Better Evaluation of Acute Chest Pain With Computed Tomography Angiography (BEACON)

Erasmus University

Status: Completed

Conditions: Acute Coronary Syndrome; Acute Chest Pain

Treatments: Radiation: Cardiac CT

Study type: Interventional

Funder types: Other

Identifiers

NCT01413282

BEACON-11

Details and patient eligibility

About

The purpose of this study is to determine whether cardiac CT can improve triage of acute chest pain patients in the emergency department.

Full description

Myocardial infarction remains one of the most important causes of death and disability. Therefore it is important that individuals with acute chest pain are accurately assessed without delaying appropriate treatment. Acute coronary syndrome is only one cause for sudden chest pain, which is a very common complaint in the ER. Other life threatening causes such as pulmonary embolism and aortic dissection may also be the cause, although most chest discomfort has a benign reason (musculoskeletal, hyperventilation, oesophageal reflux, etc).

The current work-up of suspected acute coronary syndrome, based on presentation, symptoms, ECG and biomarkers, is not efficient and results in unnecessary diagnostics and hospital admissions, as well as errors or delayed diagnoses, in a substantial number of patients. Computed tomography angiography (CTA) images atherosclerosis, coronary obstruction as well as myocardial hypoperfusion. We hypothesize that early use of CTA is of incremental value and allows for accurate and immediate triage of patients with acute chest pain.

Enrollment: 500 patients

Sex: All

Ages: 30 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Acute chest pain or equivalent
• Patients older than 30 years
• Males < 75 years and Females < 80 years

Exclusion criteria

• STEMI
• Troponin > 0.1
• History of known myocardial infarction, PCI or CABG
• Pregnancy
• Contrast allergy
• Renal disfunction
• No informed consent possible
• No follow-up possible

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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500 participants in 2 patient groups

Cardiac CT

Active Comparator group

Description:

Triage based on cardiac CT results.

Treatment:

Radiation: Cardiac CT

Standard Care

No Intervention group

Description:

Standard diagnostic management according to the European guidelines.