Study Comparing CT Scan and Stress Test in Diagnosing Coronary Artery Disease in Patients Hospitalized for Chest Pain

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-07-31

Study Completion Date

2013-12-31

Brief Summary

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The purpose of this study is to determine whether coronary artery CT scanning or nuclear stress testing is better at diagnosing chest pain patients with coronary artery disease to select appropriate candidates for coronary catheterization and re-vascularization.

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Detailed Description

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Conditions

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Coronary Artery Disease Angina Pectoris Unstable Angina Acute Coronary Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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CTA

Initial EKG-gated computed tomography angiography of the coronary arteries

Group Type EXPERIMENTAL

Coronary Computed Tomography Angiography

Intervention Type PROCEDURE

64-detector, retrospectively EKG-gated, computed tomography angiography of the coronary arteries during heart rate control (intravenous metoprolol, when necessary)

MPI

Initial nuclear stress myocardial perfusion imaging

Group Type ACTIVE_COMPARATOR

Stress Nuclear Myocardial Perfusion Imaging

Intervention Type PROCEDURE

Usually dual-isotope perfusion imaging at rest (201-Thallium) and at stress (99m-Technetium-MIBI). Some patients will have a 2-day MIBI protocol. Gated SPECT and attenuation-correction images will be obtained. Treadmill stress will be performed. If a patient is unable to exercise, adenosine or dobutamine will be given.

Interventions

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Coronary Computed Tomography Angiography

64-detector, retrospectively EKG-gated, computed tomography angiography of the coronary arteries during heart rate control (intravenous metoprolol, when necessary)

Intervention Type PROCEDURE

Stress Nuclear Myocardial Perfusion Imaging

Usually dual-isotope perfusion imaging at rest (201-Thallium) and at stress (99m-Technetium-MIBI). Some patients will have a 2-day MIBI protocol. Gated SPECT and attenuation-correction images will be obtained. Treadmill stress will be performed. If a patient is unable to exercise, adenosine or dobutamine will be given.

Intervention Type PROCEDURE

Other Intervention Names

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CCTA Coronary CT Coronary CTA Coronary Artery CT Coronary Artery CTA Coronary CT Angiography CTA of the Coronary Arteries stress test nuclear stress test dual-isotope stress test sestamibi thallium myocardial perfusion imaging nuclear perfusion imaging gated SPECT nuclear cardiology

Eligibility Criteria

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Inclusion Criteria

* patient admitted for chest pain or pressure
* patient at intermediate short term risk of MI or death (AHA/ACC guidelines)

Exclusion Criteria

* prior diagnosis of coronary artery disease
* evidence of ongoing myocardial infarction (and other high risk criteria per AHA/ACC guidelines)
* contraindications to EKG-gated CT scanning with iodinated intravenous contrast under beta-blockade
* pregnancy
* presence of an implanted pacemaker or defibrillator
* stress myocardial perfusion imaging, coronary CTA or coronary catheterization within the last 6 months

Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No