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

This study has been completed.
American Heart Association
Information provided by (Responsible Party):
Jeffrey Levsky, Montefiore Medical Center Identifier:
First received: June 15, 2011
Last updated: March 21, 2017
Last verified: March 2017
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.

Condition Intervention
Chest Pain
Angina Pectoris
Coronary Artery Disease
Procedure: Stress Echocardiography
Procedure: Coronary CT Angiography

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: No masking
Primary Purpose: Diagnostic
Official Title: A Randomized Trial Comparing Coronary CT Angiography and Stress Echocardiography for Evaluation of Low-to-Intermediate Risk Emergency Department Chest Pain Patients

Resource links provided by NLM:

Further study details as provided by Montefiore Medical Center:

Primary Outcome Measures:
  • Hospital admission [ Time Frame: 30 days ]

Secondary Outcome Measures:
  • Emergency Department length of stay [ Time Frame: 30 days ]
  • Hospital length of stay [ Time Frame: 30 days ]
  • Estimated cost of initial care [ Time Frame: 30 days ]
  • Repeat visits to the Emergency Department [ Time Frame: 30 days and 1 year ]
  • Death [ Time Frame: 30 days and 1 year ]
  • Non-fatal myocardial infarction [ Time Frame: 30 days and 1 year ]

Enrollment: 400
Study Start Date: August 2011
Study Completion Date: February 2017
Primary Completion Date: February 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Initial Stress Echocardiography Procedure: Stress 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.
Other Names:
  • stress echo
  • treadmill stress echocardiography
  • treadmill stress echo
  • exercise stress echocardiography
  • exercise stress echo
  • dobutamine stress echocardiography
  • dobutamine stress echo
  • ESE
  • TSE
  • DSE
  • SE
Experimental: Initial Coronary CT Angiography Procedure: Coronary 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.
Other Names:
  • Cardiac CT
  • Cardiac CTA
  • Coronary CT
  • Coronary CTA
  • Coronary Artery CT
  • Coronary Artery CTA
  • CT Angiography of the Coronary Arteries
  • Computed Tomography Angiography of the Coronary Arteries
  • CTA
  • CCT
  • CCTA


Ages Eligible for Study:   30 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

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
  Contacts and Locations
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Please refer to this study by its identifier: NCT01384448

United States, New York
Montefiore Medical Center - Weiler / Einstein Division
Bronx, New York, United States, 10462
Sponsors and Collaborators
Montefiore Medical Center
American Heart Association
Principal Investigator: Jeffrey M Levsky, MD, PhD Montefiore Medical Center / Albert Einstein College of Medicine
  More Information

Responsible Party: Jeffrey Levsky, Associate Director of Research, Department of Radiology, Montefiore Medical Center Identifier: NCT01384448     History of Changes
Other Study ID Numbers: MMC-11-03-107
11SDG7380006 ( Other Grant/Funding Number: American Heart Association National Center )
Study First Received: June 15, 2011
Last Updated: March 21, 2017

Keywords provided by Montefiore Medical Center:
stress echocardiography
coronary ct angiography

Additional relevant MeSH terms:
Coronary Artery Disease
Myocardial Ischemia
Coronary Disease
Angina Pectoris
Chest Pain
Heart Diseases
Cardiovascular Diseases
Arterial Occlusive Diseases
Vascular Diseases
Disease Attributes
Pathologic Processes
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Cardiotonic Agents
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Adrenergic beta-1 Receptor Agonists
Adrenergic beta-Agonists
Adrenergic Agonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Protective Agents processed this record on April 28, 2017