NCT03929341

Brief Summary

This study will evaluate the ability of Coronary Computed Tomography Angiography (CCTA), used as a first-line diagnostic tool in women with stable chest pain and low risk for Coronary Artery Disease (CAD), to reduce the number of women requiring more than one diagnostic test to rule in or rule out CAD. Half of the participants will undergo CCTA as the first test to investigate stable chest pain, while the other half will undergo any test ordered by their family physician.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
130

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jan 2019

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 15, 2019

Completed
9 days until next milestone

Study Start

First participant enrolled

January 24, 2019

Completed
3 months until next milestone

First Posted

Study publicly available on registry

April 26, 2019

Completed
1.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2021

Completed
Last Updated

April 30, 2019

Status Verified

April 1, 2019

Enrollment Period

1.9 years

First QC Date

January 15, 2019

Last Update Submit

April 26, 2019

Conditions

Keywords

angina

Outcome Measures

Primary Outcomes (1)

  • Total Number of Tests

    The total number of tests a patient has to complete in order to diagnose the cause of their chest pain or equivalent symptoms

    Through study completion, which may take up to 1 year

Secondary Outcomes (6)

  • Time to Diagnosis

    From date of first presentation with chest pain to date of CAD diagnosis or exclusion, assessed up to 24 months

  • Wait Times to See a Cardiologist

    From date of cardiology referral letter sent by family physician to date of cardiologist appointment with patient, assessed up to 24 months

  • Hospital/ER visits

    Through study completion, which may take up to 1 year

  • Number of Normal Invasive Diagnostic Angiograms

    From date of randomization to date of CAD diagnosis or exclusion, assessed up to 24 months

  • Total Cost of Investigations

    Through study completion, which may take up to 1 year

  • +1 more secondary outcomes

Other Outcomes (2)

  • Incidence of Procedure Related Adverse Events

    From date of randomization to date of CAD diagnosis or exclusion, assessed up to 24 months

  • Incidence of Cardiovascular Events

    From date of randomization to date of CAD diagnosis or exclusion, assessed up to 24 months

Study Arms (4)

CCTA first approach with Cardiac Link

EXPERIMENTAL

Patient will undergo Coronary Computed Tomography Angiography as the first test and have Cardiac Link pathway activated for expedited cardiology referral.

Diagnostic Test: Coronary Computed Tomography Angiography (CCTA)Other: Cardiac Link

CCTA first approach without Cardiac Link

EXPERIMENTAL

Patient will undergo Coronary Computed Tomography Angiography as the first test, but Cardiac Link pathway will not be activated.

Diagnostic Test: Coronary Computed Tomography Angiography (CCTA)

Usual Care with Cardiac Link

ACTIVE COMPARATOR

Patient will undergo the usual diagnostic test ordered by their family physician as the first test, and have Cardiac Link pathway activated for expedited cardiology referral.

Diagnostic Test: Coronary Computed Tomography Angiography (CCTA)Other: Cardiac Link

Usual Care without Cardiac Link

ACTIVE COMPARATOR

Patient will undergo the usual diagnostic test ordered by their family physician as the first test, but Cardiac Link pathway will not be activated.

Diagnostic Test: Coronary Computed Tomography Angiography (CCTA)

Interventions

Cardiac imaging test that is able to detect changes is cardiac vessels and the heart.

CCTA first approach with Cardiac LinkCCTA first approach without Cardiac LinkUsual Care with Cardiac LinkUsual Care without Cardiac Link

Clinical patient flow pathway that will enable radiologist to activate expedited cardiology referral for patients who exhibit clinically significant changes during CCTA.

CCTA first approach with Cardiac LinkUsual Care with Cardiac Link

Eligibility Criteria

Age40 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Men and women age ≥ 40 years of age
  • Stable chest pain or equivalent symptoms
  • Planned non-urgent, non-invasive testing for diagnosis of chest pain or equivalent symptoms

You may not qualify if:

  • Acute coronary syndrome, including acute myocardial infarction or unstable angina, known non-ischemic cardiomyopathy or other cardiac disease (e.g. mitral valve prolapse, etc.) which would require urgent cardiac evaluation
  • Known CAD
  • Prior cardiac evaluation for current episode of symptoms
  • Previously investigated for CAD in the last 12 months
  • Severe allergic reaction to iodinated contrast (mild reactions such as urticaria that can be controlled by premedication with Benadryl \& Prednisone may be included in the study)
  • Renal failure or dysfunction (estimated Glomerular Filtration Rate\<30ml/min/m2 within the past 3 months)
  • Pregnancy (status will be confirmed verbally. For premenopausal patients who are unsure, status will be confirmed by completing a pregnancy strip test).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Women's College Hospital

Toronto, Ontario, M5S1B2, Canada

RECRUITING

MeSH Terms

Conditions

Chest PainAngina Pectoris

Condition Hierarchy (Ancestors)

PainNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and SymptomsMyocardial IschemiaHeart DiseasesCardiovascular DiseasesVascular Diseases

Study Officials

  • Elsie T Nguyen, MD, FRCPC

    Women's College Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Fahmeen J Afgani, MBBS

CONTACT

Elsie T Nguyen, MD, FRCPC

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
DIAGNOSTIC
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Associate Professor of Radiology

Study Record Dates

First Submitted

January 15, 2019

First Posted

April 26, 2019

Study Start

January 24, 2019

Primary Completion

January 1, 2021

Study Completion

January 1, 2021

Last Updated

April 30, 2019

Record last verified: 2019-04

Data Sharing

IPD Sharing
Will not share

Locations