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Better Evaluation of Acute Chest Pain With Computed Tomography Angiography (BEACON)

This study has been completed.
Information provided by (Responsible Party):
Koen Nieman, Erasmus Medical Center Identifier:
First received: August 9, 2011
Last updated: August 3, 2016
Last verified: August 2016
The purpose of this study is to determine whether cardiac CT can improve triage of acute chest pain patients in the emergency department.

Condition Intervention
Acute Coronary Syndrome
Acute Chest Pain
Radiation: Cardiac CT

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Diagnostic
Official Title: Better Evaluation of Acute Chest Pain With Computed Tomography Angiography - A Randomized Controlled Trial

Resource links provided by NLM:

Further study details as provided by Koen Nieman, Erasmus Medical Center:

Primary Outcome Measures:
  • Successful discharge rate [ Time Frame: 30 days ]
    The proportion of patients discharged home without major adverse events during the following 30 days. Major adverse events are cardiovascular death or non-fatal myocardial infarction.

  • Diagnostic yield of invasive angiography [ Time Frame: 30 days ]
    Number of patients identified with severe coronary artery disease identified by invasive angiography requiring revascularisation according to the international guidelines.

Secondary Outcome Measures:
  • Successful discharge rate for all adverse events [ Time Frame: 30 days ]
    The proportion of patients discharged home without any adverse events during the following 30 days. Adverse events are cardiovascular death, non-fatal myocardial infarction, unstable angina, coronary revascularization, repeat hospital visits for chest pain.

  • Major adverse events [ Time Frame: 6 months ]
    Composite endpoint of major adverse cardiac events at 6 months: cardiovascular death, non-fatal myocardial infarction, unstable angina, coronary revascularisation and repeat hospital visits for chest pain.

  • Acute coronary syndrome [ Time Frame: Index hospital visit ]
    Diagnosis of acute coronary syndrome, according to international guidelines, at time of discharge.

  • Missed myocardial infarctions [ Time Frame: 2 days ]
    Missed myocardial infarctions, at 2-day follow-up, in patients discharged from the emergency department.

  • Duration of hospital stay [ Time Frame: Index hospital visit ]
    Duration of hospital stay

  • Direct medical cost [ Time Frame: 30 days ]
    Direct medical costs until 30th day after ED visit.

  • Radiation exposure [ Time Frame: 6 months ]
    Cumulative medical radiation exposure at 6 months.

  • Renal function [ Time Frame: 2 days ]
    Change in renal function after 2 days.

Enrollment: 500
Study Start Date: July 2011
Study Completion Date: February 2015
Primary Completion Date: February 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Cardiac CT
Triage based on cardiac CT results.
Radiation: Cardiac CT
Calcium scan and CT coronary angiography
No Intervention: Standard Care
Standard diagnostic management according to the European guidelines.

Detailed Description:

Myocardial infarction remains one of the most important causes of death and disability. Therefore it is important that individuals with acute chest pain are accurately assessed without delaying appropriate treatment. Acute coronary syndrome is only one cause for sudden chest pain, which is a very common complaint in the ER. Other life threatening causes such as pulmonary embolism and aortic dissection may also be the cause, although most chest discomfort has a benign reason (musculoskeletal, hyperventilation, oesophageal reflux, etc).

The current work-up of suspected acute coronary syndrome, based on presentation, symptoms, ECG and biomarkers, is not efficient and results in unnecessary diagnostics and hospital admissions, as well as errors or delayed diagnoses, in a substantial number of patients. Computed tomography angiography (CTA) images atherosclerosis, coronary obstruction as well as myocardial hypoperfusion. We hypothesize that early use of CTA is of incremental value and allows for accurate and immediate triage of patients with acute chest pain.


Ages Eligible for Study:   30 Years to 80 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Acute chest pain or equivalent
  • Patients older than 30 years
  • Males < 75 years and Females < 80 years

Exclusion Criteria:

  • Troponin > 0.1
  • History of known myocardial infarction, PCI or CABG
  • Pregnancy
  • Contrast allergy
  • Renal disfunction
  • No informed consent possible
  • No follow-up possible
  Contacts and Locations
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Please refer to this study by its identifier: NCT01413282

Erasmus MC
Rotterdam, Netherlands
Sponsors and Collaborators
Erasmus Medical Center
Principal Investigator: Koen Nieman, MD, PhD Erasmus MC
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Koen Nieman, Associate professor, Erasmus Medical Center Identifier: NCT01413282     History of Changes
Other Study ID Numbers: BEACON-11
Study First Received: August 9, 2011
Last Updated: August 3, 2016
Individual Participant Data  
Plan to Share IPD: No

Keywords provided by Koen Nieman, Erasmus Medical Center:
Acute coronary syndrome

Additional relevant MeSH terms:
Acute Coronary Syndrome
Chest Pain
Myocardial Ischemia
Heart Diseases
Cardiovascular Diseases
Vascular Diseases
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms processed this record on May 25, 2017