Early Coronary CT Angiography for Adults With Chest Pain At Intermediate Risk of Heart Problems in the Emergency Department

What this Trial Is About

Researchers are evaluating a diagnostic strategy using early coronary computed tomographic angiography CCTA in patients at intermediate risk who come to the Emergency Department with chest pain or symptoms suggestive of acute coronary syndrome but without acute myocardial infarction. The goal is to see if including early CCTA reduces the combined risk of death, hospital readmission for myocardial infarction, or unstable angina needing revascularization. Participants are randomly assigned to one of two groups one group receives standard care plus early CCTA as soon as possible, preferably within 24 hours but no later than 21 days, using local CT scanning protocols. The other group receives standard care without early CCTA but may undergo other non-invasive functional tests like Exercise-ECG or stress echocardiography according to usual practice. All patients receive prevention treatments based on current guidelines if their examinations indicate coronary artery disease. During the study, patients will be monitored for the primary outcome, which is a combination of death, readmission for myocardial infarction, or unstable angina requiring revascularization, over an average follow-up of five years. Secondary outcomes include various cardiovascular events, health-related quality of life, and healthcare resource use. The study involves regular assessments and the responsible physician plans ongoing care based on diagnostic results and clinical findings.

Coronary Computed Tomographic Angiography in Intermediate-risk Chest Pain Patients