Coronary CT Angiography for Improved Assessment of Suspected Acute Coronary Syndrome

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

230 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-01

Study Completion Date

2022-09-01

Brief Summary

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Current evaluation of patients suspected of non-ST-elevation acute coronary syndrome is greatly dictated by the results of high-sensitivity troponins. In a substantial number of patients this approach does not provide a conclusive work-up. Patients typically present with slightly elevated high-sensitivity troponins without significant changes during serial sampling and no other clinical clues that can aid in determining the etiology of their chest pain complaints. Uncertainty remains about the optimal diagnostic management of these patients and they are often admitted to undergo invasive angiography. Coronary CT angiography can improve efficiency of clinical care in these patients by reducing unnecessary hospital admissions and invasive angiography. In this study, the investigators will investigate whether a diagnostic strategy comprising of early coronary CT angiography is more clinically efficient than standard optimal care in patients with an inconclusive work-up for non-ST-elevation acute coronary syndrome.

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Detailed Description

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Conditions

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Acute Coronary Syndrome Chest Pain

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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CT-group

Coronary CT angiography

Group Type EXPERIMENTAL

Coronary CT Angiography

Intervention Type DIAGNOSTIC_TEST

Coronary CT angiography

Interventions

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Coronary CT Angiography

Coronary CT angiography

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Patients presenting to the emergency department with symptoms suggestive of NSTE-ACS. They do not fulfil criteria for either "rule-in" or "rule-out" NSTE-ACS based on serial sampling of high-sensitivity troponins and standard clinical work-up.

Exclusion Criteria

* Inability or unwillingness to provide informed consent.
* History of proven CAD, defined as documented prior myocardial infarction, percutaneous coronary intervention or coronary artery bypass graft surgery.
* Previous examination with either invasive angiography or CCTA in the last 3 years.
* Clinical instability: clinical heart failure, hemodynamic instability, severe chest pain.
* CCTA-specific contra-indications:

* Allergy to iodine contrast media
* Pregnancy
* Impaired renal function: estimated glomerular filtering rate \<60% of the age-corrected normal values
* Severe arrhythmia likely to affect image interpretation
* BMI \> 40
* Inability to cooperate during the examination.

Minimum Eligible Age

30 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No