Diagnostic Accuracy of Multislice CT Angiography for Acute Chest Pain

NCT00855231 | Completed

• 2 other identifiers: 27903-D05-6337-D 03
• Study Type: observational
• Target: 102
• Locations: 1 country
• Sites: 1

Brief Summary

The ACUTE CT trial is designed to test whether the assessment of chest structures by high-resolution multislice computed tomography (CT) provides equivalent diagnostic accuracy for patient with acute chest pain or other potential cardiac symptoms as compared to a standard of care evaluation.

Conditions

Chest Pain; Acute Coronary Syndrome; Pulmonary Embolism; Aortic Dissection

Keywords

Acute coronary syndrome; Coronary artery disease; cardiac imaging; computed tomography

Outcome Measures

Primary Outcomes (1)

• Diagnostic accuracy of CT compared to standard of care evaluation

  3 months

Secondary Outcomes (1)

• Cost savings of CT-based evaluation compared to the standard of care evaluation

  3 months

Eligibility Criteria

• Age: 30 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Alll patients presenting to the University of Washington Medical Center Emergency Department with possible acute coronary syndrome

You may qualify if:

• Low to intermediate risk of angina with a TIMI ACS Risk Score ≤ 4
• chest pain or other symptoms suggestive of ACS within 24 hours
• male ≥30 years or female ≥45 years old
• at least one cardiac risk factor
• no obvious cause for symptoms.

You may not qualify if:

• known CAD
• ST segment elevation, new left bundle branch block or dynamic ECG changes
• creatinine ≥1.8 g/dL
• pregnant or lactating female
• hemodynamic or respiratory instability
• ongoing bronchospasm
• known iodinated contrast allergy
• atrial fibrillation or irregular heart rate

Sponsors & Collaborators

• University of Washington: lead
• GE Healthcare: collaborator

Study Sites (1)

University of Washington Medical Center

Seattle, Washington, 98195, United States

Location

Related Publications (7)

• Branch KR, Busey J, Mitsumori LM, Strote J, Caldwell JH, Busch JH, Shuman WP. Diagnostic performance of resting CT myocardial perfusion in patients with possible acute coronary syndrome. AJR Am J Roentgenol. 2013 May;200(5):W450-7. doi: 10.2214/AJR.12.8934.

  PMID: 23617513 BACKGROUND

• Branch KR, Strote J, Shuman WP, Mitsumori LM, Busey JM, Rue T, Caldwell JH. Diagnostic accuracy and clinical outcomes of ECG-gated, whole chest CT in the emergency department. PLoS One. 2013 Apr 16;8(4):e61121. doi: 10.1371/journal.pone.0061121. Print 2013.

  PMID: 23613797 BACKGROUND

• Branch KR, Bresnahan BW, Veenstra DL, Shuman WP, Weintraub WS, Busey JM, Elliott DJ, Mitsumori LM, Strote J, Jobe K, Dubinsky T, Caldwell JH. Economic outcome of cardiac CT-based evaluation and standard of care for suspected acute coronary syndrome in the emergency department: a decision analytic model. Acad Radiol. 2012 Mar;19(3):265-73. doi: 10.1016/j.acra.2011.10.029. Epub 2011 Dec 30.

  PMID: 22209422 BACKGROUND

• May JM, Shuman WP, Strote JN, Branch KR, Mitsumori LM, Lockhart DW, Caldwell JH. Low-risk patients with chest pain in the emergency department: negative 64-MDCT coronary angiography may reduce length of stay and hospital charges. AJR Am J Roentgenol. 2009 Jul;193(1):150-4. doi: 10.2214/AJR.08.2021.

  PMID: 19542407 RESULT

• Shuman WP, Branch KR, May JM, Mitsumori LM, Strote JN, Warren BH, Dubinsky TJ, Lockhart DW, Caldwell JH. Whole-chest 64-MDCT of emergency department patients with nonspecific chest pain: Radiation dose and coronary artery image quality with prospective ECG triggering versus retrospective ECG gating. AJR Am J Roentgenol. 2009 Jun;192(6):1662-7. doi: 10.2214/AJR.08.1872.

  PMID: 19457832 RESULT

• Mitsumori LM, Wang E, May JM, Lockhart DW, Branch KR, Dubinsky TJ, Shuman WP. Triphasic contrast bolus for whole-chest ECG-gated 64-MDCT of patients with nonspecific chest pain: evaluation of arterial enhancement and streak artifact. AJR Am J Roentgenol. 2010 Mar;194(3):W263-71. doi: 10.2214/AJR.09.2788.

  PMID: 20173125 RESULT

• Shuman WP, May JM, Branch KR, Mitsumori LM, Strote JN, Green DE, Caldwell JH. Negative ECG-gated cardiac CT in patients with low-to-moderate risk chest pain in the emergency department: 1-year follow-up. AJR Am J Roentgenol. 2010 Oct;195(4):923-7. doi: 10.2214/AJR.09.3972.

  PMID: 20858819 RESULT

MeSH Terms

Conditions

Chest Pain; Acute Coronary Syndrome; Pulmonary Embolism; Aortic Dissection; Coronary Artery Disease

Condition Hierarchy (Ancestors)

Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Lung Diseases; Respiratory Tract Diseases; Embolism; Embolism and Thrombosis; Dissection, Blood Vessel; Aneurysm; Acute Aortic Syndrome; Aortic Diseases; Coronary Disease; Arteriosclerosis; Arterial Occlusive Diseases

Study Officials

• Kelley R Branch, MD

  University of Washington

  PRINCIPAL INVESTIGATOR

• William P Shuman, MD

  University of Washington

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: March 3, 2009
• First Posted: March 4, 2009
• Study Start: July 1, 2006
• Primary Completion: July 1, 2009
• Study Completion: September 1, 2009
• Last Updated: November 27, 2017

Record last verified: 2017-11

Locations

US (1)