Document Detail


Design of the Rule Out Myocardial Ischemia/Infarction Using Computer Assisted Tomography: a multicenter randomized comparative effectiveness trial of cardiac computed tomography versus alternative triage strategies in patients with acute chest pain in the emergency department.
MedLine Citation:
PMID:  22424002     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although early cardiac computed tomographic angiography (CCTA) might improve the management of emergency department (ED) patients with acute chest pain, it could also result in increased testing, costs, and radiation exposure. ROMICAT II was a randomized comparative effectiveness trial enrolling patients 40 to 74 years old without known coronary artery disease who presented to the ED with chest pain but without ischemic electrocardiographic (ECG) changes or elevated initial troponin and who required further risk stratification. Overall, 1000 patients at 9 sites within the United States were randomized to either CCTA as the first diagnostic test following serial biomarkers or to standard of care, which included no testing or functional testing such as exercise ECG, stress radionuclide imaging, or stress echocardiography. Test results were provided to ED physicians, yet patient management was not driven by a study protocol in either arm. Data were collected on diagnostic testing, cardiac events, and cost of medical care for the index hospitalization and during the following 28 days. The primary end point was length of hospital stay. Secondary end points were cumulative radiation exposure, resource utilization, and costs of competing strategies. Tertiary end points were institutional, physician, and patient characteristics associated with primary and secondary outcomes. Rate of missed acute coronary syndrome within 28 days was the safety end point. The ROMICAT II will provide rigorous data on whether CCTA is more efficient than standard of care in the management of patients with acute chest pain at intermediate risk for acute coronary syndrome.
Authors:
Udo Hoffmann; Quynh A Truong; Jerome L Fleg; Alexander Goehler; Scott Gazelle; Stephen Wiviott; Hang Lee; James E Udelson; David Schoenfeld;
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2012-02-22
Journal Detail:
Title:  American heart journal     Volume:  163     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-19     Completed Date:  2012-05-15     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  330-8, 338.e1     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01084239
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Chest Pain / diagnosis*,  etiology
Diagnosis, Differential
Electrocardiography
Emergency Service, Hospital*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / complications,  diagnosis*
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Triage / methods*
Grant Support
ID/Acronym/Agency:
K23 HL098370/HL/NHLBI NIH HHS; K23HL098370/HL/NHLBI NIH HHS; K24 HL113128/HL/NHLBI NIH HHS; L30 HL093806/HL/NHLBI NIH HHS; L30HL093896/HL/NHLBI NIH HHS; U01 HL092040/HL/NHLBI NIH HHS; U01HL092040/HL/NHLBI NIH HHS
Investigator
Investigator/Affiliation:
Thomas Hauser / ; J Hector Pope / ; Eric Chou / ; Pamela Woodward / ; Scott Weiner / ; Charles White / ; John Tobias Nagurney / ; Frank Peacock / ; Peter S Pang / ; Issam Mikati / ; Linda Pierchala / ; Elonia Martin / ; W Frank Peacock / ; Scott Daniel Flamm / ; Paul Schoenhagen / ; Mike Bolen / ; Elizabeth Gaul / ; Michael E Mullins / ; Ravi Rasalingham / ; Scott Harring / ; Donna Lesniak / ; Brien A Barnewolt / ; Shant Kalajian / ; Bao K Do / ; Suzanne Zychowicz / ; Lynn Owens / ; Usha Vaghasia / ; Ava Chappell / ; Haregwoin Woldetensay / ; Rosemary Byrne / ; David Brown / ; Han-Na Kim Gaggin / ; Brian Ghoshhajra / ; James Bayley / ; Heidi Lumish / ; Teresa Cheng Cheng / ; Blair Alden Parry / ; Christopher Moore / ; Fidela S J Blank / ; Richard Barus / ; Ryan Coute / ; Tricia Schmidt / ; Daniel Johnston / ; James Waring / ; Nathan Shapiro / ; Andrew Bierhals / ; Cylen Javidan-Nejad / ; Michael Bond / ; Kian Lahiji Reza Fardanesh /
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  A multifaceted intervention to narrow the evidence-based gap in the treatment of acute coronary synd...
Next Document:  A randomized controlled trial of oxygen therapy in acute myocardial infarction Air Verses Oxygen In ...