Cardiovascular Disease Clinical Trial
Official title:
Cardiovascular Molecular Calcification Assessed by 18F-NaF PET CT: The CAMONA Study
The purpose of the CAMONA study is to demonstrate the feasibility of cardiovascular molecular calcification (CMC) assessment by means of 18F-sodium-fluoride (18F-NaF) positron emission tomography (PET) computed tomography (CT) in a prospective cohort of healthy control subjects and subjects with cardiovascular disease.
Atherosclerosis associated cardiovascular disease (CVD) remains a significant cause of
morbidity and mortality. Asymptomatic individuals with a moderate to high-risk of developing
acute atherosclerotic cardiovascular events will benefit most from intensive evidence-based
medical interventions.
The traditional approach to identify patients with moderate to high-risk of CVD involves
quantifying the presence of CVD risk factors. Based on gender, age, smoking, systolic blood
pressure and cholesterol levels, risk stratification algorithms such as the Framingham Risk
Score (FRS) and the European SCORE system can predict the 10-year risk of cardiovascular
death.
However, these algorithms are associated with several limitations, including
misclassification of women and individuals with high levels of a single risk factor. The
risk is underestimated in these individuals. Therefore, these individuals are not eligible
for treatment by current criteria of CVD prevention guidelines. Several studies indicate
that the traditional risk score models leave room for improvement, as they work reasonably
well for populations, but remain suboptimal for individual subjects.
New risk parameters are discovered on a regular basis. One of these parameters is
cardiovascular molecular calcification (CMC). This entity can be detected and quantified by
18F-NaF PET CT. It has been hypothesized that CMC can be detected years, maybe even decades,
before coronary artery calcium scoring (CACS) can be detected by conventional imaging
modalities like multislice CT. Theoretically, this tool can detect patients at a very early
stage of the disease. Providing evidence-based treatment to these individuals can,
theoretically, improve the prevention of CVD. Before this hypothesises can be tested, the
feasibility of 18F-NaF PET CT has to be demonstrated in both healthy controls as well as in
subjects with cardiovascular disease.
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Observational Model: Cohort, Time Perspective: Prospective
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