The RAPID-CTCA trial (Rapid Assessment of Potential Ischaemic Heart Disease with CTCA) — a multicentre parallel-group randomised trial to compare early computerised tomography coronary angiography versus standard care in patients presenting with suspected or confirmed acute coronary syndrome: study protocol for a randomised controlled trial
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Why the study?
Does early CTCA in addition to standard care reduce all-cause death or recurrent myocardial infarction in patients with suspected or confirmed acute coronary syndrome?
Population
2,500 planned adults with symptoms mandating investigation for suspected or confirmed acute coronary…
Comparison
Early use of ≥64-slice computerised tomography… vs Standard care only.
Design
RCT, 1:1 randomised, stratified by study site, using a web-based randomisation…
Follow-up
1 year
Authors
Discussion
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Implication
Early CTCA may refine CAD assessment beyond troponin in intermediate-risk ED chest pain; leaves open outcome impact and practice change.
Structured PICO
Does early CTCA in addition to standard care reduce all-cause death or recurrent myocardial infarction in patients with suspected or confirmed acute coronary syndrome?
P
Population
2,500 planned adults (≥18 years) with symptoms mandating investigation for suspected or confirmed acute coronary syndrome (ACS) with at least one of: ECG abnormalities, history of ischaemic heart disease, or troponin elevation above the 99th centile. Exclusions include STEMI, ACS with acute heart failure or shock, crescendo angina, marked ECG changes, severe renal failure, and contrast allergy.
I
Intervention
Early use of ≥64-slice computerised tomography coronary angiography (CTCA) in addition to standard care, performed during initial admission or within 72 hours if discharged.
C
Comparator
Standard care only (standard management for patients with suspected or confirmed ACS at the hospital site).
O
Outcome
Composite of all-cause death or recurrent non-fatal type 1 or type 4b myocardial infarction at 1 year, measured as time to first event.composite
The RAPID-CTCA trial protocol outlines a large multicenter RCT to determine if early CTCA improves clinical outcomes and cost-effectiveness in intermediate-risk patients presenting with suspected or confirmed acute coronary syndrome.
Cite This Study
Gray et al. (2016) studied this question.
Topics
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