CARE-CP (Testing a Cardiovascular Ambulatory Rapid Evaluation for Patients With Chest Pain)

Description

The goal of this study is to determine if rapid outpatient evaluation vs hospitalization management is the best strategy (based on patient-centered measures and safe, equitable, and efficient resource use) for evaluating patients with acute chest pain who are at moderate risk for acute coronary syndrome (ACS). Patients will be randomized in the Emergency Department to either an outpatient evaluation (CARE-CP) or hospitalization evaluation for their symptoms.

Conditions

Chest Pain

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Study Overview

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Study Details

Study overview

The goal of this study is to determine if rapid outpatient evaluation vs hospitalization management is the best strategy (based on patient-centered measures and safe, equitable, and efficient resource use) for evaluating patients with acute chest pain who are at moderate risk for acute coronary syndrome (ACS). Patients will be randomized in the Emergency Department to either an outpatient evaluation (CARE-CP) or hospitalization evaluation for their symptoms.

CARE-CP (Testing a Cardiovascular Ambulatory Rapid Evaluation for Patients With Chest Pain )

CARE-CP (Testing a Cardiovascular Ambulatory Rapid Evaluation for Patients With Chest Pain)

Condition
Chest Pain
Intervention / Treatment

-

Contacts and Locations

Detroit

Henry Ford Hospital, Detroit, Michigan, United States, 48202

Charlotte

Carolinas Medical Center, Charlotte, North Carolina, United States, 28203

Winston-Salem

Wake Forest University Health Sciences, Winston-Salem, North Carolina, United States, 27157

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Age ≥21 years old
  • * Chest pain or Symptoms of acute coronary syndrome (ACS)
  • * Moderate risk of ACS (all of the below)
  • * Hear Score 4-6
  • * Non-Ischemic electrocardiogram (ECG)
  • * Two Troponin measures \< Sex-Specific Upper Reference Limit
  • * Women \<15 pg/ml
  • * Men \<20 pg/ml
  • * No prior coronary artery disease (CAD)
  • * No Prior Myocardial Infarction (MI)
  • * No Prior Coronary Revascularization Procedures
  • * No Patients with ≥ 70% Obstructive Coronary Disease
  • * ST Elevation Myocardial Infarction (STEMI) Activation
  • * ST Changes or new T-wave inversions ≥1mm on ECG
  • * Any Elevated Troponin Measure (Based on Sex-Specific 99th Percentile)
  • * Serial change between Troponin Measures (Delta) ≥5 pg/mL
  • * Stress Echocardiography, Nuclear Stress Test, Stress ECG, Stress Cardiac MRI, Coronary CT Angiogram (CCTA), Invasive Coronary Angiography (Cardiac Cath) within 1 year
  • * "Clean" CCTA or Cardiac Cath (0% stenosis in all vessels) within the past 2 years
  • * Chest Trauma
  • * Pregnancy
  • * Life Expectancy \< 1 year
  • * Other comorbid conditions requiring hospitalization
  • * Unstable Vitals (Blood Pressure \<90, Heart Rate \>120 or \<50, O2 Sat \<90%)
  • * End Stage Renal Disease; Dialysis or estimated glomerular filtration rate (eGFR) \<30 mL/min
  • * Transfers From Another Hospital
  • * Non-English Speaking
  • * Prisoners
  • * Prior Enrollment
  • * Already Enrolled in Other Interventional Trial

Ages Eligible for Study

21 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Wake Forest University Health Sciences,

Simon Mahler, MD, MS, PRINCIPAL_INVESTIGATOR, Wake Forest University Health Sciences

Study Record Dates

2026-10