Cardiovascular Diseases Clinical Trial
To investigate use of Fast Gated Helical Computed Tomography (FGHCT) measures of coronary artery calcium (CAC), FGHCT-CAC, for discrimination of coronary artery disease (CAD) and to quantify progression of coronary artery calcium over time.
BACKGROUND:
While advances have been made in control of some coronary heart disease (CHD) risk factors,
especially smoking and high dietary fat intake, much of the decline in age-adjusted CHD
mortality rates has been due to medical treatment and procedural interventions for overt CHD
as well as hypertension and hypercholesterolemia. In this context, the availability of an
inexpensive, sensitive and specific method for noninvasive detection of both early coronary
atherosclerosis and asymptomatic but advanced CHD could allow beneficial treatments to be
targeted at many high-risk individuals. The study was designed to determine whether
fast-gated helical computed tomography (FGHCT), a more advanced and readily-available
variant of a technique (EBCT) that has not achieved its full promise, could play such a
role.
DESIGN NARRATIVE:
Dr. Crouse and his colleagues augmented ongoing case-control studies, HL35333, "Carotid
Atherosclerosis Progression Study" and HL59503, "Vascular Disease, Structure and Function".
HL35333 comprises 280 symptomatic individuals > 45 years equally divided between men and
women, half with and half without angiographically defined coronary artery disease evaluated
for risk factors and extracranial carotid intimal-medial thickness (ECIMT, with B-mode
ultrasound) at baseline and yearly for three years. The grant has quantified the
associations of coronary artery disease and coronary artery disease risk factors for ECIMT
and its progression. HL59503 quantifies flow-mediated brachial artery reactivity (FM-BAR) in
this cohort. Literature review suggests that while ECIMT predicts coronary artery disease
status in clinical samples it does less well in asymptomatic samples; longitudinal data
(CLAS study) suggest that progression of ECIMT best predicted incident coronary artery
disease, and Electron Beam Computed Tomography (EBCT) quantification of Coronary Artery
Calcium (CAC) likely has even greater discriminatory power for coronary artery disease than
ECIMT. However, EBCT has limited accessibility.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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