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Coronary CT Angiography in Acute Chest Pain is a Cost Effective Risk Stratification Strategy

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ClinicalTrials.gov Identifier: NCT00825435
Recruitment Status : Unknown
Verified January 2009 by University of Texas Southwestern Medical Center.
Recruitment status was:  Recruiting
First Posted : January 21, 2009
Last Update Posted : January 21, 2009
Sponsor:
Information provided by:
University of Texas Southwestern Medical Center

Brief Summary:
This study will evaluate the impact of adding coronary computed tomographic angiography (CTA) on health care costs for diagnosing patients with acute chest pain.

Condition or disease Intervention/treatment Phase
Acute Chest Pain Procedure: Coronary CT Angiogram Phase 3

  Show Detailed Description

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Official Title: Inclusion of Multi-Detector CT Angiography (MDCT) in Low to Intermediate Risk Chest Pain Patients Presenting to the Emergency Department; a Randomized Cost Analysis
Study Start Date : October 2008
Estimated Primary Completion Date : June 2009

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Chest Pain

Arm Intervention/treatment
Experimental: 1
Coronary CT angiogram plus Standard of care (CTA+SOC)
Procedure: Coronary CT Angiogram
Coronary CT Angiogram

No Intervention: 2
Standard of Care (SOC)



Primary Outcome Measures :
  1. Determine if the cumulative costs over 90-days of providing treatment services are reduced when adding coronary CTA to the standard-of-care (CTA + SOC) in patients with acute chest pain compared to SOC alone. [ Time Frame: 90-days ]

Secondary Outcome Measures :
  1. Determine if the rate of hospitalizations, nuclear perfusion scans and interventional cardiac catheterizations will be reduced by adding the coronary CTA to the SOC (CTA + SOC) compared to the SOC alone. [ Time Frame: 90-days ]
  2. Compare the rate of death, myocardial infarct (MI), acute coronary syndrome (ACS), and recidivism to the ED over 90-days when adding coronary CTA to the SOC (CTA + SOC) in ED patients with acute chest pain compared to the SOC alone group. [ Time Frame: 90-days ]


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Ages Eligible for Study:   35 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • patients who complain of typical or atypical chest pain (that is compatible with ischemia during the past 12 hrs);
  • patients a prediction of low to intermediate risk of myocardial infarction and/or complications according to established criteria;
  • patients who have normal or non-diagnostic electrocardiograms;
  • patients who have negative cardiac biomarker including creatine kinase-MB, myoglobin, and/or cardiac troponin I at initial testing; patients who require admission to the hospital by the EP at the time of risk-stratification;
  • patients who require cardiology consultation in the ED 7. patients who are age 35 years or older;
  • patients who are able to hold their breath for ≥ 15 seconds (to obtain a quality static anatomical image, scanning requires at least fifteen seconds of breath holding;
  • patients who have heart rate of < 70 beats per minute before or after the administration of beta-blocker medication

Exclusion Criteria:

  • patients who have a contraindication to iodinated and/ or beta-blocking drugs; patients who have compromised renal function defined as creatinine ≥ 1.2 mg/dl;
  • patients who are pregnant, suspected pregnant or other vulnerable populations e.g., incarcerated patients;
  • patients who have documented CAD by prior invasive coronary angiography or coronary CT angiography and/or patients with coronary artery stents, prior angioplasty, or prior coronary artery bypass grafts (CABG);
  • patients who have had prior cardiac imaging (within the past year) with normal result including invasive coronary angiography, coronary CT angiography, or nuclear stress testing;
  • patients who are unstable; patients who have an electrocardiogram diagnostic of ischemia or myocardial infarction (significant Q waves, ST -segment deviations > 0.5 mm, or T wave inversions);
  • patients in atrial fibrillation or have markedly irregular rhythm 9. patients who have had contrast administration within the past 24hrs;
  • patients without an 18 gauge antecubital intravenous access; patients who have a medical home outside of the UTSWMC/Parkland Medical system.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00825435


Contacts
Contact: Adam H Miller, MD 2149063179 adam.miller@utsouthwestern.edu

Locations
United States, Texas
Parkland Hospital Recruiting
Dallas, Texas, United States, 75390
Contact: Valaria Hart, PhD    214-590-8966    Vhart@parknet.pmh.org   
Sponsors and Collaborators
University of Texas Southwestern Medical Center

Responsible Party: Adam H. Miller, UT Southwestern Medical Center
ClinicalTrials.gov Identifier: NCT00825435     History of Changes
Other Study ID Numbers: 032007-067
First Posted: January 21, 2009    Key Record Dates
Last Update Posted: January 21, 2009
Last Verified: January 2009

Keywords provided by University of Texas Southwestern Medical Center:
Coronary CT angiogram
Cardiac imaging
Cost analysis
acute chest pain
risk stratification
cumulative costs over 90-days of providing treatment services

Additional relevant MeSH terms:
Chest Pain
Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms