Ischemic Heart Disease
Conditions
Keywords
Cardiac CT, Ischemic heat disease, Stress test
Brief summary
Objectives The CATCH trial (CArdiac cT in the treatment of acute CHest pain) is a prospective randomized controlled trial designed to evaluate the clinical value of cardiac multidetector computed tomography (MDCT) as a first-line diagnostic strategy in patients with acute chest pain, compared to a conventional functional-based testing strategy. Methods: Consecutive patients admitted with acute chest pain of suspected cardiac origin, but normal electrocardiogram and biomarkers were randomized to evaluation with 320-MDCT coronary angiography (CT-guided group) or with standard bicycle exercise test and/or myocardial perfusion imaging - MPI (Control group). After one year, patients will be followed-up, with registration of clinical endpoints such as Cardiac death, myocardial infarction, need for revascularisation, admittance for heart related problems, sustained chest pain, live quality score, use of medication.
Interventions
PROCEDURECardiac computed tomographic angiography (CCTA)
Patients will (on top of the standard clinical evaluation with a functional-based stress-test) be examined with a Cardiac CT scan. In the control group, the Cardiac CT will be blinded for clinical evaluation and only used retrospectively for research purpose.
Sponsors
Hvidovre University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Admittance because of Chest pain * Non- or non-diagnostic ecg-changes. * Normal biomarkers for ischemia (Troponins) * Chest X-ray without pathological findings associated with chest pain.
Exclusion criteria
* Women of childbearing age, or \> 40 years and using approved contraception. * Claustrophobia * Patients with geographical residence, that complicates follow-up * Patients with mental or physical conditions that impede follow-up * Increase in Troponins * New diagnostic ECG changes with ST-segment elevation or depression greater than 1mm or T-yew inversion\> 4 mm in\> 2 anatomically connected derivations. * Allergy to iodinated contrast agents * Serum creatinine greater than 130 mg/l * Abnormal chest x-ray or blood tests hospitalization as assessed as the main cause of the patient's pain problem.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| combined endpoint of: Cardiac death, myocardial infarction, unstabile angina, revascularisation, readmissions for chest pain | 1 year follow-up |
Secondary
| Measure | Time frame |
|---|---|
| myocardial infarction | 1 year follow-up |
| readmissions for chest pain | 1 year follow-up |
| Revascularisation | 1 year follow-up |
| unstabile angina | 1-year follow-up |
| Cardiac death | 1 year follow-up |
| Quality of life (SF-36) | 1-year follow-up |
| medication | 1-year follow-up |
| non-cardiac findings on CT | 1-year follow-up |
| downstream testing | 1-year follow-up |
| continued chest pain | 1 year follow-up |
Countries
Denmark
Outcome results
None listed