None listed
Conditions
Brief summary
Heart artery disease (also known as coronary heart disease), which can lead to heart attacks, remains the leading cause of death in Australia. A significant proportion of heart attacks have been shown to be among those deemed ‘young’. This study aims to determine if siblings of young heart attack patients are likely to have significant coronary heart disease themselves even if they currently have no symptoms of it. If this were true then they maybe at an increased risk of suffering a heart attack or dying compared to the general population. This study will also explore whether currently available heart artery disease risk scoring tools are significantly less accurate in predicting the presence of CHD compared to computerised tomography (CT scan) of the heart arteries. If this is found to be true then it may establish CT as a screening test to allow early detection of coronary heart disease by visualising the heart arteries. Hence the aims are as follows: 1.To determine what proportion of siblings of young heart attack patients have coronary heart disease themselves. 2.To compare how accurate heart ultrasound scans during exercise (stress echo) are as compared to CT scans. 3.To investigate the accuracy of popular heart artery disease risk scoring tools: Framingham, Interheart and SCORE. 4.To determine the clinical outcomes of the participants who have coronary heart disease detected on their CT scans. Design and Methodology: We are aiming involve 50 siblings of young heart attack patients in this pilot study. All participants will undergo blood tests for cholesterol levels, stress echo and CT scans of the heart. Their probability of having coronary heart disease will be calculated using the aforementioned risk scoring tools. The reliability of these risk scoring tools will be compared with the findings of CT scan. The end point of the study will be two fold. Firstly, the findings of CT scan, stress echo and risk scoring tool will be compared and the proportion of participants with coronary heart disease (as detected by CT) will be determined. Secondly, participants will be followed with telephone calls for 30 days, 6 months and 12 months for any event of chest pain, hospitalisation for cardiac problem, heart attack or death. Their outcomes will be compared with their test results.
Interventions
Stress echocardiography - increase heart rate with exercise or dobutamine. Heart ultrasound scan before and after increasing the heart rate. Will take approximately 30 minutes.
Coronary CT angiography - injection of intravenous contrast followed by CT scan of the heart arteries. Will take approximately 30 minutes.
Each test will be undertaken in all participants on 2 different occasions within 1 week of each other.
Sponsors
Western Health
Eligibility
Sex/Gender
All
Age
30 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
Young asymptomatic individuals (male with age between 30-55 and female with age between 30-60) with a history of an acute MI (AMI) in a sibling before 55 years of age for both sexes will be recruited.
Exclusion criteria
Clinical exclusion criteria are known history of CHD (positive findings on previous functional test or invasive coronary angiogram, history of prior MI or coronary revascularisation), age younger than 30 for both sexes, age older than 55 for male and 60 for female, and refusal to consent. Individuals with contrast or Dobutamine allergy, chronic renal impairment (eGFR <60 mls/min), atrial fibrillation or frequent ventricular ectopics, thyrotoxicosis, pregnancy, ventricular pacing, left bundle branch block or known severe valvular disease will be excluded.
Outcome results
None listed