دورية أكاديمية
Early computed tomography coronary angiography in adults presenting with suspected acute coronary syndrome: the RAPID-CTCA RCT
| العنوان: | Early computed tomography coronary angiography in adults presenting with suspected acute coronary syndrome: the RAPID-CTCA RCT |
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| المؤلفون: | Gray, A.J., Roobottom, C., Smith, J.E., Goodacre, S., Oatey, K., O’Brien, R., Storey, R.F., Curzen, N., Keating, L., Kardos, A., Felmeden, D., Lee, R.J., Thokala, P., Lewis, S.C., Newby, D.E. |
| بيانات النشر: | National Institute for Health and Care Research (NIHR) |
| سنة النشر: | 2022 |
| المجموعة: | White Rose Research Online (Universities of Leeds, Sheffield & York) |
| الوصف: | Background Acute coronary syndrome is a common medical emergency. The optimal strategy to investigate patients who are at intermediate risk of acute coronary syndrome has not been fully determined. Objective To investigate the role of early computed tomography coronary angiography in the investigation and treatment of adults presenting with suspected acute coronary syndrome. Design A prospective, multicentre, open, parallel-group randomised controlled trial with blinded end-point adjudication. Setting Thirty-seven hospitals in the UK. Participants Adults (aged ≥ 18 years) presenting to the emergency department, acute medicine services or cardiology department with suspected or provisionally diagnosed acute coronary syndrome and at least one of the following: (1) a prior history of coronary artery disease, (2) a cardiac troponin level > 99th centile and (3) an abnormal 12-lead electrocardiogram. Interventions Early computed tomography coronary angiography in addition to standard care was compared with standard care alone. Participants were followed up for 1 year. Main outcome measure One-year all-cause death or subsequent type 1 (spontaneous) or type 4b (stent thrombosis) myocardial infarction, measured as the time to such event adjudicated by two cardiologists blinded to the computerised tomography coronary angiography (CTCA) arm. Cost-effectiveness was estimated as the lifetime incremental cost per quality-adjusted life-year gained. Results Between 23 March 2015 and 27 June 2019, 1748 participants [mean age 62 years (standard deviation 13 years), 64% male, mean Global Registry Of Acute Coronary Events score 115 (standard deviation 35)] were randomised to receive early computed tomography coronary angiography (n = 877) or standard care alone (n = 871). The primary end point occurred in 51 (5.8%) participants randomised to receive computed tomography coronary angiography and 53 (6.1%) participants randomised to receive standard care (adjusted hazard ratio 0.91, 95% confidence interval 0.62 to 1.35; p ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| العلاقة: | https://eprints.whiterose.ac.uk/195691/1/3040257%20%281%29.pdfTest; Gray, A.J. orcid.org/0000-0003-1460-8327 , Roobottom, C. orcid.org/0000-0001-5066-7645 , Smith, J.E. orcid.org/0000-0002-6143-0421 et al. (12 more authors) (2022) Early computed tomography coronary angiography in adults presenting with suspected acute coronary syndrome: the RAPID-CTCA RCT. Health Technology Assessment, 26 (37). ISSN 1366-5278 |
| DOI: | 10.3310/irwi5180 |
| الإتاحة: | https://doi.org/10.3310/irwi5180Test https://eprints.whiterose.ac.uk/195691Test/ https://eprints.whiterose.ac.uk/195691/1/3040257%20%281%29.pdfTest |
| حقوق: | cc_by_4 |
| رقم الانضمام: | edsbas.BCE4F7C2 |
| قاعدة البيانات: | BASE |
| DOI: | 10.3310/irwi5180 |
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