Trial reportHeart (British Cardiac Society)2022
Prospective RandOmised Trial of Emergency Cardiac Computerised Tomography (PROTECCT).
Trial report in Heart (British Cardiac Society), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03583320 (Prospective RandOmised Trial of Emergency Cardiac CT), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective RandOmised Trial of Emergency Cardiac CT
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Representation of Older Adults and Women in Randomized Trials of Noninvasive Imaging for Chest Pain.Circulation. Cardiovascular imaging · 2025Pooled it
- Coronary Computed Tomography Angiography to Exclude Acute Coronary Syndrome in Low-Risk Chest Pain Patients.Journal of cardiovascular development and disease · 2025Review
- Utility of Cardiovascular CT in Ischemic Heart Disease.Echocardiography (Mount Kisco, N.Y.) · 2025Review
- Cardiac Computed Tomography Angiography in the Evaluation of Coronary Artery Disease: An Interventional Perspective.Journal of the Society for Cardiovascular Angiography & Interventions · 2024Review
- Comparative Effectiveness of Coronary CT Angiography and Standard of Care for Evaluating Acute Chest Pain: A Living Systematic Review and Meta-Analysis.Radiology. Cardiothoracic imaging · 2023Article
- Validation of pressure-bounded coronary flow reserve using invasive coronary physiologic assessment.Heart and vessels · 2023Article
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Authors and funding
22 authors.
Funding
Abstract
objectiveMany patients presenting with suspected acute coronary syndrome (ACS) have high-sensitivity cardiac troponin (hs-cTn) concentrations between rule-in and rule-out thresholds and hence need serial testing, which is time consuming. The Prospective RandOmised Trial of Emergency Cardiac Computerised Tomography (PROTECCT) assessed the utility of coronary CT angiography (CCTA) in patients with suspected ACS, non-ischaemic ECG and intermediate initial hs-cTn concentration.
methodsPatients were randomised to CCTA-guided management versus standard of care (SOC). The primary outcome was hospital length of stay (LOS). Secondary outcomes included cost of in-hospital stay and major adverse cardiac events (MACE) at 12 months of follow-up. Data are mean (SD); for LOS harmonic means, IQRs are shown.
results250 (aged 55 (14) years, 25% women) patients were randomised. Harmonic mean (IQR) LOS was 7.53 (6.0-9.6) hours in the CCTA arm and 8.14 (6.3-9.8) hours in the SOC arm (p=0.13). Inpatient cost was £1285 (£2216) and £1108 (£3573), respectively, p=0.68. LOS was shorter in the CCTA group in patients with <25% stenosis, compared with SOC; 6.6 (5.6-7.8) hours vs 7.5 (6.1-9.4) hours, respectively; p=0.021. More referrals for cardiology outpatient clinic review and cardiac CT-related outpatient referrals occurred in the SOC arm (p=0.01). 12-month MACE rates were similar between the two arms (7 (5.6%) in the CCTA arm and 8 (6.5%) in the SOC arm-log-rank p=0.78).
conclusionsCCTA did not lead to reduced hospital LOS or cost, largely because these outcomes were influenced by the detection of ≥25% grade stenosis in a proportion of patients. TRIAL REGISTRATION NUMBER: NCT03583320.
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