Angina Pectoris, Angina, Stable, Angina, Unstable, Myocardial Infarction
Conditions
Brief summary
This study involves the use of Magnetic Resonance Imaging (MRI) to determine whether blood clots can be identified within the blood vessels supplying blood to the heart in patients with angina and who have recently suffered a heart attack.
Detailed description
The majority of heart attacks are caused as a result of small blood clots forming within the blood vessels supplying blood to the heart, obstructing blood flow to the heart muscle. Research has also shown that blood clots may form in the blood vessels of the heart without causing a heart attack. At present, blood clots may be identified by techniques used during invasive coronary angiography, but we wish to determine whether a non-invasive test (MRI scanning) can be used to detect small blood clots within the blood vessels supplying blood to the heart muscle.
Interventions
OTHERMagnetic Resonance Imaging
Each participant will undergo at least one MRI scan. A small number will be asked to undergo repeat MRI scanning at one and three months following the initial scan.
DEVICEOptical Coherence Tomography
Participants may undergo Optical Coherence Tomography (OCT) during the angiogram procedure in order to detect thrombus within the coronary arteries.
PROCEDUREInvasive Coronary Angiography
This will be performed as part of usual care and does not constitute part of the research project.
Sponsors
University of Edinburgh
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Aged over 18 years * Previously diagnosed coronary artery disease undergoing elective invasive angiography (Cohort 1) OR * Admitted with Acute Coronary Syndrome (ACS) diagnosed by two of the following criteria; 1. Elevation of cardiac biomarkers (high sensitivity troponin I greater than 34ng/l in men and 16ng/l in women). 2. Symptoms of myocardial ischaemia 3. Electrocardiogram (ECG) changes indicative of acute ischaemia (Cohort 2) * Planned invasive coronary angiography
Exclusion criteria
* Contraindication or inability to undergo MRI scanning * Renal failure (estimated glomerular filtration rate less than 30millilitres/minute) * Undergoing Primary Percutaneous Coronary Intervention * Ongoing myocardial ischaemia or dynamic ECG changes * Inability to provide informed consent * Known allergy to gadolinium based contrast * Women who are pregnant, breastfeeding or of child-bearing potential
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Evidence of high intensity signals within the coronary arteries on T1 weighted magnetic resonance imaging. | Within 72 hours prior to angiography |
Secondary
| Measure | Time frame |
|---|---|
| The correlation between high risk plaques as determined on MRI with culprit plaques on invasive angiography in patients with acute coronary syndrome (ACS). | Through study completion, an average of 1 year |
| Incidence of intracoronary thrombosis, as detected by magnetic resonance imaging, in patients with stable coronary artery disease. | Through study completion, an average of 1 year |
| The change in plaque signal intensity on magnetic resonance imaging at one month following acute coronary syndrome (ACS). | Baseline and 1 month |
| The change in plaque signal intensity on magnetic resonance imaging at three months following acute coronary syndrome (ACS). | Baseline and 3 months |
Outcome results
None listed