Status:
COMPLETED
Coronary CT Angiography in Acute Chest Pain is a Cost Effective Risk Stratification Strategy
Lead Sponsor:
University of Texas Southwestern Medical Center
Conditions:
Acute Chest Pain
Eligibility:
All Genders
35+ years
Phase:
PHASE3
Brief Summary
This study will evaluate the impact of adding coronary computed tomographic angiography (CTA) on health care costs for diagnosing patients with acute chest pain.
Detailed Description
Background and Significance Standard-of-care risk-stratification algorithm (SOC): In the past 20 years since Goldman et al4 described a clinical algorithm to predict MI in ED patients, the clinical ...
Eligibility Criteria
Inclusion
- patients who complain of typical or atypical chest pain (that is compatible with ischemia during the past 12 hrs);
- patients a prediction of low to intermediate risk of myocardial infarction and/or complications according to established criteria;
- patients who have normal or non-diagnostic electrocardiograms;
- patients who have negative cardiac biomarker including creatine kinase-MB, myoglobin, and/or cardiac troponin I at initial testing; patients who require admission to the hospital by the EP at the time of risk-stratification;
- patients who require cardiology consultation in the ED 7. patients who are age 35 years or older;
- patients who are able to hold their breath for ≥ 15 seconds (to obtain a quality static anatomical image, scanning requires at least fifteen seconds of breath holding;
- patients who have heart rate of \< 70 beats per minute before or after the administration of beta-blocker medication
Exclusion
- patients who have a contraindication to iodinated and/ or beta-blocking drugs; patients who have compromised renal function defined as creatinine ≥ 1.2 mg/dl;
- patients who are pregnant, suspected pregnant or other vulnerable populations e.g., incarcerated patients;
- patients who have documented CAD by prior invasive coronary angiography or coronary CT angiography and/or patients with coronary artery stents, prior angioplasty, or prior coronary artery bypass grafts (CABG);
- patients who have had prior cardiac imaging (within the past year) with normal result including invasive coronary angiography, coronary CT angiography, or nuclear stress testing;
- patients who are unstable; patients who have an electrocardiogram diagnostic of ischemia or myocardial infarction (significant Q waves, ST -segment deviations \> 0.5 mm, or T wave inversions);
- patients in atrial fibrillation or have markedly irregular rhythm 9. patients who have had contrast administration within the past 24hrs;
- patients without an 18 gauge antecubital intravenous access; patients who have a medical home outside of the UTSWMC/Parkland Medical system.
Key Trial Info
Start Date :
October 1 2008
Trial Type :
INTERVENTIONAL
Allocation :
ESTIMATED
End Date :
September 1 2012
Estimated Enrollment :
60 Patients enrolled
Trial Details
Trial ID
NCT00825435
Start Date
October 1 2008
End Date
September 1 2012
Last Update
September 17 2019
Active Locations (1)
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1
Parkland Hospital
Dallas, Texas, United States, 75390