Using CT Angiography for Chest Pain in Intermediate-risk Patients
Randomized Evaluation of Coronary Computed Tomographic Angiography in Intermediate-risk Patients Presenting to the Emergency Department With Chest Pain
This study is testing if using a special heart scan early on can help people with chest pain who are at moderate risk feel better and avoid serious heart problems.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 1600 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Karolinska Institutet Academic / other |
| Locations | 1 site (Stockholm) |
| Trial ID | NCT04748237 on ClinicalTrials.gov |
What this trial studies
This study aims to evaluate whether early coronary computed tomographic angiography (CCTA) can improve outcomes for intermediate-risk patients presenting to the Emergency Department with chest pain. Patients will be randomized to receive either an early CCTA or standard care without it. The primary goal is to assess if the CCTA strategy reduces the risk of death, readmission due to myocardial infarction, or unstable angina requiring revascularization. All patients will receive optimal preventive care according to current guidelines.
Who should consider this trial
Good fit: Ideal candidates are adults aged 18 and older who present to the Emergency Department with chest pain and a HEART-score greater than 3.
Not a fit: Patients with acute myocardial infarction, known obstructive coronary artery disease, or clear alternative diagnoses may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could lead to better management and outcomes for patients with chest pain and intermediate risk of coronary artery disease.
How similar studies have performed: Other studies have shown promising results with similar diagnostic strategies, suggesting potential for success in this approach.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: 1. Age≥18 years. 2. Within 24 hours from presenting to the ED with chest pain or other symptoms suggestive of coronary artery disease (CAD) 3. HEART-score \>3 (according to http://www.heartscore.nl/) 4. Written informed consent obtained Exclusion Criteria: 1. Any condition that may influence the patient's ability to comply with study protocol. 2. Acute MI 3. Known obstructive CAD (\>50%) or previous PCI or CABG. 4. Clear alternative diagnosis 5. Estimated glomerular filtration rate (eGFR) \< 30 ml/min/1.73m2 6. Major allergy to iodinated contrast media 7. Circumstances making high quality images unlikely. 8. Not a Swedish resident with a personal ID-number. 9. Pregnancy or breast feeding 10. Further investigation for CAD not indicated, due to limited life expectancy, quality of life or functional status 11. Previous inclusion in the trial
Where this trial is running
Stockholm
- Danderyd Hospital — Stockholm, Sweden (Recruiting)
Study contacts
- Principal investigator: Tomas Jernberg, PhD — Karolinska Institutet
- Study coordinator: Liselotte Persson, RN
- Email: Liselotte.Persson@sll.se
- Phone: +46812355000
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.