Coronary Artery Disease
Conditions
Keywords
Perfusion, Echocardiograpy, SPECT, angiography, Chest pain
Brief summary
This trial is to compare PB127 echocardiography to other heart imaging studies.
Interventions
0.175 mg/kg diluted in 150 mL Dextrose in Water 5% in glass bottles to be infused at 250 mL/hour until stead state achieve, 150 mL/hour during rest image acquisition, and 100-150 mL/hr during stress image acquistion. Single IV infusion, not to exceed 60 minutes.
Sponsors
Point Biomedical
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Stratum 1: 1. Able to provide written informed consent 2. Low (less than 10%) pre-test probability of CAD (Appendix D) 3. Scheduled for clinically indicated stress echocardiography or stress SPECT within the 14 days prior to or following Study Day 1 (prior to coronary angiography) or coronary angiography within the 7 days following Study Day 1 4. Technically adequate unreconstructed stress SPECT data or scheduled for clinically indicated stress SPECT within 14 days of Study Day 1 and prior to coronary angiography 5. Adequate visualization of all myocardial segments in at least one view during non-contrast echocardiography (See Section 5.3.1) 6. No evidence of a right-to-left shunt during non-contrast echocardiography Stratum 2: 1. Able to provide written informed consent 2. Intermediate (10% to 90%) pre-test probability of CAD (Appendix D) 3. Scheduled for clinically indicated coronary angiography within the 7 days following Study Day 1 4. Technically adequate unreconstructed stress SPECT data or scheduled for stress SPECT within 14 days of Study Day 1 and prior to coronary angiography 5. Adequate visualization of all myocardial segments in at least one view during non-contrast echocardiography (See Section 5.3.1) 6. No evidence of a right-to-left shunt during non-contrast echocardiography Stratum 3: 1. Able to provide written informed consent 2. High (greater than 90%) pre-test probability of CAD (Appendix D) 3. Scheduled for clinically indicated coronary angiography within the 7 days following Study Day 1 4. Technically adequate unreconstructed stress SPECT data or scheduled for stress SPECT within 14 days of Study Day 1 and prior to coronary angiography 5. Adequate visualization of all myocardial segments in at least one view during non-contrast echocardiography (See Section 5.3.1) 6. No evidence of a right-to-left shunt during non-contrast echocardiography
Exclusion criteria
1. Women who are pregnant or lactating 2. Known hypersensitivity or known contraindication to: 1. Dipyridamole 2. Ultrasound contrast agents (including PB127 and excipients) 3. Blood, blood products, albumin, egg, or protein 3. Use of caffeine or xanthine containing products within the 24 hours prior to PB127 MCE 4. Previous exposure to PB127 Ultrasound Contrast Agent 5. Heart transplant 6. Known right-to-left shunt including atrial septal defect 7. Current or history of uncontrolled ventricular tachycardia 8. Current atrial fibrillation, atrial tachycardia, or atrial flutter 9. Pacemaker or defibrillator 10. Unstable cardiac status 1. Unstable angina grade CCS Class IV severity with ongoing symptoms and/or ongoing infusion of intravenous nitroglycerin (See Appendix F) 2. Second-degree or greater heart block 3. Frequent (\>60/hour) or symptomatic ventricular ectopics at baseline 4. Hypertension (SPB \>200 and/or DBP \>110 mmHg on two consecutive readings within one hour of PB127 MCE) 5. Hypotension (SPB \<90 mmHg) 6. Severe aortic stenosis (\>100 mmHg peak transvalvar gradient or \<0.6 cm2 estimated valve area) 7. Pulmonary edema within the 7 days prior to Study Day 1 8. Resting oxygen saturation of less than 90% 9. Q-wave myocardial infarction within the 7 days prior to Study Day 1 10. PTCA or CABG within the 7 days prior to Study Day 1 11. Chronic Obstructive Pulmonary Disease (COPD) or bronchospastic airway disease which, in the opinion of the Investigator, is significant enough to contraindicate dipyridamole 12. Known history of severe pulmonary hypertension characterized by estimated pulmonary artery systolic pressure of \>50 mmHg 13. Use of intravenous or intracoronary contrast agent other than thallium or technetium within the 24 hours prior to Study Day 1 14. Liver disease (i.e., current or previous hepatic viral infection, chronic hepatitis) characterized by one or more of the following 1. Current jaundice 2. Elevated bilirubin \> upper limit of normal 3. Currently elevated hepatic enzymes \> 2X upper limit of normal 15. Medical conditions or other circumstances that would significantly decrease the chances of obtaining reliable data or achieving the study objectives (i.e., drug dependence, psychiatric disorder, dementia, or associated illness), extenuating circumstances, medical conditions that make it unlikely that a patient can complete the clinical trial or follow-up evaluations, or other reasons for expected poor compliance with the Investigator's instructions
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To demonstrate the non-inferiority of the diagnostic performance of PB127 MCE versus stress SPECT in the detection and/or exclusion of significant obstructive CAD as defined by QCA or qualifying clinical outcome. | 90 days |
Secondary
| Measure | Time frame |
|---|---|
| To assess the concordance of PB127 MCE with stress SPECT in differentiating between reversible vs. fixed defects in patients with significant obstructive CAD | 28 days |
| To compare the diagnostic performance of PB127 MCE with stress SPECT in identifying the location of stenosis as identified by coronary angiography. | 28 days |
Countries
United States
Outcome results
None listed