pennsylvania, United States
• University of Pittsburgh Medical Center — Pittsburgh, Pennsylvania, United States

Full record on ClinicalTrials.gov

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