Chest Pain Clinical Trial
Official title:
Risk Evaluation and Stratification of Low Risk for Cardiovascular Disease in Women: An Innovative Strategy for Investigating Stable Chest Pain in Low to Intermediate Risk Women
This study will evaluate the ability of Coronary Computed Tomography Angiography (CCTA), used as a first-line diagnostic tool in women with stable chest pain and low risk for Coronary Artery Disease (CAD), to reduce the number of women requiring more than one diagnostic test to rule in or rule out CAD. Half of the participants will undergo CCTA as the first test to investigate stable chest pain, while the other half will undergo any test ordered by their family physician.
Coronary artery disease (CAD) is the leading cause of death in women globally. Women are more
likely to present with atypical chest pain that may be difficult to diagnose using
traditional testing methods, resulting in over-investigation.
Coronary computed tomography angiography (CCTA) has high negative predictive value for
exclusion of CAD in low to intermediate risk populations. We plan to investigate CCTA as a
first line test to exclude coronary artery disease as a cause of stable chest pain and
whether it is a cost effective strategy that reduces time to diagnosis, wait times to see
cardiologists, emergency department visits, downstream and repeat testing and radiation
exposure as compared to usual care with comparable patient safety and satisfaction level.
Another intervention being tested in this trial is the Cardiac Link pathway. This is a new
clinical program at Women's College Hospital that aims to expedite cardiology referral for
patients exhibiting clinically significant findings while undergoing CCTAs.
We hope that with use of CCTA as the first test, the number of women who require only one
test (i.e. CCTA) to sort out whether or not CAD is responsible for their chest pain will
increase, thereby decreasing over-investigation of low risk women.
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