Patient population
renal failure, myocardial infarction
RENAL FAILURE, SECONDARY, MYOCARDIAL INFARCTION, ACUTE CORONARY SYNDROME
This trial will recruit at least 2270 participants from the emergency department or an equivalent acute medical admissions unit in secondary or tertiary care hospitals across the UK who will be randomised 1:1 to CTCA plus standard of care or standard of care alone. The inclusion criteria will be as follows: (i) presented to hospital with symptoms of suspected acute coronary syndrome; (ii) age ≥ 18 years old; and (iii) a maximum high-sensitivity cardiac troponin I or T concentration between 5 ng/L and the 99th centile. Exclusion criteria will be as follows: (i) diagnosis of myocardial infarction during index presentation; (ii) clear alternative diagnosis or participant requires further inpatient clinical assessment; (iii) CTCA or invasive coronary angiogram within 1 year from hospital attendance; (iv) inability to undergo CT scanning, for example due to severe renal failure (estimated glomerular filtration rate < 30 mL/min/1.73 m