Coronary Artery Disease Clinical Trial
— PRECISE-CTCAOfficial title:
Troponin Within the Normal Reference Range to Risk Stratify Patients With Acute Chest Pain for Computed Tomography Coronary Angiography
NCT number | NCT04549805 |
Other study ID # | 245971 |
Secondary ID | |
Status | Completed |
Phase | |
First received | |
Last updated | |
Start date | December 4, 2018 |
Est. completion date | October 6, 2020 |
Verified date | March 2021 |
Source | University of Edinburgh |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Most patients presenting to hospital with chest pain are discharged home without further tests once a heart attack has been ruled out. Current strategies to assess patients with a suspected heart attack involve blood tests to measure troponin, a protein released into the bloodstream when the heart muscle is damaged. Despite having had a heart attack ruled-out, some patients have unrecognised coronary heart disease and are at risk of having a heart attack in the future. However, we do not know what is the best approach to identify and treat these patients. This study will use a heart scan known as computed tomography coronary angiogram (CTCA) to look for underlying coronary heart disease in patients who have had a heart attack ruled out. In an earlier study, we performed this scan in patients referred to the outpatient cardiology clinic with stable chest pain and found that this improved the diagnosis of coronary heart disease, leading to improvement in patient care that prevented many future heart attacks. Our research has also demonstrated that troponin levels below the threshold used to diagnose a heart attack identify those who are at greater risk of having a heart attack in the future. The aim of this study is to confirm whether these low levels of troponin can identify patients who have underlying coronary heart disease and may benefit from further testing and preventative treatment.
Status | Completed |
Enrollment | 250 |
Est. completion date | October 6, 2020 |
Est. primary completion date | October 6, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 30 Years and older |
Eligibility | Inclusion Criteria: - Presentation to hospital with acute chest pain or equivalent symptoms of suspected acute coronary syndrome - Maximum high-sensitivity cardiac troponin I concentration below the 99th centile (16 ng/L for women and 34 ng/L in men) Exclusion Criteria: - Diagnosis of myocardial infarction during index presentation - Clear alternative diagnosis for index presentation - Recent CT or invasive coronary angiogram (within 1 year) - Patient inability to undergo CT scanning, due to severe renal failure (estimated glomerular filtration rate <30 mL/min) or major allergy to iodinated contrast media - Pregnancy or breast feeding - Inability to give informed consent - Further investigation for coronary artery disease would not in the patient's interest, due to limited life expectancy, quality of life or functional status |
Country | Name | City | State |
---|---|---|---|
United Kingdom | Centre for Cardiovascular Science, University of Edinburgh | Edinburgh |
Lead Sponsor | Collaborator |
---|---|
University of Edinburgh | British Heart Foundation, NHS Lothian |
United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Leaman score for overall coronary artery disease burden | Ideally within 4 weeks of index presentation | ||
Other | Proportion of participants with adverse coronary artery plaque features | Ideally within 4 weeks of index presentation | ||
Other | Myocardial mass | Ideally within 4 weeks of index presentation | ||
Other | Proportion of participants with hemodynamically significant coronary stenosis on CT-derived fractional flow reserve (CT-FFR) | Ideally within 4 weeks of index presentation | ||
Other | Left ventricular volume | Ideally within 4 weeks of index presentation | ||
Primary | Proportion of participants with obstructive coronary artery disease | Proportion of participants with >50% stenosis in the left main stem or >70% stenosis in other coronary arteries | Ideally within 4 weeks of index presentation | |
Secondary | Proportion of participants with moderate non-obstructive coronary artery disease | Proportion of participants with 50-70% stenosis in one or more coronary arteries | Ideally within 4 weeks of index presentation | |
Secondary | Proportion of participants with mild non-obstructive coronary artery disease | Proportion of participants with 10-50% stenosis in one or more coronary arteries | Ideally within 4 weeks of index presentation | |
Secondary | Proportion of participants with insignificant coronary artery disease | Proportion of participants with 1-10% stenosis in one or more coronary arteries | Ideally within 4 weeks of index presentation | |
Secondary | Proportion of participants with normal coronary arteries | Proportion of participants with no stenosis in coronary arteries | Ideally within 4 weeks of index presentation |
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