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Chest Pain - ClinicalTrials.gov

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Last Updated: 19 May 2022

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Acute Chest Pain Imaging in Emergency Department With Combined Approach of Coronary CT Angiography and CT Myocardial Perfusion

BACKGROUND AND RATIONALE: BACKGROUND AND RATIONALE: Because of the subjectivity of clinical signs and the indirect nature of established ischemia tests, efficient initial triage of patients with acute new onset chest pain is difficult, resulting in a large number of patients admitted to the hospital despite not having obstructive coronary disease, and acute new onset chest pain is common. Coronay morphology will be assessed by CT coronary angiography along with CT myocardial perfusion analysis, allowing you to more accurately identify coronary lesions for decision making of a potential coronary intervention. The cardiac radiologist will analyze whether the patient has a disease or not evaluable segment as defined in the protocol. The sum of all the segment scores will determine whether the patient has a disease decision to do CT myocardial Perfusion will be made by the cardiac radiologist after the acquisition of the calcium score or after identifying a moderate stenosis or non-evaluable segment as described in the protocol. If stenosis by coronary CT angiography is > 50% or an intermediate/non-diagnostic lesion is identified, acute coronary syndrome will be excluded from acute coronary syndrome, and no myocardial ischemia is seen by CT myocardial Perfusion. This report is recommending a new chest pain management tool in arm-B at West Kendall Baptist Hospital, which will reduce the length of stay as well as the consumed resources in comparison to the current approach. Perfusion by CT myocardial perfusion is a better way to prevent false positive findings by CT angiography alone. Perfusion of CT myocardial perfusion will also have incremental diagnostic value over and above CT angiography. Both research arms will triage in the ED using the 5-Level Miami Baptist Chest Pain Protocol. Patients at the West Kendall Baptist Hospital will be triaged using a modified chest pain framework that includes coronary CT angiography and CT myocardial perfusion assessment at protocol Level 3 instead of SPECT and patients at West Kendall Baptist Hospital. Patient length of stay, direct cost, and chest pain exam results related to chest pain are all common issues that can be addressed by the study coordinator. Patients enrolled at West Kendall Baptist Hospital will be enrolled in a modified version of the Miami Bible Chest Pain Protocol, in which a SPECT nuclear perfusion scan is replaced by a coronary CT angiography and a CT myocardial perfusion study for Level 3 patients is updated, and a CT myocardial perfusion study is added to the program, with intermediate stenoses, Agatston Calcium Score > 400, or non-evaluable segments in CT myot Angiograph angia Angiograph Angiy Angia angigraphy and angiada angiography and angigraphy and angigraphy, angigraphy and angigraphy and angiography and angiograph and angiograph and angia angiography and angia angiadiadiahya angia angiagyadaeda to Patients in ARM-B will be randomly and divided into two groups; group-1 will get the CT Angiography and CT myocardial perfusion, while group-2 will receive the SPECT imaging examination. According to de-identified data of a West Kendall Arm Revolution, only access to the West Kendall Arm Revolution in heath care will be available. The dose of contrast is lower than in the majority of conventional contrast-enhanced computed tomography studies, and appropriate steps will be taken to identify patients with known contrast allergy or renal dysfunction and exclude them from participating in the study. Shortness of breath, headache, flushing, chest pain, dizziness, abdominal pain, diarrhea, vomiting, abdominal pain, diarrhea, nausea, abdominal pain, a metallic taste in the mouth, and feeling hot are the most common side effects of Regadenoson.

Source link: https://clinicaltrials.gov/ct2/show/NCT02538861


Influence of Intensive Lipid-lowering Witgh Statin and Ezetimibe Prescription on Computed Tomography Derived Fractional Flow Reserve in Patients With Stable Chest Pain

Patients with persistent chest pain and moderate CAD, statin naive, and at least one translesional FFRct value of 0. 81 are randomly assigned to either "atorvastatin 40 mg daily" or "ezetimibe 10 mg daily" therapy. FFRct values from 0 to 9 months of follow-up, as changes in low density plaques volumes and number of lesions with positive trend changes over time relative to LDL cholesterol changes are all significant changes.

Source link: https://clinicaltrials.gov/ct2/show/NCT05368545


Mindfulness Based Intervention in Patients With Persistent Pain in Chest (MIPIC) of Non-Cardiac Cause - a Feasibility Randomised Control Study

Chest pain is a common problem in primary care, with the lifetime incidence of no cardiac disease being 20% to 6-7 percent for chest pains. Mindfulness has risen in importance in the last two decades as an accepted method of behavior therapy for stress and depression. Several RCTs have been carried out in patients with chronic pain, but no one specifically related to chest pains. With this feasibility RCT report, the investigators would like to get more insight into some of the factors that might lead to a larger, well-designed RCT. The investigators intend to bring 50 people from the chest pain clinic in the last 12-months and randomize them in a simple 1:1 manner into receiving Mindfulness-based Cognitive Therapy or standard medical care.

Source link: https://clinicaltrials.gov/ct2/show/NCT04151121

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions