Using Combined Dynamic CT Stress Myocardial Perfusion, Fractional Flow Reserve, and Coronary CT Angiography to Guide Treatment in Patients with Stable Chest Pain Syndromes

What this Trial Is About

Researchers are evaluating whether combining dynamic CT myocardial stress perfusion, CT fractional flow reserve FFR-CT, and coronary CT angiography can improve health outcomes and symptom relief in patients with stable chest pain syndromes suspected or confirmed to have ischemic heart disease. This randomized, open-label trial compares this combined imaging guided treatment strategy against conventional management in patients with chronic chest pain. The study is conducted in the Capital Region of Copenhagen, Denmark, focusing on reducing major adverse cardiovascular events and improving clinical care. Participants are assigned to one of two groups one receives treatment guided by the combined dynamic CT stress myocardial perfusion, FFR-CT, and CT coronary angiography results the other follows standard clinical evaluation and treatment practices. The imaging-based strategy involves a team including a cardiac CT specialist, invasive cardiologist, thoracic surgeon, and cardiology nurse specialist who determine treatment plans such as referral for percutaneous coronary intervention, coronary artery bypass surgery, or optimal medical therapy. Both groups undergo evaluation and treatment as per their assigned strategy. During the study, participants will be monitored over several years with key assessments including major adverse cardiovascular events over 3 years, symptom relief measures like the Seattle Angina Questionnaire at 3 and 12 months, quality of life assessments, hospitalization events, and mortality tracked up to 10 years. Additional data on diagnostic test usage, radiation exposure, procedural complications, and diagnoses explaining symptoms will also be collected. This comprehensive follow-up aims to understand the impact of the imaging-guided strategy on clinical outcomes and patient well-being.

CT Stress Myocardial Perfusion, Fractional Flow Reserve and Angiography in Patients With Stable Chest Pain Syndromes