Chest Pain, Shortness of Breath, Suspected Acute Coronary Syndrome
Conditions
Keywords
Chest pain, shortness of breath, suspected acute coronary syndrome, stress testing, coronary computed tomography angiography
Brief summary
The purpose of this study is to determine the best initial test in patients admitted to the hospital complaining of chest pain.
Detailed description
Currently, physicians can either choose a stress test or a CT scan of the heart to evaluate patients admitted with with chest pain. Very little is known about which test provides the best information to physicians, positively impacts patients medical care, and decreases future hospital admissions and testing. To study this the investigators are randomizing patients admitted to our hospital with chest pain to a stress test or coronary CT angiography. The investigators will then follow these patients for a 2 year period.
Interventions
PROCEDURECoronary CT Angiography
CCTA
PROCEDUREStress Test
Stress Test
Sponsors
St. Luke's-Roosevelt Hospital Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
45 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with chest pain or SOB admitted for rule out acute coronary syndrome * Age ≥45 years * EKG non-diagnostic for acute coronary syndrome * At least 1 set of negative troponin I
Exclusion criteria
* Patient with ST elevation myocardial infarction. * Patients with non-ST elevation myocardial infarction. * Patients with known CAD. * Patients with serum creatinine \> 1.5. * Atrial fibrillation or marked irregular heart rhythm. * Patients in whom heart rate cannot be controlled. * Patient with allergies to iodinated contrast agents. * Pregnant women * Patients unable to give informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time to discharge | Initial hospitalization |
| Change in medical regimen | Initial hospitalization |
| Downstream cardiovascular testing and hospitalization | 2 years |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| All-cause mortality | 7 days, 30 days, 6, 12, and 24 months. | This measure is to ascertain if CCTA and stress testing can be used safely as the initial test in patients admitted to the hospital with chest pain. |
| Cardiovascular mortality | 7 days, 30 days, 6, 12, and 24 months. | This measure is to ascertain if CCTA and stress testing can be used safely as the initial test in patients admitted to the hospital with chest pain. |
| Non-fatal myocardial infarction | 7 days, 30 days, 6, 12, and 24 months. | This measure is to ascertain if CCTA and stress testing can be used safely as the initial test in patients admitted to the hospital with chest pain. |
Countries
United States
Outcome results
None listed