Coronary Artery Disease
Conditions
Brief summary
A considerable proportion of patients with clinically suspected coronary artery disease (CAD) do not have angiographic signs of luminal narrowing caused by coronary atherosclerosis. In patients with suspected CAD, we will assess the ability of cardiovascular biomarkers to identify patients with (a) angiographically normal epicardial coronary vessels (b) absence of significant epicardial coronary stenosis, as assessed by coronary computed tomography angiography (CCTA). Patients will be stratified according to the presence or absence of dynamic changes of high sensitivity cardiac troponin T levels above the 99th percentile.
Detailed description
This is an observational study of patients with suspected coronary artery disease referred to coronary computed tomography angiography (CCTA). The plan is to include 1000 patients prior to CCTA at two centers. Blood samples for biomarker measurement will be obtained prior to the procedures. The diagnostic results of the imaging tests will be compared to the levels of circulating troponins. Patient will be followed for a minimum of 12 months and the incidence of cardiovascular death, all-cause mortality, acute coronary syndromes, revascularization, heart failure, stroke and cardiac arrhythmias requiring rehospitalization. Symptoms of angina pectoris according to the Canadian Cardiovascular Society grading of angina pectoris and symptoms of chronic heart failure according to the New York Heart Association classification of chronic heart failure will be recorded.
Interventions
None listed
Sponsors
University Hospital, Akershus
Haukeland University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Consenting patient over the age of 18 referred to CCTA for suspected coronary artery disease
Exclusion criteria
* Inability to provide informed consent. * Short life expectancy (\<12 months) due to non-cardiovascular disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The presence of obstructive coronary artery stenosis defined as diameter > 50% on CCTA | 0 days (Cross-sectional) | Diagnostic end-point |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The presence of non-obstructive coronary artery stenosis defined as diameter stenosis 30-50% on CCTA | 0 days (Cross-sectional) | Diagnostic end-point |
| Composite of cardiovascular death and hospitalization for heart failure or acute coronary syndrome | Follow-up until 2030 | Prognostic end-point |
| Incidence of cardiovascular death, hospitalization for myocardial infarction, unstable angina, revascularization, stroke, heart failure and cardiac arrhythmias. | Follow-up until 2030 | Prognostic-end-point |
Countries
Norway
Contacts
PRINCIPAL_INVESTIGATORTorbjørn Omland, MD, PhD
University Hospital, Akershus
Outcome results
None listed