Clinical Outcomes and Cost-effectiveness of a Diagnostic and Treatment Strategy of Upfront CTCA Plus Selective Non-invasive Functional Imaging Compared With Standard Care in Patients With Chest Pain and Suspected Coronary Artery Disease

What this Trial Is About

This research aims to evaluate a diagnostic and treatment approach for patients experiencing chest pain who may have stable coronary artery disease (CAD). The study compares a new strategy using computed tomography coronary angiography (CTCA) as the first test against standard care, which depends on the attending cardiologist's judgment. The goal is to see if the CTCA-based approach is at least as effective as standard care in preventing major heart problems and possibly better in improving patient health and reducing invasive tests. Participants in the study are randomly assigned to one of two groups. The experimental group undergoes upfront CT coronary angiography to diagnose CAD and guide optimal medical treatment. If obstructive CAD is found and chest pain persists despite medication, further non-invasive imaging helps guide possible revascularization. The control group receives usual care without a set diagnostic protocol. This study is conducted across multiple centers and follows patients for clinical outcomes. During the study, researchers will monitor participants for the combined outcome of death from any cause or non-fatal heart attacks over one year. They will also assess the health status related to chest pain and record the number of invasive coronary angiograms performed. This trial helps determine if starting with CTCA can improve clinical outcomes and reduce healthcare costs. Participation involves regular assessments and follow-up to track these measures until the study ends in 2026.

Comparing a Diagnostic and Treatment Strategy of Upfront CTCA With SOC in Patients With Chest Pain and Suspected CAD