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Direct non-invasive coronary imaging by computed tomography (CT) has the potential to improve the workup of patients with stable chest pain complaints. The objective of the study is to compare in a randomized fashion the effectiveness and efficiency of a CT angiographic driven workup of suspected coronary artery disease in comparison to the standard workup using stress testing.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cardiac CT | Experimental | Cardiac CT (CT calcium and/or CT angiography), followed by stress testing, invasive angiography or neither depending on the CT scan result |
|
| Standard care | Other | Standard diagnostic management, including stress testing and/or invasive angiography |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cardiac CT | Other | Cardiac CT: calcium scan and CT coronary angiography |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Chest pain | Reduction of chest pain symptoms by standardized questionnaire, at one year follow-up | 1 year |
| Class IA Revascularizations | Number of revascularizations with an ESC class 1A indication | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Overall medical expenses | Overall medical expenses | 1 year |
| Cost-effectiveness | Cost-effectiveness analysis based on the overall quality of life and medical expenses at one year. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| MC Haaglanden | Leidschendam | Netherlands | ||||
| Erasmus MC |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28174196 | Derived | Lubbers M, Coenen A, Bruning T, Galema T, Akkerhuis J, Krenning B, Musters P, Ouhlous M, Liem A, Niezen A, Dedic A, van Domburg R, Hunink M, Nieman K. Sex Differences in the Performance of Cardiac Computed Tomography Compared With Functional Testing in Evaluating Stable Chest Pain: Subanalysis of the Multicenter, Randomized CRESCENT Trial (Calcium Imaging and Selective CT Angiography in Comparison to Functional Testing for Suspected Coronary Artery Disease). Circ Cardiovasc Imaging. 2017 Feb;10(2):e005295. doi: 10.1161/CIRCIMAGING.116.005295. |
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| ID | Term |
|---|---|
| D000787 | Angina Pectoris |
| D002637 | Chest Pain |
| D003324 | Coronary Artery Disease |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| D059039 | Standard of Care |
| ID | Term |
|---|---|
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |
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| Standard care |
| Other |
Standard care according to international guidelines |
|
| 1 year |
| Radiation dose | Cumulative radiation exposure at one year | 1 year |
| Major adverse cardiovascular events | Composite endpoint of adverse cardiovascular events, including: All-cause mortality Non-fatal myocardial infarction Unstable angina requiring hospital admission Late revascularization procedures (>6 months after initial evaluation) | 1 year |
| Quality of life | Change of quality of life at 1 year | 1 year |
| Rotterdam |
| Netherlands |
| Havenziekenhuis | Rotterdam | Netherlands |
| Maasstadziekenhuis | Rotterdam | Netherlands |
| D010146 |
| Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D003327 | Coronary Disease |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |