Study Comparing CT Scan and Stress Test in Diagnosing Coronary Artery Disease in Patients Hospitalized for Chest Pain (PROSPECT)

Montefiore Medicine Academic Health System

Status: Completed

Conditions: Coronary Artery Disease; Unstable Angina; Acute Coronary Syndrome; Angina Pectoris

Treatments: Procedure: Stress Nuclear Myocardial Perfusion Imaging; Procedure: Coronary Computed Tomography Angiography

Study type: Interventional

Funder types: Other

Identifiers

NCT00705458

MMC-07-07-197

Details and patient eligibility

About

The purpose of this study is to determine whether coronary artery CT scanning or nuclear stress testing is better at diagnosing chest pain patients with coronary artery disease to select appropriate candidates for coronary catheterization and re-vascularization.

Enrollment: 400 patients

Sex: All

Ages: 21+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patient admitted for chest pain or pressure
• patient at intermediate short term risk of MI or death (AHA/ACC guidelines)

Exclusion criteria

• prior diagnosis of coronary artery disease
• evidence of ongoing myocardial infarction (and other high risk criteria per AHA/ACC guidelines)
• contraindications to EKG-gated CT scanning with iodinated intravenous contrast under beta-blockade
• pregnancy
• presence of an implanted pacemaker or defibrillator
• stress myocardial perfusion imaging, coronary CTA or coronary 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

CTA

Experimental group

Description:

Initial EKG-gated computed tomography angiography of the coronary arteries

Treatment:

Procedure: Coronary Computed Tomography Angiography

MPI

Active Comparator group

Description:

Initial nuclear stress myocardial perfusion imaging

Treatment:

Procedure: Stress Nuclear Myocardial Perfusion Imaging