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

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01384448
Recruitment Status : Completed
First Posted : June 29, 2011
Last Update Posted : March 22, 2017
American Heart Association
Information provided by (Responsible Party):
Jeffrey Levsky, Montefiore Medical Center

June 15, 2011
June 29, 2011
March 22, 2017
August 2011
February 2016   (Final data collection date for primary outcome measure)
Hospital admission [ Time Frame: 30 days ]
Same as current
Complete list of historical versions of study NCT01384448 on Archive Site
  • 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 ]
Same as current
Not Provided
Not Provided
Stress Echocardiography and Heart Computed Tomography (CT) Scan in Emergency Department Patients With Chest Pain
A Randomized Trial Comparing Coronary CT Angiography and Stress Echocardiography for Evaluation of Low-to-Intermediate Risk Emergency Department Chest Pain Patients
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.
Not Provided
Not Applicable
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
  • Chest Pain
  • Angina
  • Angina Pectoris
  • Coronary Artery Disease
  • 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
  • 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
  • Experimental: Initial Stress Echocardiography
    Intervention: Procedure: Stress Echocardiography
  • Experimental: Initial Coronary CT Angiography
    Intervention: Procedure: Coronary CT Angiography
Levsky JM, Haramati LB, Taub CC, Spevack DM, Menegus MA, Travin MI, Vega S, Lerer R, Brown-Manhertz D, Hirschhorn E, Tobin JN, Garcia MJ. Rationale and design of a randomized trial comparing initial stress echocardiography versus coronary CT angiography in low-to-intermediate risk emergency department patients with chest pain. Echocardiography. 2014 Jul;31(6):744-50. doi: 10.1111/echo.12464. Epub 2013 Dec 23.

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Same as current
February 2017
February 2016   (Final data collection date for primary outcome measure)

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
Sexes Eligible for Study: All
30 Years and older   (Adult, Senior)
Contact information is only displayed when the study is recruiting subjects
United States
11SDG7380006 ( Other Grant/Funding Number: American Heart Association National Center )
Not Provided
Not Provided
Jeffrey Levsky, Montefiore Medical Center
Montefiore Medical Center
American Heart Association
Principal Investigator: Jeffrey M Levsky, MD, PhD Montefiore Medical Center / Albert Einstein College of Medicine
Montefiore Medical Center
March 2017

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP