Coronary Artery Disease (CAD), Coronary Artery Calcification, Occupational Diseases, Aviator's; Disease
Conditions
Brief summary
SUSPECT is a prospective, single-center, cohort study of 250 military aircrew at the Center for Man in Aviation, Royal Netherlands Air Force. All asymptomatic aircrew (≥40 years) are asked to undergo a coronary CT scan on a voluntary basis, following the exercise electrocardiograms performed at their routine aeromedical examination. Coronary Artery Calcium score (CACS) and CCTA findings are reported.
Interventions
RADIATIONCT Angiography
A CTA will be performed on asymptomatic individuals
DIAGNOSTIC_TESTExercise stress test
A routine exercise stress test will be performed on a bicycle
Sponsors
Center for Man in Aviation, Royal Netherlands Air Force
UMC Utrecht
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
SCREENING
Masking
NONE
Intervention model description
Every participant will perform an exercise test and receive a CTA afterwards
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Military aircrew of the Royal Netherlands Air Force * ≥ 40 years old * Required to undergo cardiac screening (per military aviation regulations)
Exclusion criteria
* Typical angina * Prior myocardial infarction * Prior revascularization therapy (i.e. percutaneous coronary intervention (PCI) and/or coronary artery bypass grafting (CABG)) * Left ventricular ejection fraction \<35% * Does not comprehend study requirements, and/or is unwilling or unable to comply to study procedures * CT-related contra-indications * Allergic to iodine contrast. * Renal insufficiency (GFR \<60 ml/min/1.73m2, calculated with the Modification of Diet in Renal Disease (MDRD) calculator: http://nephron.org/mdrd\_gfr\_si. * Severe claustrophobia. * Uncontrolled irregular heart rhythm or tachycardia unresponsive to beta blockade * Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Determine the prevalence and severity of CAD in asymptomatic air crew using CCTA as a primary screening tool | 8 Years |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Determine the diagnostic accuracy of clinically relevant CAD of the exercise stress test versus CCTA | 8 Years | Both modalities are used to track down clinically relevant CAD. Clinically relevant CAD is defined as a stenosis of \>50%. |
| Compare the incidence of Major Adverse Cardiac Events (MACE) and all-cause mortality in populations screened between primary and secondary screening after 12 months | 8 Years | — |
| Compare the incidence of coronary angiograms and revascularization procedures in the population screened with CTA compared to a historical population using CTA as a secondary screening tool | 8 Years | — |
| Establish the additive value of coronary artery calcium score (CACS) in addition to clinical risk scores as a predictor of CAD on CCTA | 8 Years | — |
Countries
Netherlands
Outcome results
None listed