An interventional study of Cardiac CT in Acute Coronary Syndrome and Acute Chest Pain, sponsored by Erasmus Medical Center. Completed at 1 site in Netherlands. Open to participants aged 30 Years to 80 Years. Per ClinicalTrials.gov, last updated 2016-08-04.
Sponsored by Erasmus Medical Center · Not applicable, Interventional, and Diagnostic
The purpose of this study is to determine whether cardiac CT can improve triage of acute chest pain patients in the emergency department.
Myocardial infarction remains one of the most important causes of death and disability. Therefore it is important that individuals with acute chest pain are accurately assessed without delaying appropriate treatment. Acute coronary syndrome is only one cause for sudden chest pain, which is a very common complaint in the ER. Other life threatening causes such as pulmonary embolism and aortic dissection may also be the cause, although most chest discomfort has a benign reason (musculoskeletal, hyperventilation, oesophageal reflux, etc).
The current work-up of suspected acute coronary syndrome, based on presentation, symptoms, ECG and biomarkers, is not efficient and results in unnecessary diagnostics and hospital admissions, as well as errors or delayed diagnoses, in a substantial number of patients. Computed tomography angiography (CTA) images atherosclerosis, coronary obstruction as well as myocardial hypoperfusion. We hypothesize that early use of CTA is of incremental value and allows for accurate and immediate triage of patients with acute chest pain.
1,461 studies on the registry are indexed under Acute Coronary Syndrome; 267 are open to participants now.
This study's enrollment of 500 is above the median of 200 across 869 interventional studies indexed under Acute Coronary Syndrome.
Browse Acute Coronary Syndrome studies →Erasmus Medical Center is the lead sponsor of 466 studies on the registry; 179 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Triage based on cardiac CT results.
Radiation: Cardiac CT
Standard diagnostic management according to the European guidelines.
Calcium scan and CT coronary angiography
Successful discharge rate
The proportion of patients discharged home without major adverse events during the following 30 days. Major adverse events are cardiovascular death or non-fatal myocardial infarction.
Time frame: 30 days
Diagnostic yield of invasive angiography
Number of patients identified with severe coronary artery disease identified by invasive angiography requiring revascularisation according to the international guidelines.
Time frame: 30 days
Successful discharge rate for all adverse events
The proportion of patients discharged home without any adverse events during the following 30 days. Adverse events are cardiovascular death, non-fatal myocardial infarction, unstable angina, coronary revascularization, repeat hospital visits for chest pain.
Time frame: 30 days
Major adverse events
Composite endpoint of major adverse cardiac events at 6 months: cardiovascular death, non-fatal myocardial infarction, unstable angina, coronary revascularisation and repeat hospital visits for chest pain.
Time frame: 6 months
Acute coronary syndrome
Diagnosis of acute coronary syndrome, according to international guidelines, at time of discharge.
Time frame: Index hospital visit
Missed myocardial infarctions
Missed myocardial infarctions, at 2-day follow-up, in patients discharged from the emergency department.
Time frame: 2 days
Duration of hospital stay
Duration of hospital stay
Time frame: Index hospital visit
Direct medical cost
Direct medical costs until 30th day after ED visit.
Time frame: 30 days
Radiation exposure
Cumulative medical radiation exposure at 6 months.
Time frame: 6 months
Renal function
Change in renal function after 2 days.
Time frame: 2 days
Plan to share: No
This study is completed, as verified in Aug 2016. You cannot join it, but the record below documents what was studied.
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Erasmus Medical Center