Coronary Arteriosclerosis Clinical Trial
Official title:
Iodine Content for Diagnostic AccuRacy and Patient Comfort For Individuals Undergoing Cardiac CT Scanning: The Multicenter ICARUS Trial
The purpose of the study is to evaluate diagnostic performance of high iodine (iopamidol 370 mg/dl) content versus low iodine (iodixanol 300 mg/dl) content for diagnostic accuracy by contrast-enhanced Coronary Cardiac Computed Tomography (CCTA) using a 64-detector-row CT scanner for detection of presence or absence of coronary artery obstruction when compared against invasive coronary angiography, the standard of truth.
Coronary Cardiac CT (CCTA) is a widely accepted modality for non-invasive evaluation of
coronary atherosclerosis. The diagnostic performance of CCTA for detecting coronary artery
plaque burden has been validated in numerous studies, reaching a negative predictive value
of 99%.
The current gold standard for anatomic coronary imaging is Invasive Coronary Angiography
(ICA) which portends a small but significant procedural-related complication of 1.7%.
Non-invasive coronary imaging has the potential to replace ICA but the variability in
diagnostic performance of CCTA remains under study. Among the potential variables causing
differences in diagnostic performance is perhaps the degree of opacification of coronary
artery by iodinated contrast. While numerous contrast agents exist, those that provide
improved low and high contrast resolution (for delineating plaque from arterial wall and
lumen from plaque, respectively) are hypothetically, the most optimal agents. To date,
however, this has not been well evaluated. Further, use of a contrast agent which maximizes
patient comfort is desired, as this may reduce heart rate increases and heart rate
variability, which may in turn improve diagnostic image quality of CCTA.
We hypothesize that the use of lower iodine content iso-osmolar agent - iodixanol - will
improve diagnostic performance and patient comfort, as compared to higher iodine content low
osmolar iodinated contrast - iopamidol.
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Time Perspective: Prospective
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