ProspEctive First Evaluation in Chest Pain Trial

St. Luke's-Roosevelt Hospital Center411 enrolled

Overview

The purpose of this study is to determine the best initial test in patients admitted to the hospital complaining of chest pain.

Currently, physicians can either choose a stress test or a CT scan of the heart to evaluate patients admitted with with chest pain. Very little is known about which test provides the best information to physicians, positively impacts patients medical care, and decreases future hospital admissions and testing. To study this the investigators are randomizing patients admitted to our hospital with chest pain to a stress test or coronary CT angiography. The investigators will then follow these patients for a 2 year period.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

411

Conditions

Chest Pain Shortness of Breath Suspected Acute Coronary Syndrome

Interventions

Coronary CT AngiographyPROCEDURE

CCTA

Stress TestPROCEDURE

Stress Test

Eligibility

Sex: ALLMin age: 45 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with chest pain or SOB admitted for rule out acute coronary syndrome * Age ≥45 years * EKG non-diagnostic for acute coronary syndrome * At least 1 set of negative troponin I Exclusion Criteria: * Patient with ST elevation myocardial infarction. * Patients with non-ST elevation myocardial infarction. * Patients with known CAD. * Patients with serum creatinine \> 1.5. * Atrial fibrillation or marked irregular heart rhythm. * Patients in whom heart rate cannot be controlled. * Patient with allergies to iodinated contrast agents. * Pregnant women * Patients unable to give informed consent

Locations (1)

St. Luke's and Roosevelt Hospitals

New York, New York, United States

Outcomes

Primary Outcomes

Time to discharge

Time frame: Initial hospitalization

Change in medical regimen

Time frame: Initial hospitalization

Downstream cardiovascular testing and hospitalization

Time frame: 2 years

Secondary Outcomes

All-cause mortality

This measure is to ascertain if CCTA and stress testing can be used safely as the initial test in patients admitted to the hospital with chest pain.

Time frame: 7 days, 30 days, 6, 12, and 24 months.

Cardiovascular mortality

This measure is to ascertain if CCTA and stress testing can be used safely as the initial test in patients admitted to the hospital with chest pain.

Time frame: 7 days, 30 days, 6, 12, and 24 months.

Non-fatal myocardial infarction

This measure is to ascertain if CCTA and stress testing can be used safely as the initial test in patients admitted to the hospital with chest pain.

Time frame: 7 days, 30 days, 6, 12, and 24 months.

Data from ClinicalTrials.gov

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