Early computed tomography coronary angiography in adults presenting with suspected acute coronary syndrome: The RAPID-CTCA RCT

Abstract

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.