Acute Coronary Syndrome Clinical Trial
Official title:
Phase II Study of 99mTc-glucarate in Chest Pain Patients Suspected With ACS With no Obvious Signs of AMI and With Known Previous CAD.
The purpose of this clinical trial is to study the ability of a radioactive drug called "Technetium Glucarate" to detect whether the cause of chest pain in patients entering the emergency department with no obvious signs of heart attack is due to a condition called Acute Coronary Syndrome (ACS). The drug will be injected intravenously. After one or two hours the patient will undergo an imaging procedure to detect if the drug has accumulated in the heart. Uptake of the radioactive drug in the heart is indicative of reduced blood flow to the heart.
Acute coronary syndrome encompasses a range of coronary artery diseases, including unstable
angina and both ST-segment elevation and non-ST-segment elevation myocardial infarction
(MI). Differentiating ACS from noncardiac chest pain remains a challenge in the emergency
department (ED). Myocardial perfusion imaging (MPI) for ischemia has been used to rule ACS
in or out among chest pain patients with nondiagnostic ECGs upon presentation to the ED.
Several studies have shown a high negative predictive value of MPI for ruling out acute
ischemia in the emergency setting. Although myocardial imaging with perfusion agents
provides important information for risk-stratifying stable post-ACS patients, this method is
of limited value in patients with prior history of CAD, since these patients will often have
abnormal resting perfusion patterns, thereby precluding the ability to differentiate old
infarcts from new ischemic events. 99mTc-glucarate does not detect old MIs and thus should
provide an improvement in specificity in the imaging of ACS patients with previous CAD.
This study proposes to extend the evaluation of 99mTc-glucarate imaging by studying its
ability to detect ACS in chest pain patients with no obvious signs of AMI but with known
CAD, in the setting of the ED. Unlike MPI, 99mTc-glucarate imaging will not detect old MIs,
thereby providing an advantage in specificity of the technique.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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