Myocardial perfusion 320-row multidetector computed tomography-guided treatment strategy for the clinical management of patients with recent acute-onset chest pain: Design of the CArdiac cT in the treatment of acute CHest pain (CATCH)-2 randomized controlled trial

Patients admitted with chest pain are a diagnostic challenge because the majority does not have coronary artery disease (CAD). Assessment of CAD with coronary computed tomography angiography (CCTA) is safe, cost-effective, and accurate, albeit with a modest specificity. Stress myocardial computed to...

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Veröffentlicht in:The American heart journal 2016-09, Vol.179, p.127-135
Hauptverfasser: Sørgaard, Mathias, Linde, Jesper J, Hove, Jens D, Petersen, Jan R, Jørgensen, Tem B S, Abdulla, Jawdat, Heitmann, Merete, Kragelund, Charlotte, Hansen, Thomas Fritz, Udholm, Patricia M, Pihl, Christian, Kühl, J Tobias, Engstrøm, Thomas, Jensen, Jan Skov, Høfsten, Dan E, Kelbæk, Henning, Kofoed, Klaus F
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container_end_page 135
container_issue
container_start_page 127
container_title The American heart journal
container_volume 179
creator Sørgaard, Mathias
Linde, Jesper J
Hove, Jens D
Petersen, Jan R
Jørgensen, Tem B S
Abdulla, Jawdat
Heitmann, Merete
Kragelund, Charlotte
Hansen, Thomas Fritz
Udholm, Patricia M
Pihl, Christian
Kühl, J Tobias
Engstrøm, Thomas
Jensen, Jan Skov
Høfsten, Dan E
Kelbæk, Henning
Kofoed, Klaus F
description Patients admitted with chest pain are a diagnostic challenge because the majority does not have coronary artery disease (CAD). Assessment of CAD with coronary computed tomography angiography (CCTA) is safe, cost-effective, and accurate, albeit with a modest specificity. Stress myocardial computed tomography perfusion (CTP) has been shown to increase the specificity when added to CCTA, without lowering the sensitivity. This article describes the design of a randomized controlled trial, CATCH-2, comparing a clinical diagnostic management strategy of CCTA alone against CCTA in combination with CTP. Patients with acute-onset chest pain older than 50 years and with at least one cardiovascular risk factor for CAD are being prospectively enrolled to this study from 6 different clinical sites since October 2013. A total of 600 patients will be included. Patients are randomized 1:1 to clinical management based on CCTA or on CCTA in combination with CTP, determining the need for further testing with invasive coronary angiography including measurement of the fractional flow reserve in vessels with coronary artery lesions. Patients are scanned with a 320-row multidetector computed tomography scanner. Decisions to revascularize the patients are taken by the invasive cardiologist independently of the study allocation. The primary end point is the frequency of revascularization. Secondary end points of clinical outcome are also recorded. The CATCH-2 will determine whether CCTA in combination with CTP is diagnostically superior to CCTA alone in the management of patients with acute-onset chest pain.
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Assessment of CAD with coronary computed tomography angiography (CCTA) is safe, cost-effective, and accurate, albeit with a modest specificity. Stress myocardial computed tomography perfusion (CTP) has been shown to increase the specificity when added to CCTA, without lowering the sensitivity. This article describes the design of a randomized controlled trial, CATCH-2, comparing a clinical diagnostic management strategy of CCTA alone against CCTA in combination with CTP. Patients with acute-onset chest pain older than 50 years and with at least one cardiovascular risk factor for CAD are being prospectively enrolled to this study from 6 different clinical sites since October 2013. A total of 600 patients will be included. 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subjects Acute coronary syndromes
Adenosine
Angina pectoris
Blood pressure
Cardiovascular disease
Chest Pain - diagnostic imaging
Chest Pain - etiology
Computed Tomography Angiography
Coronary Angiography
Coronary Artery Disease - complications
Coronary Artery Disease - diagnostic imaging
Coronary vessels
Data analysis
Disease Management
Electrocardiography
Family medical history
Heart attacks
Heart rate
Hospitalization
Humans
Image Processing, Computer-Assisted
Imaging, Three-Dimensional
Medical imaging
Medical prognosis
Multidetector Computed Tomography
Myocardial Perfusion Imaging
Objectives
Pain
Patients
Sensitivity and Specificity
Studies
Vascular Calcification - diagnostic imaging
title Myocardial perfusion 320-row multidetector computed tomography-guided treatment strategy for the clinical management of patients with recent acute-onset chest pain: Design of the CArdiac cT in the treatment of acute CHest pain (CATCH)-2 randomized controlled trial
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