Coronary Computed Tomography Versus Invasive Angiography for Non-ST Elevation Acute Coronary Syndrome (TRACTION)

Rigshospitalet

Status: Enrolling

Conditions: Coronary Artery Disease; Multidetector Computed Tomography; Acute Myocardial Infarction (AMI); Randomized Controlled Trial; Coronary Stenoses; Non STEMI; Angina Pectoris, Unstable; Ischemic Heart Disease; Percutaneous Coronary Intervention; Heart Attack; Diagnostic Imaging; Coronary Disease

Treatments: Procedure: Conventional ICA; Other: Team-based interventional triage; Procedure: CCTA

Study type: Interventional

Funder types: Other

Identifiers

NCT06101862

H-23024848

Details and patient eligibility

About

Coronary computed tomography angiography (CCTA) is a widely accepted initial diagnostic test for individuals suspected of having chronic coronary syndromes. However, there is limited evidence supporting its use in the acute setting. So far, no large-scale randomized trial has examined the performance of CCTA as an alternative to invasive coronary angiography (ICA) in individuals with non-ST-segment elevation myocardial infarction (NSTEACS).

If CCTA were to replace ICA as a routine procedure for individuals with NSTEACS, it could reduce the risk of complications related to ICA, improve patient comfort, expedite decision-making, and reduce healthcare expenses and interhospital transfers.

Enrollment: 2,300 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Admitted with non-ST-segment elevation myocardial infarction or unstable angina pectoris and an indication for subacute ICA
• Elevated troponin or ischemic electrocardiographic changes
• Written informed consent

Exclusion criteria

• Instability requiring acute or emergent ICA
• History of percutaneous coronary intervention or coronary artery bypass grafting
• Estimated glomerular filtration rate < 30 mL/min/1.73m2
• Probable type 2 acute myocardial infarction
• Severe valvular heart disease as primary diagnosis or potential need for valve intervention
• History of spontaneous coronary artery dissection
• Expected poor quality of the CCTA
• Prior CCTA or ICA during index admission or within 1 week
• Known allergy to beta-blockers or contrast agent
• Pregnant or nursing
• Previously randomized in this trial

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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2,300 participants in 2 patient groups

Coronary computed tomography angiography + team-based interventional triage

Active Comparator group

Treatment:

Procedure: CCTA

Other: Team-based interventional triage

Conventional invasive coronary angiography

Other group

Treatment:

Procedure: Conventional ICA