None listed
Conditions
Brief summary
The aim of this study is to assess the clinical applications of the proven diagnostic abilities of Computer Tomography Coronary Angiography (CTCA). Specifically, in patient groups with an intermediate probability of coronary artery disease is there a difference between computer tomography coronary angiography and myocardial perfusion imaging in ruling out significant coronary artery disease.
Interventions
Computer Tomography Coronary Angiography (CTCA) or Coronary CT is a new technique which involves injecting dye into an arm vein and performing a specialised x-ray of the heart called a CT scan. While CT scans have been extensively used to image many organs, it is only recently that the technology has evolved to be fast enough to scan a beating heart. It is important for test accuracy that the heart is beating in a regular rhythm so that the scan can give the best results. This means that you wil
Computer Tomography Coronary Angiography (CTCA) or Coronary CT is a new technique which involves injecting dye into an arm vein and performing a specialised x-ray of the heart called a CT scan. While CT scans have been extensively used to image many organs, it is only recently that the technology has evolved to be fast enough to scan a beating heart. It is important for test accuracy that the heart is beating in a regular rhythm so that the scan can give the best results. This means that you will be given a medication (called a beta-blocker) to slow your heart down before the test. These same tablets are regularly used to treat coronary heart disease, and your specialist is very familiar with their use. Like the Nuclear Medicine study, the Coronary CT does not have the coronary angiography hazards associated with the placement of catheters but appears to have similar accuracy to angiography. Patients randomised to the CTCA test will undergo one CTCA.
Sponsors
The Queen Elizabeth Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patient fulfilling all of the following criteria (a, b & c) will be considered: a) Intermediate pre-test probability of CAD (10-70%), ie Men = 40 years without typical angina Women = 60 years without typical angina; b) One of the following clinical presentation: 1) Chest pain with Left Bundle Branch Block (LBBB), or 2) Equivocal exercise test (ie Duke Treadmill Score -10 to 4), or 3) Suspected Dilated Cardiomyopathy (ie Unexplained global left ventricular systolic dysfunction) and c) Treating-cardiologist would undertake ISCA if these non-invasive tests were not available.
Exclusion criteria
Patients with following features will be excluded from the study: 1) Patients with high pre-test probability of CAD ( > 70%), ie those with typical angina, 2) Patients with low pre-test probability of CAD ( < 10%) including those with normal coronary angiography within the past 2 years, 3) Previously Documented CAD, ie. Previous myocardial infarction, Previous revascularisation therapy (Percutanious Coronary Intervention or Coronary Artery Bypass Graft) Previous coronary angiography demonstrating > 50% stenosis or Regional wall motion abnormality 4) Contra-indications to undertaking CTCA or MPI such as: Contrast allergy, Pregnancy, suspected pregnancy, Contra-indications to beta-blockers (asthma), Absence of sinus rhythm, Renal Impairment (Creatinine = 180 umol/L or eGFR < 50ml/min) or Thyroid Stimulating Hormone (TSH) < 0.36 mU/L
Outcome results
None listed