The American College of Radiology Imaging Network (ACRIN) has created the ACRIN 4701 trial—known as RESCUE (Randomized Evaluation of Patients with Stable Angina Comparing Utilization of Noninvasive Examinations). This test is a multicenter clinical trial to evaluate how two diagnostic imaging procedures affect outcomes in patients with stable angina (chest pain or discomfort that typically occurs with activity or stress).
The study will randomly assign study participants either to cardiac CT angiography (CCTA) or to single photon emission tomography-myocardial perfusion imaging (SPECT-MPI) for diagnosis of symptoms potentially related to coronary artery disease (CAD). Participants diagnosed with CAD by either CCTA or SPECT-MPI examination will be treated initially by OMT, unless these diagnostic tools show evidence of significant left main coronary artery CAD (≥ 50% stenosis) on CCTA or a markedly abnormal stress test with SPECT-MPI (≥ 10% reversible perfusion defect), in which case they will undergo ICA and possibly revascularization as is standard practice. Participants will be followed to collect health care utilization data, cardiac events, and quality-of-life questionnaires.
The RESCUE trial addresses the hypothesis that, in comparison to the SPECT-MPI arm, the CCTA arm will not result in an increase of myocardial infarction, cardiac-related death, or revascularization; reduced risks; provide additional insights into alternate explanations of chest pain; and be more cost-effective.
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