Coronary Artery Disease Clinical Trial
Official title:
NON-Invasive Examinations of Coronary Artery Disease
The aim of the study is to evaluate and compare the value of 5 different non-invasive diagnostic methods in patients with chest pain suspected for coronary artery disease. The investigators intend to include 200 patients over a 3 year period in the study. The participants will be recruited from patients referred to coronary angiography at the institution. Before the angiography the participants will (1) test the effect of sublingual Nitroglycerin, (2) give their medical history so mathematical models can estimate the probability of the presence of coronary artery disease, (3) take part in a contrast stress echocardiography and (4) a 2D-strain stress echocardiography and a myocardial scintigraphy. Stenosis found at the angiography will be the gold standard.
The aim of the study is to evaluate the diagnostic value of various non-invasive methods.
The study is divided into five substudies:
Substudy NITRO
Purpose: To investigate whether a subjective effect of Nitroglycerine is associated with
significantly narrowed coronary arteries.
The participants are instructed to alternate between rest and Nitroglycerine as treatment
for chest pain attacks during a 2 week period. Chest pain score is recorded in a diary
handed out at day 1 together with 30 tablets Nitroglycerine in the maximal tolerated dose.
Substudy SCORE
Aim: To test and compare the ability of different statistical methods using clinical data to
predict the presence of narrowed coronary arteries in a contemporary Danish population.
Substudy CONTRAST
Aim: To evaluate if the blood flow in an area in the heart muscle measured by contrast
adenosine stress echocardiography can predict the presence of significant stenosis in the
coronary artery supplying the area.
Substudy 2D strain
Aim: To Evaluate if lack of increase in 2D strain during adenosine stress echocardiography
can predict the presence of narrowed coronary arteries.
Substudy SPECT
Aim: To evaluate whether the result of a myocardial scintigraphy can predict symptomatic
chest pain relief 6 months after a coronary angiography and possible treatment with balloon
or bypass surgery.
Participants: Annually around 1,500 coronary angiographies are performed at Region Hospital
Herning. We intend to include 200 patients referred by their physicians to coronary
angiography in the study and expect the data collection phase to last 3 years.
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Observational Model: Cohort, Time Perspective: Prospective
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