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| ID | Type | Description | Link |
|---|---|---|---|
| 11SDG7380006 | Other Grant/Funding Number | American Heart Association National Center |
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| Name | Class |
|---|---|
| American Heart Association | OTHER |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Initial Stress Echocardiography | Experimental |
| |
| Initial Coronary CT Angiography | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stress Echocardiography | Procedure | Stress echocardiography will be performed once. Treadmill stress is default. Patients that cannot exercise will receive dobutamine stress with or without atropine. Definity intravenous contrast will be given when needed. |
| Measure | Description | Time Frame |
|---|---|---|
| Hospital admission | 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| Emergency Department length of stay | 30 days | |
| Hospital length of stay | 30 days | |
| Estimated cost of initial care |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jeffrey M Levsky, MD, PhD | Montefiore Medical Center/Albert Einstein College of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Montefiore Medical Center - Weiler / Einstein Division | The Bronx | New York | 10462 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24372760 | Background | Levsky JM, Haramati LB, Taub CC, Spevack DM, Menegus MA, Travin MI, Vega S, Lerer R, Brown-Manhertz D, Hirschhorn E, Tobin JN, Garcia MJ. Rationale and design of a randomized trial comparing initial stress echocardiography versus coronary CT angiography in low-to-intermediate risk emergency department patients with chest pain. Echocardiography. 2014 Jul;31(6):744-50. doi: 10.1111/echo.12464. Epub 2013 Dec 23. | |
| 29909113 |
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| Coronary CT Angiography | Procedure | 64-detector, resting EKG-gated coronary CT angiography will be performed once. Patients with elevated heart rates will be given oral and/or intravenous metoprolol. Prospective gating with reduced tube current will be default. Retrospective gating with tube current modulation will be used in patients with higher heart rates. |
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| 30 days |
| Repeat visits to the Emergency Department | 30 days and 1 year |
| Death | 30 days and 1 year |
| Non-fatal myocardial infarction | 30 days and 1 year |
| Background |
| Levsky JM, Haramati LB, Spevack DM, Menegus MA, Chen T, Mizrachi S, Brown-Manhertz D, Selesny S, Lerer R, White DJ, Tobin JN, Taub CC, Garcia MJ. Coronary Computed Tomography Angiography Versus Stress Echocardiography in Acute Chest Pain: A Randomized Controlled Trial. JACC Cardiovasc Imaging. 2018 Sep;11(9):1288-1297. doi: 10.1016/j.jcmg.2018.03.024. Epub 2018 Jun 13. |
| ID | Term |
|---|---|
| D002637 | Chest Pain |
| D000787 | Angina Pectoris |
| D003324 | Coronary Artery Disease |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
| D003327 | Coronary Disease |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
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