Stress Echocardiography and Heart Computed Tomography (CT) Scan in Emergency Department Patients With Chest Pain

Montefiore Medicine Academic Health System

Status: Completed

Conditions: Coronary Artery Disease; Angina Pectoris; Chest Pain; Angina

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

Study type: Interventional

Funder types: Other

Identifiers

NCT01384448

11SDG7380006 (Other Grant/Funding Number)

MMC-11-03-107

Details and patient eligibility

About

The purpose of this study is to determine whether stress echocardiography or computed tomography (CT) of the heart is better at diagnosing emergency room chest pain patients to select appropriate candidates for hospitalization and further work-up.

Enrollment: 400 patients

Sex: All

Ages: 30+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Presentation to the Emergency Department with chest pain
• Low-to-intermediate risk of coronary disease per Diamond-Forrester criteria
• Free of known coronary artery disease

Exclusion criteria

• Inability to undergo both stress echo or coronary CT for any reason
• Contraindication to intravenous iodinated contrast
• Dysrhythmia precluding EKG gating
• Heart rate greater than 60 with contraindication to beta blockers
• Administration of beta blockers within the last 12 hours
• Known severe cardiac valvular disease or pulmonary hypertension
• Stress echocardiography, coronary CT or catheterization within the last 6 months

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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400 participants in 2 patient groups

Initial Stress Echocardiography

Experimental group

Treatment:

Procedure: Stress Echocardiography

Initial Coronary CT Angiography

Experimental group

Treatment:

Procedure: Coronary CT Angiography