Now closed to recruitment, EMERGE are delighted to be leading the RAPID-CTCA trial with the Edinburgh Clinical Trials Unit (ECTU). This is a pragmatic study that has recruited 1,749 adult patients admitted with suspected or confirmed Acute Coronary Syndrome.
The study is taking place throughout the UK and is now in the follow up stage which will be completed in Summer 2020.
This website provides some key information and contacts for participating sites, including recruitment figures and is a source of information for medical professionals who may be interested in the trial.
This is a synopsis of the RAPID-CTCA trial based upon the current version of the trial Protocol, version 6, 19-07-2018, which may be subject to change.
The trial aims to evaluate role of early CT Coronary Angiography in the evaluation, intervention and outcome of patients presenting to the Emergency Department with suspected or confirmed Acute Coronary Syndrome.
Clinical Trials.gov ID:
UK Portfolio Adoption:
The trial is funded by the NIHR Health Technology Assessment Programme. The trial has been adopted onto the NIHR portfolio and therefore is eligible to receive CRN support.
Open parallel group randomised controlled trial of early computed tomography coronary angiography (CTCA) in patients presenting with suspected/confirmed acute coronary syndrome (ACS) to Emergency Departments (ED) and Medical Assessment Units (MAUs).
~30 EDs, acute medical services, radiology and cardiology departments in tertiary/district general NHS hospitals.
Patients with suspected or confirmed ACS
Health technologies being assessed:
Early use of ≥64-slice CTCA as part of routine assessment compared to standard care.
The primary end-point will be all-cause death or recurrent non-fatal type 1 or type 4b MI at one year and time to first such event.
Royal Infirmary of Edinburgh – Professor Alasdair Gray
Sheffield Teaching Hospitals Trust – Professor Steve Goodacre
Derriford Hospital, Plymouth – Professor Carl Roobottom and Surgeon Captain Jason Smith
Torbay Hospital, Torquay – Dr Dirk Felmeden
Victoria Hospital, Kirkcaldy – Dr Andy Kinnon
Royal Berkshire Hospital, Reading – Dr Liza Keating
Russells Hall, Hospital, Dudley – Dr Robert Huggett
Royal Bournemouth & Christchurch Hospitals – Dr Jehangir Din
Borders General Hospital – Dr Anne Scott
Lewisham Hospital – Dr Khaled Alfakih
Jersey General Hospital – Dr Andrew Mitchell
Bradford Teaching Hospital – Dr Sudantha Bulugahapitiya
Sandwell Hospital – Dr Derek Connolly
Milton Keynes Hospital – Dr Atilla Kardos
University Hospital Southampton – Professor Nick Curzen
Guys & St Thomas NHS Foundation Trust – Dr Ronak Rajani
Leeds Teaching Hospitals NHS Trust – Dr Saif-El-Dean Abdel-Rahman
Queen Elizabeth Hospital, Birmingham – Dr Ben Holloway
Royal London Hospital – Dr Ceri Davies
Ninewells Hospital – Dr John Irving
University Hospital of North Tees – Dr Justin Carter
New Cross Hospital, Woverhampton – Dr Elsa McAlindon
Basildon and Thurrock University Hospital – Dr. Jason Dungu
University hospital of South Manchester – Dr. Matthias Schmitt
Ulster Hospital – Dr. Patrick Donnelly
Raigmore Hospital, Inverness – Dr. Jonathon Watt
Queen Elizabeth University Hospital, Glasgow – Dr. Claire McGroarty
Worcestershire Acute Hospitals NHS Trust – Dr Will Roberts
East Surrey Hospital – Dr Ansuman Saha
Rotherham NHS Trust – Dr Rangasamy Muthusamy
Royal Victoria Infirmary, Newcastle – Dr Anna Beattie
Glasgow Royal Infirmary – Dr Adrian Brady and Dr David Lowe
Royal Stoke University Hospital- Dr Hefin Jones
Luton & Dunstable Hospital- Dr Christopher Travill
Whipps Cross Hospital- Professor Tim Harris
Queen Alexandra, Portsmouth- Dr Chris Vorweck
Wrexham Mealor Hospital- Dr Ash Basu
Patient ≥18 years with symptoms mandating investigation for suspected or confirmed ACS with at least one of:
- ECG abnormalities e.g. ST segment depression >0.5 mm;
- History of ischaemic heart disease (where the clinician assessing patient confirms history based on patient history or available records);
- Troponin elevation above the 99th centile of the normal reference range or increase in high sensitivity troponin meeting European Society of Cardiology criteria for ‘rule-in’ or myocardial infarction
(NB troponin assays will vary from site to site; local laboratory reference standards will be used).
- Signs, symptoms, or investigations supporting high-risk ACS:
- ST elevation MI;
- ACS with signs or symptoms of acute heart failure or circulatory shock;
- Crescendo episodes of typical anginal pain;
- Marked or dynamic ECG changes e.g. ST depression of >3 mm
- Clinical team have scheduled early invasive coronary angiography on day of trial eligibility assessment.
- Patient inability to undergo CT:
- Severe renal failure (serum creatinine >250 µmol/L or estimated glomerular filtration rate <30 mL/min);
- Contrast allergy;
- Beta blocker intolerance (if no alternative heart rate limiting agent available/suitable) or allergy ;
- Inability to breath hold;
- Atrial fibrillation (where mean heart rate is anticipated to be greater than 75 beats per minute after beta blockade).
- Patient has had invasive coronary angiography or CTCA within last 2 years and the previous investigation revealed obstructive coronary artery disease, or patient had either investigation within the last 5 years and the result was normal.
- Previous recruitment to the trial;
- Known pregnancy or currently breast feeding;
- Inability to consent;
- Further investigation for ACS would not in the patient’s interest, due to limited life expectancy, quality of life or functional status;
GDPR Privacy Statement
If you have participated in the RAPID CTCA study and would like to read how the study complies with GDPR, please click on this link: RAPID CTCA GDPR Privacy Statement v1 13 06 2018