Condition category
Circulatory System
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Dr David Stone


Contact details

Department of Cardiology
Papworth and West Suffolk Hospitals
Papworth Hospital
Papworth Everard
CB23 3RE
United Kingdom
+44 (0)1480 830541

Additional identifiers

EudraCT number number

Protocol/serial number

HTA 99/26/04

Study information

Scientific title


Study hypothesis

The aim of this study is to decide whether assessment of myocardial perfusion (by TcMIBI or perfusion MRI or stress echocardiography) in comparison to routine investigation (exercise testing and angiography) can improve the identification of patients who will benefit from revascularisation. The cost effectiveness of each regime will be analysed with respect to more precise targeting of appropriate patients and will include analysis of any implications of change in practice. This study is comparing the clinical and cost effectiveness of cardiac perfusion tests (stress echocardiography, stress MRI, stress MIBI) with the current gold standard test (angiography) for identifying those patients who will benefit from revascularisation (angioplasty or coronary bypass surgery). Patients with unstable angina are randomised to one of the four investigations and assessed at defined time points after treatment. The hypothesis behind this trial is that techniques which measure blood flow to the heart may be more effective than angiography at identifying those patients who are likely to benefit from revascularisation.

Ethics approval

Not provided at time of registration

Study design

Parallel group randomised controlled trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting

Not specified

Trial type

Not Specified

Patient information sheet


Cardiovascular diseases: Heart disease


Group 1 (control) will have angiography
Group 2 Tc-methoxyisobutylisonitrile (TcMIBI)
Group 3 Magnetic Resonance Imaging (MRI)
Group 4 will have stress echo. The referring cardiologist will have the option of proceeding to angiography but will be urged to do so only when the stress imaging test is 'positive' for reversible ischaemia.
In order to assess clinical confidence in the additional investigations, the cardiologist will record their expected diagnosis and treatment strategy at baseline assessment.
Patients will then proceed to appropriate treatment: Percutaneous Transluminal Coronary Angioplasty
(PTCA) or Coronary Artery Bypass Graft (CABG) or medical therapy.

Intervention type



Not Specified

Drug names

Primary outcome measure

The primary outcome measure is exercise capacity: treadmill time according to modified Bruce protocol measured at baseline, at 6 months following treatment with CABG, PTCA or medical therapy and at 18 months following entry to the trial.

Secondary outcome measures

Secondary measures include the Canadian Cardiovascular Society classification of angina; health related quality of life assessments: the generic SF36, disease specific Seattle Angina Questionnaire and utility EQ-5D; cardiologist's assessment of IHD risk (compared with formal risk assessment) and treatment intentions expressed prior to the diagnostic test; patients' preferences; revascularisation rate; hospital admissions for unstable angina, incidence of MI and deaths after treatment. These outcome measures will be used to evaluate the contribution of functional data to successful revascularisation. Annuitized capital costs will be calculated for each of the imaging procedures. These will be combined with running, treatment, community and patient costs in an incremental cost-effectiveness analysis.

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

Patients with chronic stable angina and a positive stress exercise test who are referred to designated Papworth cardiologists for angiography will be randomised to one of 4 groups.

Participant type


Age group

Not Specified


Not Specified

Target number of participants


Participant exclusion criteria

Patients with recent (<3 months) MI, previous or urgent need for revascularisation, those known to have adverse reactions to pharmacological stress, incapable of performing ETT, pacemaker or other contraindication to MRI, not available by telephone.

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Department of Cardiology
CB23 3RE
United Kingdom

Sponsor information


Department of Health (UK)

Sponsor details

Quarry House
Quarry Hill
United Kingdom
+44 (0)1132 545 843

Sponsor type




Funder type


Funder name

NIHR Health Technology Assessment Programme - HTA (UK)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

2007 results in:
2014 results in:

Publication citations

  1. Results

    Sharples L, Hughes V, Crean A, Dyer M, Buxton M, Goldsmith K, Stone D, Cost-effectiveness of functional cardiac testing in the diagnosis and management of coronary artery disease: a randomised controlled trial. The CECaT trial., Health Technol Assess, 2007, 11, 49, iii-iv, ix-115.

  2. Results

    Thom H, West NE, Hughes V, Dyer M, Buxton M, Sharples LD, Jackson CH, Crean AM, , Cost-effectiveness of initial stress cardiovascular MR, stress SPECT or stress echocardiography as a gate-keeper test, compared with upfront invasive coronary angiography in the investigation and management of patients with stable chest pain: mid-term outcomes from the CECaT randomised controlled trial., BMJ Open, 2014, 4, 2, e003419, doi: 10.1136/bmjopen-2013-003419.

Additional files

Editorial Notes