Coronary Artery Disease Clinical Trial
Official title:
Maastricht Biomarker CT Study. Relation Between Cardiovascular Biomarkers and Coronary Atherosclerosis in Patients Undergoing Multi Detector Cardiac Computed Tomography.
Introduction
Cardiovascular disease is the leading cause of death in the Western world. The main cause
for cardiovascular events is the development of atherosclerosis in the coronary arteries. In
more than 70% of cases, myocardial infarctions are caused by atherosclerotic plaque rupture,
which results in subsequent formation of an occluding thrombus. Plaques that have a high
risk of rupture are called vulnerable plaques. Cardiovascular imaging provides a
complementary diagnostic approach in the assessment of cardiovascular risk in patients.
However, the lack of biological detection possibilities of current imaging technologies
limits their predictive value. For instance, multi detector computed tomography (MDCT) is an
excellent tool to visualize coronary atherosclerosis. However, individual risk assessment is
still problematic. Which of the diagnosed atherosclerotic plaques will undergo plaque
rupture and lead to acute vascular events is currently hard to predict. Potentially, serum
biomarkers could help identify the patient at risk. A wide variety of prognostic markers
related to atherosclerosis have been identified in the past to predict for cardiovascular
events. Nevertheless, their predictive value in individual patients is still limited. A
difficulty in serum biomarker research is the requirement of large patient cohorts to study
the relation between event rate and serum biomarker levels. The necessity to perform lengthy
and costly studies, hinders the translation of novel cardiovascular serum biomarkers into
the clinic. An alternative approach could be to study the correlation between levels of
serum biomarkers and the presence of atherosclerosis in the coronary arteries.
Study objectives
Primary objective of the present analysis is to investigate the predictive value of a
variety of serum biomarkers to predict atherosclerosis in the coronary tree of patients
undergoing cardiac MDCT.
Design and Methods
Patients undergoing cardiac MDCT are eligible for the study. Excluded are patients with
acute coronary syndrome, hemodynamic instability, pregnancy, severe renal insufficiency,
allergy for contrast medium and inability to obtain informed consent. Permission to store
the serum samples for future analysis of new prognostic markers for cardiovascular events
will be acquired from the patients. Written information is send to the patient at least 1
week prior to CT. The samples will be stored coded, at the Biobank Maastricht, for a maximum
duration of 15 years. Once measurements from the samples will be performed, the serum
samples will be sent by the Biobank coded to the analyzing researchers, which have no access
to the key file where codes are linked to the specific hospital identity number. This file
will be stored by an independent researcher at the Cardiology department of the Maastricht
University Medical Center. The assessment of atherosclerotic burden of the coronary tree
will be performed by cardiac MDCT specialists blinded to the clinical data and serum
biomarker outcome. Biomarker levels are correlated to the severity and amount of coronary
artery disease as assessed by cardiac MDCT.
n/a
Observational Model: Cohort, Time Perspective: Cross-Sectional
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