Study Comparing CT Scan and Stress Test in Diagnosing Coronary Artery Disease in Patients Hospitalized for Chest Pain (PROSPECT)
A Randomized Trial Comparing Multi-Detector Coronary CT Angiography and Stress Myocardial Perfusion Imaging as the Initial Test for the Diagnosis of Coronary Artery Disease in Intermediate Risk Patients Admitted for Chest Pain
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
New York
-
Bronx, New York, United States, 10467
- Moses Division, Montefiore Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
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
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: CTA
Initial EKG-gated computed tomography angiography of the coronary arteries
|
64-detector, retrospectively EKG-gated, computed tomography angiography of the coronary arteries during heart rate control (intravenous metoprolol, when necessary)
Other Names:
|
|
Active Comparator: MPI
Initial nuclear stress myocardial perfusion imaging
|
Usually dual-isotope perfusion imaging at rest (201-Thallium) and at stress (99m-Technetium-MIBI).
Some patients will have a 2-day MIBI protocol.
Gated SPECT and attenuation-correction images will be obtained.
Treadmill stress will be performed.
If a patient is unable to exercise, adenosine or dobutamine will be given.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Coronary catheterization that does not lead to re-vascularization
Time Frame: 1 year
|
1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Length of Hospital Stay (time to discharge)
Time Frame: usually from hours to a few days (average about one day)
|
usually from hours to a few days (average about one day)
|
|
Non-fatal myocardial infarction
Time Frame: 1 year
|
1 year
|
|
Death (all cause)
Time Frame: 1 year
|
1 year
|
|
Post-test renal dysfunction
Time Frame: usually within a few days
|
usually within a few days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Jeffrey M Levsky, MD, PhD, Montefiore Medical Center/Albert Einstein College of Medicine
- Study Director: Linda B Haramati, MD, MS, Montefiore Medical Center/Albert Einstein College of Medicine
Publications and helpful links
General Publications
- Levsky JM, Travin MI, Spevack DM, Menegus MA, Huang PW, Goldberg Y, Clark ET, Banoth P, Freeman KD, Tobin JN, Haramati LB. Rationale and design of a randomized controlled trial comparing stress myocardial perfusion imaging with coronary CT angiography as the initial imaging study for intermediate-risk patients admitted with chest pain. J Cardiovasc Comput Tomogr. 2009 Jul-Aug;3(4):264-71. doi: 10.1016/j.jcct.2009.05.006. Epub 2009 May 21.
- Levsky JM, Spevack DM, Travin MI, Menegus MA, Huang PW, Clark ET, Kim CW, Hirschhorn E, Freeman KD, Tobin JN, Haramati LB. Coronary Computed Tomography Angiography Versus Radionuclide Myocardial Perfusion Imaging in Patients With Chest Pain Admitted to Telemetry: A Randomized Trial. Ann Intern Med. 2015 Aug 4;163(3):174-83. doi: 10.7326/M14-2948.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- MMC-07-07-197
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