Coronary artery disease Circulatory System Heart disease
Conditions
Interventions
Observational Study:
Patients referred to the RACPC in the Ulster Hospital and not excluded by criteria will be considered for the trial. Once in the trial patients will complete questionnaires, have
HS-CRP
Apolipoprotein A-I
Apolipoprotein A-2
Apolipoprotein(a) precursor (LPA)
HbA1C
Serum Testosterone
Sex hormone-binding globulin (SHBG)
Fasting Insulin.
Lipid soluble anti-oxidants
Ascorbic Acid
Lipoprotein and enzyme status
Cholesterol ester transfer protein
Alpha Tumor necrosis factor
Sponsors
Ulster Hospital (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Patients over 40 referred to the Rapid Access Chest Pain Clinic (RACPC), Ulster Hospital, Northern Ireland for suspicion of angina 2. Patients must have the ability to hold breath
Exclusion criteria
Exclusion criteria: 1. Less than 40 years of age 2. Significant renal dysfunction with an estimated Glomerular Filtration Rate (eGFR) less than 35. As the contrast used in CCT and conventional angiography can cause contrast nephropathy these patients with will be excluded from the study 3. Recent history of alcohol, drug abuse, or other medical conditions that might compromise safety, successful completion of, or drug compliance during the study 4. Patients with a history of chronic inflammatory conditions, such as severe arthritis, lupus, or inflammatory bowel disease, as well as subjects taking immunosuppressant agents, such as cyclosporine, tacrolimus, azathioprine, or chronic oral glucocorticoids. Because High-Sensitivity C-Reactive Protein (hs-CRP) will be measured, patients with other conditions that may cause a chronically elevated CRP will be excluded. 5. Unstable angina pectoris 6. Uncontrolled fast atrial fibrillation or other arrhythmias that may interfere with ECG-gated triggering of CT 7. Patients with extreme tachycardia, greater than 110 bpm, despite rate controlling agents 8. Pregnancy 9. Morbid obesity (Body Mass Index [BMI] >35) 10. Known contrast medium allergy 11. Known ischaemic heart disease with previous intervention in the form of coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) 12. Inability to lie flat. 13. Severe Aortic Stenosis (clinically suspected and confirmed by echocardiogram) 14. Acute myocarditis/pericarditis 15. Uncontrolled hypertension >220/100 16. Severe peripheral vascular disease or impaired immobility 17. Severe mental disability that would impair capacity to consent 18. Significant COPD that would impair exercise or B blocker use 19. Left bundle branch
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in scores from baseline at 3 months on the physical limitation scale of the SAQ-UK | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. The cost effectiveness of cardiac CT as a primary diagnostic strategy will be compared with the costs associated with the current standard of care 2. Health-related quality of life 3. Cumulative radiation exposure 4. Resource utilisation | — |
Countries
United Kingdom
Outcome results
None listed