Cardiac-CT in the Treatment of Acute Chest Pain

Cardiac-CT in the Treatment of Acute Chest Pain

Objectives The CATCH trial (CArdiac cT in the treatment of acute CHest pain) is a prospective randomized controlled trial designed to evaluate the clinical value of cardiac multidetector computed tomography (MDCT) as a first-line diagnostic strategy in patients with acute chest pain, compared to a conventional functional-based testing strategy.

Methods:

Consecutive patients admitted with acute chest pain of suspected cardiac origin, but normal electrocardiogram and biomarkers were randomized to evaluation with 320-MDCT coronary angiography (CT-guided group) or with standard bicycle exercise test and/or myocardial perfusion imaging - MPI (Control group).

After one year, patients will be followed-up, with registration of clinical endpoints such as Cardiac death, myocardial infarction, need for revascularisation, admittance for heart related problems, sustained chest pain, live quality score, use of medication.

Inclusion Criteria:

• Admittance because of Chest pain
• Non- or non-diagnostic ecg-changes.
• Normal biomarkers for ischemia (Troponins)
• Chest X-ray without pathological findings associated with chest pain.

Exclusion Criteria:

• Women of childbearing age, or > 40 years and using approved contraception.
• Claustrophobia
• Patients with geographical residence, that complicates follow-up
• Patients with mental or physical conditions that impede follow-up
• Increase in Troponins
• New diagnostic ECG changes with ST-segment elevation or depression greater than 1mm or T-yew inversion> 4 mm in> 2 anatomically connected derivations.
• Allergy to iodinated contrast agents
• Serum creatinine greater than 130 mg/l
• Abnormal chest x-ray or blood tests hospitalization as assessed as the main cause of the patient's pain problem.