Myocardial perfusion 320-row multidetector computed tomography–guided treatment strategy for the clinical management of patients with recent acute-onset chest pain
| Autor: | Mathias Sørgaard, Dan Eik Høfsten, Jan Skov Jensen, Jesper J. Linde, Merete Heitmann, Thomas Fritz Hansen, Tem Jørgensen, Patricia M. Udholm, Charlotte Kragelund, Jens D. Hove, Christian Pihl, J R Petersen, Henning Kelbæk, Jawdat Abdulla, Klaus F. Kofoed, J. Tobias Kühl, Thomas Engstrøm |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry medicine.medical_treatment Fractional flow reserve 030204 cardiovascular system & hematology Chest pain Revascularization medicine.disease law.invention Coronary artery disease 03 medical and health sciences Myocardial perfusion imaging 0302 clinical medicine Randomized controlled trial law medicine Clinical endpoint 030212 general & internal medicine Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Computed tomography angiography |
| Zdroj: | American Heart Journal. 179:127-135 |
| ISSN: | 0002-8703 |
| DOI: | 10.1016/j.ahj.2016.05.016 |
| Popis: | Aims 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. Methods 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. Discussion 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. |
| Databáze: | OpenAIRE |
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