Coronary Plaque Geometry and Acute Coronary Syndromes

July 30, 2022 updated by: Cardio Med Medical Center

Definition: Impact of Coronary Plaque Geometry on Plaque Vulnerability and Their Association With the Risk of Future Cardiovascular Events in Patients With Chest Pain Undergoing Coronary Computed Tomographic Angiography - the GEOMETRY STUDY

The aim of GEOMETRY study is to investigate the correlation between coronary plaque geometric modifications and lesion vulnerability in patients with suspected coronary artery disease referred for cardiac computed tomography angiography (CCTA). Furthermore the study will evaluate the impact of plaque eccentricity and morphology on the rate of major adverse cardiovascular events (MACE) for a 2 years follow-up period.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Coronary artery disease (CAD) remains the leading cause of mortality and morbidity worldwide. Early detection of CAD may reduce the incidence of myocardial infarction by improving primary prevention and providing more effective treatment methods. A step in this direction is identifying the pattern of coronary plaques which are prone to rupture. Coronary computed tomography angiography (CCTA) has emerged recently as a reliable noninvasive tool used in the evaluation of coronary arteries. Some features related to plaque composition and morphology such as low attenuation plaques, spotty calcification, positive remodeling or napkin ring sign, were already identified as vulnerability markers. However the role of lesion geometry on plaque vulnerability was not investigated yet.

This is a prospective, cohort, single-center study which will be carried out in the Center of Advanced Research in Multimodal Cardiac Imaging Cardiomed.

The study will include 1.000 subjects with suspected CAD who are referred to CCTA by the attending physician and in which presence of at least one coronary plaque is confirmed by CCTA.

Plaque burden, composition, and morphology will be assessed for each plaque. Longitudinal and transversal eccentricity will be also assessed in each plaque and in all cases, eccentricity index will be calculated in cross-section plane at the degree of maximum stenosis in order to determine the position of the remaining circulant lumen and to classify the plaque into concentric and eccentric lesion.

The study will be conducted over a period of 3 years, in which patients will be examined at baseline, and will be followed-up for 2 years for occurrence of MACE.

Study objectives:

Primary: to evaluate the association between different patterns of plaque geometry and the risk for major adverse cardiac events MACE (all-cause mortality, cardiovascular death, myocardial infarction, repeated revascularization, repeated hospitalizations for cardiovascular related incidents, cerebrovascular events) during a 2-year follow-up, Secondary: to evaluate the association of plaque eccentricity, plaque vulnerability and plaque progression after 2 years of follow-up

Study Timeline:

  • Baseline (day 0)

    • Obtain and document consent from participant on study consent form.
    • Verify inclusion/exclusion criteria.
    • Obtain demographic information, medical history, medication history, alcohol and tobacco use history.
    • Record results of physical examinations and 12-lead ECG.
    • Collect blood specimens.
    • Imaging: 128-multislice CT angiography.

  • Visit 1 (month 6)

    • Record results of physical examinations, 12-lead ECG and medical history.
    • MACE assessment

  • Visit 2 (month 12)

    • Record results of physical examinations, 12-lead ECG and medical history.
    • MACE assessment

  • Visit 3 (month 18)

    • Record results of physical examinations, 12-lead ECG and medical history.
    • MACE assessment

  • Final study visit (month 24)

    • Record results of physical examinations, 12-lead ECG and medical history.
    • Repeat CCTA and plaque assessment
    • End-point evaluation.

Study procedures:

  • Medical history, clinical examination, laboratory tests;
  • 12-lead ECG
  • 128-multislice CT coronary angiography with the evaluation of: calcium score, plaque burden, markers for lesion severity (degree of stenosis, lesion length, lumen area and diameter, minimum and maximum plaque thickness); morphological plaque characteristics (plaque related volumes, plaque burden, remodeling indexes); shear stress by computational fluid dynamics; markers of plaque vulnerability (low attenuation plaque, spotty calcification, positive remodeling, napkin ring sign); plaque geometry by eccentricity index, longitudinal and transversal eccentricity.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
1000

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Romania
    • Mures
      • Târgu-Mureş, Mures, Romania, 540102
        • Cardio Med Medical Center

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.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

14 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

N/A

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Study population includes patients from a single center with suspected coronary artery disease, meeting inclusion and exclusion criteria and undergoing CCTA by physician referral for coronary luminal evaluation.

Description

Inclusion Criteria:

  • Patients with suspected coronary artery disease (CAD) and pre-test probability of CAD between 15% and 85%, who undergo CCTA, and in whom CCTA has identified presence of at least one coronary plaque
  • Ability to provide informed consent
  • Age grater then 18 years

Exclusion Criteria:

  • Patients with pre-test probability of CAD >85% or <15%
  • Electrocardiographic evidence of STEMI
  • Presence of pre-existing CAD including prior myocardial infarction
  • History of coronary artery revascularization (by percutaneous coronary intervention, stent or bypass graft surgery)
  • Atrial fibrillation or other irregular rhythm
  • Unwillingness or incapacity to provide informed consent
  • Allergy to iodine contrast media
  • Inability to tolerate beta-blocker medication
  • Renal insufficiency (creatinine greater than 1.5 mg/dL) or renal failure requiring dialysis
  • Pregnant women or lactation
  • Active malignancy or malignancy within the last 5 year prior to enrolment
  • Conditions associated with an estimated life expectancy of under 2 years
  • Coronary calcium score >1000

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
VP-SG 01
Study subjects that present concentric coronary plaques
Diagnostic test: CCTA
128-multislice CT coronary angiography and complex atherosclerotic plaque analysis, with the use of CT imaging post-processing techniques.
VP-SG 02
Study subjects that present eccentric coronary plaques
Diagnostic test: CCTA
128-multislice CT coronary angiography and complex atherosclerotic plaque analysis, with the use of CT imaging post-processing techniques.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Major adverse cardiovascular events
Time Frame: Month 24
Incidence of MACE during follow-up
Month 24

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Coronary plaque vulnerability associated to plaque eccentricity
Time Frame: Month 24
Number of vulnerability markers in eccentric vs concentric plaques
Month 24

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Cardio Med Medical Center

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
University of Targu Mures, Romania
University Hospital of Targu Mures, Romania

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 1, 2019

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 30, 2019

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 30, 2021

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
October 8, 2018

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 9, 2018

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
October 11, 2018

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
August 2, 2022

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 30, 2022

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • CM0218-GEO

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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