Novel Imaging Approaches To Identify Unstable Coronary Plaques
2021年6月18日 更新者：University of Edinburgh
Cardiovascular disease is the leading cause of death in Scotland and the Western World.
Approaches to improve the identification of vulnerable or ruptured coronary atherosclerotic plaques are urgently needed to help risk stratification, to identify patients for intensive therapies, and to provide novel biomarkers for the development of anti-atherosclerotic drug interventions.
Using positron emission tomography, we have recently shown that sodium 18-fluoride uptake holds major promise as a novel marker of plaque vulnerability and rupture.
Here we wish to characterise coronary atherosclerotic plaque using 128-multidetector computed tomography combined with 18-fluorodeoxyglucose and sodium 18-fluoride positron emission tomography and Virtual histology-intravascular ultrasound in 80 patients with stable and unstable coronary artery disease.
This has the potential to provide an innovative and highly valuable translational model with which to test novel therapeutic interventions targeted at reducing atheroma and plaque rupture.
This could have major implications for the future treatment of cardiovascular disease.
研究概览
地位
完全的
条件
研究类型
观察性的
注册 (实际的)
80
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
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Midlothian
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Edinburgh、Midlothian、英国、EH16 4SB
- Clinical Research Imaging Centre/ NHS LOTHIAN
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
50年 及以上 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
取样方法
非概率样本
研究人群
The investigators will recruit two populations of 40 patients each.
The first population will be patients with known stable coronary heart disease.
They will have previously documented and angiographically proven coronary artery disease (≥70% luminal stenosis of a major epicardial vessel).
The second population will be patients with a recent (within 30 days) acute myocardial infarction defined by the Universal definition of myocardial infarction.
The culprit plaque will be defined according to the invasive coronary angiogram appearances, electrocardiogram and clinical features by two cardiologists blinded to the results of positron emission tomography.
描述
Inclusion Criteria:
Age > or = 50 yrs. Patients with Acute coronary syndromes or stable coronary artery disease.
Exclusion Criteria:
Insulin dependent diabetes Inability or unwillingness to undergo computed tomography scanning Severe renal failure (serum creatinine >250 µmol/L or estimated glomerular filtration rate <30 mL/min) Known contrast allergy Inability to give informed consent. Females in child bearing age will undergo pregnancy test if pregnancy suspected.
Participation in other research studies requiring exposure to further radiation (over and above mentioned in this study).
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
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Acute Coronary Syndrome
40 patients admitted with ACS (NSTEMI/STEMI) will be recruited undergo 18F NaF PET, 18F FDG and CTCA within 1 month of the event.
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Stable angina cohort
40 patients with previously diagnosed coronary artery disease and listed to undergo elective coronary angiogram will be recruited.
VH-IVUS will be attempted in all patients.
Selected patients will undergo PET scan after stent implantation.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Patients with ACS have focal 18F-NaF uptake and high tissue to background ratio(TBR) and standardised uptake values (SUV) in the culprit vessels.
大体时间：Within 1 month of index event
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Using PET/CT, the investigators will assess if there is presence of focal uptake at the areas of plaque ruptures in patients presenting with ACS.
Standardised uptake values and Tissue to Background ratios of the culprit vessels with be compared with non-culprit lesions.
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Within 1 month of index event
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What are the morphological characteristics of plaque with high 18F-NaF tissue to background ratio or standardised uptake value
大体时间：1 month
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Using VH-IVUS, the investigators will look at the morphological characteristics of plaques that have higher SUVs and TBRs.
Additional information about the plaque characteristics will be derived from CT coronary angiogram
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1 month
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次要结果测量
结果测量 |
大体时间 |
|---|---|
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Is there a co-relation between the two PET/CT tracers(18FDG and 18F NaF) as measured as Tissue to background ratio or standardised uptake value.
大体时间：1 month
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1 month
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Is there a difference between the coronary and aortic TBR/SUVs in stable and unstable patients
大体时间：1 month
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The investigators will look for differences in activity in stable angina and ACS patients using 18F-NaF and 18F-FDG
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1 month
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Will patients with higher 18F-NaF uptake as measured by SUV/TBR will have higher levels of cardiac biomarkers such as hsCRP or Troponin
大体时间：1 year
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Blood collected from volunteers in the study will be analysed for inflammatory biomarkers such as hsCRP and Troponin
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1 year
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2012年2月1日
初级完成 (实际的)
2015年4月1日
研究完成 (实际的)
2015年4月1日
研究注册日期
首次提交
2012年11月30日
首先提交符合 QC 标准的
2012年12月11日
首次发布 (估计)
2012年12月13日
研究记录更新
最后更新发布 (实际的)
2021年6月21日
上次提交的符合 QC 标准的更新
2021年6月18日
最后验证
2021年6月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.