ECG-less CT angiogram for people with high-troponin chest pain
Official title: ECG-less Coronary Computed Tomography Angiography in the Management of Patients Presenting With High-troponin Chest Pain
Run by Universitair Ziekenhuis Brussel · NCT07192965 · Data updated 2026-11-12
This trial will test whether an ECG-less CT angiogram can quickly rule out life-threatening causes in people who come to the ER with chest pain and elevated troponin levels.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 30 Years and up |
| Sex | All |
| Enrollment | 230 (estimated) |
| Sponsor | Universitair Ziekenhuis Brussel Academic / other |
| Drugs / interventions | radiation |
| Locations | 1 site (Jette) |
| Status | Recruiting |
| Started | September 10, 2025 |
| Main results expected | September 2027 |
| Study ends | March 2028 |
| Registry record updated | September 25, 2025 |
| Trial ID | NCT07192965 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates are adults ≥30 years presenting to the ER with chest pain and either ECG abnormalities or elevated/observe-pathway hs‑cTnT per inclusion thresholds, who are hemodynamically stable and meet renal and consent criteria.
✕Probably not a fit
Patients who need urgent invasive angiography (ST‑elevation, hemodynamic or electrical instability, refractory pain), or who have prior CABG/stents, atrial fibrillation, severe renal failure, or contrast allergy are unlikely to benefit from this approach.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This interventional protocol enrolls adults presenting to the emergency room with chest pain and elevated troponin and uses a single-contrast, non‑ECG-gated coronary CT angiography (CCTA) protocol with reduced radiation to image the coronary arteries and thoracic causes of pain. Results from the ECG-less CCTA will be compared to the standard invasive coronary angiography (ICA) for diagnostic accuracy (negative and positive predictive values) in patients considered at risk for NSTEMI. The trial also compares the prognostic predictive value of CCTA versus ICA while following current guideline-directed clinical management and making PCI decisions based on ICA, physiology, and intravascular imaging. If diagnostic and prognostic performance are similar, the approach could allow some patients to avoid invasive angiography and shorten ED stays.
Why it matters
Potential benefit: If successful, ECG-less CCTA could safely identify patients with normal coronaries who can be discharged without invasive angiography, reducing procedural risks, contrast use, and time in the hospital.
How similar studies have gone: While CCTA has been used in chest pain settings and CT is established for PE/AAD, the specific use of ECG‑less, non‑gated CCTA for ACS diagnostic and prognostic purposes remains largely novel and not yet widely validated.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age ≥ 30 years old * Admission at the ER with acute chest pain and at least one of the follow-ing: 1. ECG abnormality; 2. positive rule-in criteria according to the ESC guidelines (hs-cTnT ≥ 52 in at least one assay or 1h ∆ ≥ 5); 3. troponine value in the "observe pathway" (hs-cTnT ≥ 12 in at least one assay or 1h ∆ ≥ 3) AND a high clinical suspicion of MI. Exclusion Criteria: * Indication for urgent ICA (ST-elevation, hemodynamic or electric instabil-ity, refractory chest pain, mechanical complications) * eGFR \< 30 ml/min * Previous coronary stenting * Previous CABG * Recent ACS within 6 months * Known severely reduced ejection fraction (EF \< 30%) * Contrast allergy * Inability to provide informed consent * Limited life expectancy \< 2 years due to non-cardiac conditions * Pregnant and breast-feeding women * Known congenital heart disease * Atrial fibrillation
Where it's running
-
Universitair Ziekenhuis Brussel
Jette, Belgium Recruiting
Study contacts
- Study coordinator: Francesco Giangiacomi, Medical Doctor
- Email: francesco.giangiacomi@uzbrussel.be
- Phone: 0039 3347165451
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.