Better Evaluation of Acute Chest Pain With Computed Tomography Angiography (BEACON)
Better Evaluation of Acute Chest Pain With Computed Tomography Angiography - A Randomized Controlled Trial
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Detaljert beskrivelse
Myocardial infarction remains one of the most important causes of death and disability. Therefore it is important that individuals with acute chest pain are accurately assessed without delaying appropriate treatment. Acute coronary syndrome is only one cause for sudden chest pain, which is a very common complaint in the ER. Other life threatening causes such as pulmonary embolism and aortic dissection may also be the cause, although most chest discomfort has a benign reason (musculoskeletal, hyperventilation, oesophageal reflux, etc).
The current work-up of suspected acute coronary syndrome, based on presentation, symptoms, ECG and biomarkers, is not efficient and results in unnecessary diagnostics and hospital admissions, as well as errors or delayed diagnoses, in a substantial number of patients. Computed tomography angiography (CTA) images atherosclerosis, coronary obstruction as well as myocardial hypoperfusion. We hypothesize that early use of CTA is of incremental value and allows for accurate and immediate triage of patients with acute chest pain.
Studietype
Studietype
Registrering (Faktiske)
Registrering
Fase
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiesteder
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-
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Rotterdam, Nederland
- Erasmus MC
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Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Acute chest pain or equivalent
- Patients older than 30 years
- Males < 75 years and Females < 80 years
Exclusion Criteria:
- STEMI
- Troponin > 0.1
- History of known myocardial infarction, PCI or CABG
- Pregnancy
- Contrast allergy
- Renal disfunction
- No informed consent possible
- No follow-up possible
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Diagnostisk
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / Behandling |
|---|---|
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Aktiv komparator: Cardiac CT
Triage based on cardiac CT results.
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Calcium scan and CT coronary angiography
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Ingen inngripen: Standard Care
Standard diagnostic management according to the European guidelines.
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Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Successful discharge rate
Tidsramme: 30 days
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The proportion of patients discharged home without major adverse events during the following 30 days.
Major adverse events are cardiovascular death or non-fatal myocardial infarction.
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30 days
|
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Diagnostic yield of invasive angiography
Tidsramme: 30 days
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Number of patients identified with severe coronary artery disease identified by invasive angiography requiring revascularisation according to the international guidelines.
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30 days
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Successful discharge rate for all adverse events
Tidsramme: 30 days
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The proportion of patients discharged home without any adverse events during the following 30 days.
Adverse events are cardiovascular death, non-fatal myocardial infarction, unstable angina, coronary revascularization, repeat hospital visits for chest pain.
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30 days
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Major adverse events
Tidsramme: 6 months
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Composite endpoint of major adverse cardiac events at 6 months: cardiovascular death, non-fatal myocardial infarction, unstable angina, coronary revascularisation and repeat hospital visits for chest pain.
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6 months
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Acute coronary syndrome
Tidsramme: Index hospital visit
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Diagnosis of acute coronary syndrome, according to international guidelines, at time of discharge.
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Index hospital visit
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Missed myocardial infarctions
Tidsramme: 2 days
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Missed myocardial infarctions, at 2-day follow-up, in patients discharged from the emergency department.
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2 days
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Duration of hospital stay
Tidsramme: Index hospital visit
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Duration of hospital stay
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Index hospital visit
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Direct medical cost
Tidsramme: 30 days
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Direct medical costs until 30th day after ED visit.
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30 days
|
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Radiation exposure
Tidsramme: 6 months
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Cumulative medical radiation exposure at 6 months.
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6 months
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Renal function
Tidsramme: 2 days
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Change in renal function after 2 days.
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2 days
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Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Etterforskere
Etterforskere
- Hovedetterforsker: Koen Nieman, MD, PhD, Erasmus MC
Publikasjoner og nyttige lenker
Studierekorddatoer
Studer hoveddatoer
Studiestart
Studiestart
Primær fullføring (Faktiske)
Primær fullføring
Studiet fullført (Faktiske)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
Andre studie-ID-numre
- BEACON-11
Plan for individuelle deltakerdata (IPD)
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