ProspEctive First Evaluation in Chest Pain Trial (PERFECT)

St. Luke's-Roosevelt Hospital Center

Status: Completed

Conditions: Shortness of Breath; Chest Pain; Suspected Acute Coronary Syndrome

Treatments: Procedure: Coronary CT Angiography; Procedure: Stress Test

Study type: Interventional

Funder types: Other

Identifiers

NCT01604655

11-307

Details and patient eligibility

About

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

Full description

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.

Enrollment: 411 patients

Sex: All

Ages: 45+ years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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411 participants in 2 patient groups

Coronary CT Angiography

Active Comparator group

Description:

Patient admitted with chest pain is randomized to CCTA for assessment.

Treatment:

Procedure: Coronary CT Angiography

Stress Test

Active Comparator group

Description:

Patients admitted with chest pain are randomized to a stress test (stress SPECT or Echocardiography) for assessment.

Treatment:

Procedure: Stress Test