CT-FIRST: Cardiac Computed Tomography Versus Stress Imaging For Initial Risk STratification

Status unconfirmed · Not applicable

Conditions studied: Coronary Artery Disease, Chest Pain, Coronary Atherosclerosis, Stress Testing

In brief

In patients with chest pain or shortness of breath who are referred for stress imaging tests (either stress echocardiography or stress nuclear testing), the investigators seek to compare impact of using cardiac CT scans of the heart arteries to the stress test that their doctors ordered.

Key facts

Study ID

NCT01061398

Run by

Walter Reed Army Medical Center

People needed

240

Starts

2007-11-01

Expected to finish

2012-12-01

Last updated by the study team

2012-06-28

Who can join

Age: 18 and older, up to 70. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age between 18 and 70 years of age at time of enrollment.
• Chest pain or anginal equivalent symptoms possibly suggestive of symptomatic coronary artery disease
• Low-intermediate risk (<75% pretest probability) for symptomatic coronary artery disease on basis of age, sex, and quality of reported symptom as classified by the Diamond and Forrester scheme.
• Referred for a either a stress echocardiogram or a nuclear stress perfusion study.
• Ability to provide informed consent.

You may not qualify if…

• Presence of known pre-existing coronary artery disease (known prior myocardial infarction, ECG evidence of prior infarction, prior angiographic evidence of significant coronary artery disease, history of prior coronary revascularization).
• Previous outpatient or inpatient evaluation for coronary artery disease to include exercise treadmill testing, stress echocardiography or nuclear myocardial perfusion studies within the last 24 months.
• Presence of signs or symptoms that are clearly compatible with non-cardiac chest pain, including musculoskeletal, gastrointestinal or neuropathic causes.
• Renal insufficiency (creatinine >1.5mg/dl) or renal failure requiring dialysis.
• Baseline heart rate > 100bpm, atrial fibrillation or other markedly irregular rhythm (frequent ectopy, multifocal atrial tachycardia) on baseline ECG.
• Pregnancy or unknown pregnancy status.
• Known allergy to iodinated contrast.
• Inability to tolerate beta-blocking drugs, including patients with reactive airways disease requiring maintenance inhaled bronchodilators or steroids, complete heart block or second-degree atrioventricular block.
• Patients with hyperthyroidism including Grave's disease and toxic multinodular goiter
• Computed tomography imaging or iodinated contrast administration over 50 ml, within the past 48 hours.
• Inability to withhold ingestion of metformin or commonly used erectile dysfunction medications (Viagra, Cialis, Levitra) for 48 hours prior to and following MSCT scan.

Where it is running

• Walter Reed Army Medical Center — Washington D.C., District of Columbia, United States

Full record on ClinicalTrials.gov

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