Cardiac-CT in the Treatment of Acute Chest Pain (CATCH)

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.

Study Overview

• Status: Completed
• Conditions: Ischemic Heart Disease
• Intervention / Treatment: Procedure: Cardiac computed tomographic angiography (CCTA)

• Study Type: Interventional
• Enrollment (Actual): 600
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Denmark
  • Hvidovre, Denmark, 2650
    • Hvidovre University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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.

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

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: CT guided group; For Patients with chest pain randomised to this arm, clinical decision will be based on the results of a Cardiac computed tomographic angiography (CCTA)	Procedure: Cardiac computed tomographic angiography (CCTA); Patients will (on top of the standard clinical evaluation with a functional-based stress-test) be examined with a Cardiac CT scan. In the control group, the Cardiac CT will be blinded for clinical evaluation and only used retrospectively for research purpose.; Other Names: Adenosin for CT myocardial perfusion
No Intervention: Control group; Patients with chest pain randomised to the control group will be evaluated using the standard functional-based strategy with either a treadmill stress-test or SPECT (single-photon emission computed tomography). A Cardiac CT will will be performed, but will be blinded for initial clinical evaluation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
combined endpoint of: Cardiac death, myocardial infarction, unstabile angina, revascularisation, readmissions for chest pain	1 year follow-up

Secondary Outcome Measures

Outcome Measure	Time Frame
Cardiac death	1 year follow-up
myocardial infarction	1 year follow-up
readmissions for chest pain	1 year follow-up
Revascularisation	1 year follow-up
unstabile angina	1-year follow-up
continued chest pain	1 year follow-up
Quality of life (SF-36)	1-year follow-up
medication	1-year follow-up
non-cardiac findings on CT	1-year follow-up
downstream testing	1-year follow-up

Collaborators and Investigators

• Sponsor: Hvidovre University Hospital
• Investigators: Study Director: Jesper J Linde, MD, Hvidovre University Hospital

Publications and helpful links

General Publications

• Linde JJ, Hove JD, Sorgaard M, Kelbaek H, Jensen GB, Kuhl JT, Hindso L, Kober L, Nielsen WB, Kofoed KF. Long-Term Clinical Impact of Coronary CT Angiography in Patients With Recent Acute-Onset Chest Pain: The Randomized Controlled CATCH Trial. JACC Cardiovasc Imaging. 2015 Dec;8(12):1404-1413. doi: 10.1016/j.jcmg.2015.07.015. Epub 2015 Nov 11.

Study record dates

Study Major Dates

• Study Start: January 1, 2010
• Primary Completion (Actual): January 1, 2014
• Study Completion (Actual): January 1, 2014

Study Registration Dates

• First Submitted: December 22, 2011
• First Submitted That Met QC Criteria: February 15, 2012
• First Posted (Estimate): February 16, 2012

Study Record Updates

• Last Update Posted (Estimate): June 19, 2014
• Last Update Submitted That Met QC Criteria: June 18, 2014
• Last Verified: June 1, 2014

More Information

Terms related to this study

• Keywords: Cardiac CT; Stress test; Ischemic heat disease
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Pain; Neurologic Manifestations; Coronary Disease; Heart Diseases; Coronary Artery Disease; Myocardial Ischemia; Chest Pain
• Other Study ID Numbers: H-C-2009-053