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ECG-less Coronary Computed Tomography Angiography in the Management of Patients Presenting With High-troponin Chest Pain

RecruitingNAAges 30 Years - anyAllUniversitair Ziekenhuis Brussel
NCT07192965 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

Chest pain represents a common reason for consultation to emergency room. This symptom can be explained by a broad spectrum of conditions, from benign musculoskeletal or esophageal pain to life-threatening disease such as aortic dissection, pulmonary embolism, and myocardial infarction. There are already different diagnostic tools to quickly identify most dangerous diseases, for example electrocardiogram, blood samples with specific markers of cardiac injury, chest X-ray and echography. In case a doubt of disease is raised after the first clinical evaluation, it is possible to proceed with more complex, expensive and invasive examinations, namely a computed tomography (CT) scan or an invasive coronary angiography (ICA). CT scan allows the diagnosis of various conditions such as pleural, pulmonary, pericardial and vascular disease such as pneumonia, pneumothorax, pleural and pericardial

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📋 Eligibility rules (as published)
Inclusion Criteria: * Age ≥ 30 years old * Admission at the ER with acute chest pain and at least one of the follow-ing: 1. ECG abnormality; 2. positive rule-in criteria according to the ESC guidelines (hs-cTnT ≥ 52 in at least one assay or 1h ∆ ≥ 5); 3. troponine value in the "observe pathway" (hs-cTnT ≥ 12 in at least one assay or 1h ∆ ≥ 3) AND a high clinical suspicion of MI. Exclusion Criteria: * Indication for urgent ICA (ST-elevation, hemodynamic or electric instabil-ity, refractory chest pain, mechanical complications) * eGFR \< 30 ml/min * Previous coronary stenting * Previous CABG * Recent ACS within 6 months * Known severely reduced ejection fraction (EF \< 30%) * Contrast allergy * Inability to provide informed consent * Limited life expectancy \< 2 years due to non-cardiac conditions * Pregnant and breast-feeding women * Known congenital heart disease * Atrial fibrillation
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What it tests

  • Non-ECG-gated computed tomography
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Where

1 site
Universitair Ziekenhuis Brussel
Jette, Belgium
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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