Stress Echocardiography and Heart Computed Tomography (CT) Scan in Emergency Department Patients With Chest Pain

A Randomized Trial Comparing Coronary CT Angiography and Stress Echocardiography for Evaluation of Low-to-Intermediate Risk Emergency Department Chest Pain Patients

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT01384448

Enrollment

400

Registered

2011-06-29

Start date

2011-08-31

Completion date

2017-02-28

Last updated

2018-10-11

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Chest Pain, Angina, Angina Pectoris, Coronary Artery Disease

Keywords

stress echocardiography, coronary ct angiography

Brief summary

The purpose of this study is to determine whether stress echocardiography or computed tomography (CT) of the heart is better at diagnosing emergency room chest pain patients to select appropriate candidates for hospitalization and further work-up.

Interventions

PROCEDUREStress Echocardiography

Stress echocardiography will be performed once. Treadmill stress is default. Patients that cannot exercise will receive dobutamine stress with or without atropine. Definity intravenous contrast will be given when needed.

PROCEDURECoronary CT Angiography

64-detector, resting EKG-gated coronary CT angiography will be performed once. Patients with elevated heart rates will be given oral and/or intravenous metoprolol. Prospective gating with reduced tube current will be default. Retrospective gating with tube current modulation will be used in patients with higher heart rates.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

DIAGNOSTIC

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

30 Years to No maximum

Healthy volunteers

Inclusion criteria

* Presentation to the Emergency Department with chest pain * Low-to-intermediate risk of coronary disease per Diamond-Forrester criteria * Free of known coronary artery disease

Exclusion criteria

* Inability to undergo both stress echo or coronary CT for any reason * Contraindication to intravenous iodinated contrast * Dysrhythmia precluding EKG gating * Heart rate greater than 60 with contraindication to beta blockers * Administration of beta blockers within the last 12 hours * Known severe cardiac valvular disease or pulmonary hypertension * Stress echocardiography, coronary CT or catheterization within the last 6 months

Design outcomes

Primary

Measure	Time frame
Hospital admission	30 days

Secondary

Measure	Time frame
Hospital length of stay	30 days
Estimated cost of initial care	30 days
Emergency Department length of stay	30 days
Death	30 days and 1 year
Non-fatal myocardial infarction	30 days and 1 year
Repeat visits to the Emergency Department	30 days and 1 year

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Mar 6, 2026