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Completed

NCT Number: NCT01384448

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

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.

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Key information

Conditions

Chest Pain Angina Angina Pectoris Arterial Occlusive Diseases Arteriosclerosis Cardiovascular Diseases Coronary Artery Disease Coronary Disease Heart Diseases Myocardial Ischemia Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms Vascular Diseases

Age range

30 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Montefiore Medical Center - Weiler / Einstein Division

The Bronx, New York, 10462, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Stress Echocardiography

Procedure

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

Coronary CT Angiography

Procedure

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

Primary outcomes

  1. Hospital admission

    Time frame: 30 days

Secondary outcomes

  1. Emergency Department length of stay

    Time frame: 30 days

  2. Hospital length of stay

    Time frame: 30 days

  3. Estimated cost of initial care

    Time frame: 30 days

  4. Repeat visits to the Emergency Department

    Time frame: 30 days and 1 year

  5. Death

    Time frame: 30 days and 1 year

  6. Non-fatal myocardial infarction

    Time frame: 30 days and 1 year

Sponsors and collaborators

Lead sponsor

Montefiore Medical Center

Other

Collaborators

  • American Heart Association

Registry information

Official study title

A Randomized Trial Comparing Coronary CT Angiography and Stress Echocardiography for Evaluation of Low-to-Intermediate Risk Emergency Department Chest Pain Patients

Important dates

Study start
2011
Primary completion
2016
Study completion
2017
First posted
Jun 29, 2011
Registry last updated
Oct 11, 2018

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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