PROTECCT Trial
Research type
Research Study
Full title
Prostpective RandOmised Trial of Emergency Cardiac CT: (PROTECCT Trial)
IRAS ID
223704
Contact name
Reza Razavi
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
1 years, 9 months, 30 days
Research summary
Patients who present to the emergency department (ED) with acute chest pain (ACP) possibly due to Coronary artery disease (CAD), with a normal heart tracing (ECG), need to have further troponin blood tests to confirm or exclude a heart attack. After initial troponin testing, a significant 50-85% of patients are said to be in an “observational zone” as one cannot confirm or exclude a diagnosis of a heart attack. Even after repeat blood testing, 22-33% remain in this “observational zone”. These patients can be challenging to manage as they are not safe to be discharged home, but they also cannot be treated as a heart attack. This contributes to ED overcrowding and uncertainty in treatment plans.
Current standard of care for confirming CAD in these patients has been invasive coronary angiography. More detailed information involves imaging individual “high-risk” narrowings (plaque characterisation). This is achieved by passing of catheters and wires into the coronary arteries.
Cardaic CT (CTCA) scanning is capable of non-invasively evaluating CAD and plaque characterisation.
However, the effect of CTCA on hospital length of stay of ACP patients who remain in the “observational” zone remains to be investigated. Also the influence of plaque characterisation by CT on the choice of patient management plans by doctors also remains to be investigated.To answer these questions, we propose a study where patients with ACP presenting to the ED at Guy’s and St. Thomas, who are found to be in the “observational zone” after initial troponin, will be evaluated by standard of care versus standard of care plus cardiac CT. It is anticipated that the study will require approximately 52 weeks to recruit a target of 250 patients.
REC name
East Midlands - Leicester South Research Ethics Committee
REC reference
17/EM/0375
Date of REC Opinion
13 Nov 2017
REC opinion
Further Information Favourable Opinion