None listed
Conditions
Brief summary
The Computed tomography to Reduce InTerventIonal Coronary Angiography and Length of stay in Acute Coronary Syndrome (CRITICAL-ACS) Study is a prospective, open-label, multi-centre, pragmatic randomised clinical trial that will compare the strategy of CTCA first versus standard care with ICA amongst patients admitted with presumed ACS. Recruitment is planned to occur over 3 years with follow-up of 1 year after randomisation to allow the primary study to be completed in 4 years. At all stages, final management decisions will be left to the discretion of the treating clinician.
Interventions
Computed tomography coronary angiography (CTCA) takes about 20 minutes.
100mls of liquid contrast medium is injected into a vein (usually in the arm) to allow the inside and outside structure of blood vessels to be clearly visible on the CT angiogram images. This is the first coronary imaging modality followed by invasive coronary angiography as required according to the treating clinician with access to the CTCA findings.
Sponsors
University of Otago
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1) Admission with presumed diagnosis of ACS with either or both of: • ECG changes indicating new ischaemia, • Rise and/or fall in troponin 2) Invasive coronary angiography planned 3) New Zealand resident 4) Age greater than or equal to 18 years 5) Provision of written informed consent.
Exclusion criteria
1) Clinician-determined requirement for urgent (<24 hours) coronary angiography due to clinical instability 2) Prior coronary revascularisation 3) Ineligibility for CTCA or ICA according to local hospital practice 4) Severe chronic kidney disease (eGFR <30 mL/min/1.73m2) 5) Prior recruitment to trial 6) Known pregnancy or currently breast feeding
Outcome results
None listed