Coronary CT Angiography in Non ST-elevation Myocardial Infarction (CT-NSTEMI)
Coronary CT Angiography in Non ST-elevation Myocardial Infarction (NSTEMI) - a Way to Reduce Unnecessary Invasive Investigations
Non ST-elevation myocardial infarction (NSTEMI) represents 70-75% of all myocardial infarctions. Current guidelines recommend invasive angiography and this patient group represents a major burden on the invasive catheterization laboratories and the health care system.
The coronary pathology found in NSTEMI-patients varies substantially, ranging from structurally normal vessels, non-obstructive atherosclerosis to severe multivessel disease. 30-40 % of patients with NSTEMI undergoing invasive coronary angiography do not undergo revascularization. If these patients could be identified by a non-invasive method like coronary CT angiography (CCTA), an invasive procedure with the potential risk for complications could be avoided. Furthermore, less patients would need transfer to an invasive center. Both for patients and for health care costs this would be of major benefit.
The quality of CCTA images has improved during the years, and radiation dose has decreased. Due to technological development it is now possible to perform high quality coronary CCTA with a very low radiation dose (1-1.5 mSv) compared to a radiation dose of 3-4 mSv for invasive coronary angiography.
The overall aim of the project is to define a subpopulation of NSTEMI patients that preferably should undergo CCTA as the first step in imaging of the coronary arteries and thus potentially be saved from an unnecessary invasive investigation. This would result in less patient discomfort, less patient risk and reduced health care costs. Patients with a clinical indication for invasive angiography according to current guidelines will undergo CCTA prior to the invasive investigation. The ability of CCTA to identify those with no need for revascularization will be assessed using invasive angiography as the gold standard.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Rune Wiseth, prof dr md
- Phone Number: +47 72828145
- Email: rune.wiseth@ntnu.no
Study Contact Backup
- Name: Synne M Sandberg
- Email: synne.m.sandberg@ntnu.no
Study Locations
-
-
-
Kristiansund, Norway
- Kristiansund Hospital, Cardiac Unit
-
Levanger, Norway
- Levanger Hospital, Cardiac Unit
-
Molde, Norway
- Molde Hospital, Cardiac Unit
-
Namsos, Norway
- Namsos Hospital, Cardiac Unit
-
Orkdal, Norway
- Orkdal Hospital, Cardiac Unit
-
Trondheim, Norway
- St Olavs Hospital Clinic of Cardiology
-
Volda, Norway
- Volda Hospital, Cardiac Unit
-
Ålesund, Norway
- Ålesund Hospital, Cardiac Unit
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- admitted to a local hospital with NSTEMI type 1 or type 2 based on clinical criteria
- indication for invasive coronary angiography according to current guidelines
Exclusion Criteria:
- indication for immediate (< 2 hours) invasive strategy according to guidelines
- GRACE score > 140
- not willing to provide written informed consent
- previous coronary revascularization
- estimated glomerular filtration rate < 30 mL/min/1,73m2
- allergic reactions to contrast agents impeding for safe examinations
- > 2 hypokinetic segments on echocardiography
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: NSTEMI scheduled for angiography
|
all patients being included will undergo CCTA before invasive coronary angiography
all patients being included will undergo CCTA before invasive coronary angiography
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The number of patients with coronary artery disease in need for revascularization as defined by invasive coronary angiography including invasive iFR/FFR
Time Frame: 1 month
|
For the primary endpoint analysis will be performed on patient level
|
1 month
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Director: Rune Wiseth, prof dr md, St Olavs Hospital, Clinic of Cardiology
- Study Director: Øystein Risa, Norwegian University of Science and Technology, ISB
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 45965
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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