Myocardial Infarction
Conditions
Keywords
Dynamic 99mTc-Tetrofosmin CZT-SPECT, Myocardial perfusion imaging, fractional flow reserve, acute coronary syndrome
Brief summary
Dynamic 99mTc-Tetrofosmin CZT-SPECT myocardial perfusion imaging (MPI) is an advanced functional imaging technique giving important myocardial flow quantification added data in comparison with conventional MPI, especially in coronary multi vessel disease. A large-scale validation of diagnostic performances of myocardial flow reserve (MFR) estimated with Dynamic 99mTc-Tetrofosmin CZT-SPECT MPI would allow a non-invasive approach instead of invasive intra-coronary fractional flow reserve (FFR) measurement. The aim of this prospective study is to assess diagnostic performances of MFR calculated with dynamic 99mTc-Tetrofosmin CZT-SPECT MPI in comparison with invasive intra-coronary FFR measurement in patients with significant residual coronary arteries stenosis after acute coronary syndrome .
Interventions
DIAGNOSTIC_TESTDynamic 99mTc-Tetrofosmin CZT-SPECT
Patients included in the study will undergo subsequently at 1-month after acute coronary syndrome Dynamic 99mTc-Tetrofosmin CZT-SPECT followed by FFR and IMR assessment
Sponsors
Nantes University Hospital
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
* Adult patient. * Multi vessel coronary arteries disease (at least one non-culprit coronary stenosis \>= 50%) diagnosis during * primary percutaneous coronary intervention \< 12h after ST-elevation myocardial infarction opercutaneous revascularisation of the culprit lesion within 24 to 48 hours of an acute non-ST-segment elevation coronary syndrome. * Written consent. * Social security affiliation
Exclusion criteria
* Non adult patient. * Adult patient under tutelage. * Reproductive age women. * Medical history of myocardial infarction or coronary artery bypass surgery. * Cardiogenic shock. * Cardiomyopathy. * Regadenoson/adenosine/FFR contraindication. * 99mTc-Tetrofosmin hypersensibility. * Small non-culprit coronary arteries. * Participation to another interventional study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity, specificity, predictive positive value, negative predictive value, accuracy of MFR in comparison with FFR | within one month after ST-elevation myocardial infarction | To determine MFR diagnostic performances in comparison with FFR |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| best MFR cut-off value | within one month after ST-elevation myocardial infarction | To determine the best MFR cut-off value correlated with FFR value \< 0.8 |
| MFR value correlated with IMR | within one month after ST-elevation myocardial infarction | analysis of discrepancies between MFR value correlated with IMR (if low MFR value and normal FFR value) |
| Sensitivity, specificity, predictive positive value, negative predictive value, accuracy of MFR in comparison with conventional static MPI | within one month after ST-elevation myocardial infarction | To determine MFR diagnostic performances in comparison with conventional static MPI |
| Sensitivity, specificity, predictive positive value, negative predictive value, accuracy of QFR in comparison with FFR value | within one month after ST-elevation myocardial infarction | QFR value at the index procedure in comparison with FFR value |
Countries
France
Outcome results
None listed