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Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.
Dr
Peter
Swoboda
+44 (0)113 39 28206
P.Swoboda@Leeds.ac.uk
Prof
John
Greenwood
+44 (0)113 343 8469
J.Greenwood@Leeds.ac.uk
Dr
Laura
Jones
+44 (0)7921121815
L.M.jones@Leeds.ac.uk
Stable chest pain
This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.
Coronary artery disease (narrowing of the heart arteries) is the typical cause of angina (cardiac chest pain) and is becoming more common as people live longer with multiple heart disease risk factors (e.g. diabetes, smoking high blood pressure, and high cholesterol). In the UK about 2 million people have angina and about 200,000 are referred to hospital each year for further investigation. There are lots of different tests to investigate suspected angina, but doctors have different opinions as to the best approach, and international guidelines make very different recommendations. This leads to wide practice variation, inefficiency of healthcare resources and it may adversely impact on patient experience and outcomes. What most doctors agree on is that we do too many invasive X-ray angiograms. About 60% of angiograms performed do not find significant narrowing of the heart arteries, and as such, do not lead to a direct change in management for that patient.
Recent UK NICE guidelines recommend a non-invasive CT angiogram as the first-line test for all patients with suspected angina. This one-size-fits-all approach does not recognise individual patient characteristics, risk factors or likelihood of them having disease. Whilst cardiac CT is an excellent test to exclude narrowing of the heart arteries when they are normal, it can lead to over-estimation of severity when moderate disease is present. It has been suggested that this approach may lead to further increases in the rates of invasive angiography, more additional downstream investigations and increased NHS costs, with no difference in patient outcomes. In addition, the recent UK NICE guidelines if fully adopted would require major service reorganisation in every hospital, and large capital and revenue investment to accommodate the 700% predicted increase in cardiac CT capacity. Thus many doctors believe that this major NHS service reorganisation should first be robustly evaluated in the setting of a clinical trial to demonstrate that it is both appropriate and cost-efficient.
The aim of this study is to try to improve the investigation and management of patients with suspected cardiac chest pain (angina), both in terms of NHS resource use and also patient experience and outcomes; producing results that would be highly generalisable across the NHS.
Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.
The recruitment start and end dates are as follows:
You can take part if:
You may not be able to take part if:
In order to keep the trial generalisable to the UK population at large, only issues related to patient safety/appropriateness will form the exclusion criteria; these will include:1. Prior normal CT coronary angiography (CTCA) within the last 2 years or prior CTCA with extensive calcification2. Clinically unstable cardiac symptoms3. Known coronary artery disease (including previous myocardial infarction [MI], acute coronary syndrome [ACS] or coronary revascularization)4. Contraindication to CTCA or functional cardiac imaging5. Pregnancy and/or breastfeeding6. Known chronic renal failure (eGFR < 30ml/min/1.73m²)7. Inability to give written informed consent
Below are the locations for where you can take part in the trial. Please note that not all sites may be open.
Dr
Peter
Swoboda
+44 (0)113 39 28206
P.Swoboda@Leeds.ac.uk
Dr
Laura
Jones
+44 (0)7921121815
L.M.jones@Leeds.ac.uk
Prof
John
Greenwood
+44 (0)113 343 8469
J.Greenwood@Leeds.ac.uk
The study is sponsored by University of Leeds and funded by Heart Research UK; Grant Codes: TR2442/19/24; British Heart Foundation.
Your feedback is important to us. It will help us improve the quality of the study information on this site. Please answer both questions.
Or CPMS 50598
You can print or share the study information with your GP/healthcare provider or contact the research team directly.
