Imaging of Vulnerable Plaques in Coronary Artery Disease by Multidetector Computed Tomography
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Aarhus
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Ability to identify and characterise atherosclerotic plaques by multidetector CT
Study Overview
Brief Summary
Atherosclerosis is a chronic and multifocal immunoinflammatory, fibroproliferative disease of medium-sized and large arteries driven by lipid. Atherosclerosis is rarely fatal unless thrombosis supervene, causing an acute coronary syndrome. Therefore, for event-free survival, the vital question is not why atherosclerosis develops but rather why atherosclerosis, after years after indolent growth, suddenly becomes complicated with luminal thrombosis.
The great majority of coronary plaques will remain quiescent, at least from a clinical point of view.
Acute coronary syndrome is primarily precipitated by a ruptured plaque. The precipitating factor or condition may be found outside rather than inside the plaque.
The challenge is to find the plaque(s) destined for the next thrombus-mediated heart attack(s), treat, and thus avoid the heart attack(s). Identification of vulnerable plaques has become a key issue. The natural history of individual plaques (risk of thrombosis) is unknown and needs to be established.
Multidetector computed tomography (MDCT) can provide angiography and imaging of the vessel wall (detection, quantification and characterization of plaques).
The intention of this project is to evaluate the accuracy of coronary MDCT in identifying and differentiating the morphology of coronary atherosclerotic plaques.
Detailed Description
Atherosclerosis without thrombosis is rarely fatal. It is the acute thrombotic complications which account for disability and death. Therefore, for event-free survival, the question is not why atherosclerosis develops but rather why atherosclerosis, after years after indolent growth, suddenly becomes complicated with luminal thrombosis.
Post-mortem and clinical observations indicate that patients with acute coronary syndromes often have many ruptured and/or active plaques in their coronary arteries.
The challenge is to find the plaque(s) destined for the next thrombus-mediated heart attack(s), treat, and thus avoid the heart attack(s). Identification of vulnerable plaques have become a key issue. The natural history of individual plaques (risk of thrombosis) is unknown and needs to be established. Multidetector computed tomography (MDCT) can provide angiography and imaging of the vessel wall.
Hypothesis:
It is by CT-scanning possible to 1a) identify and differentiate the morphology of coronary atherosclerotic plaques.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Diagnostic
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Unstable angina pectoris Stable angina pectoris
Exclusion Criteria
- •known allergy towards the contrast agent not able to hold ones breath for 20 seconds pulmonal, renal or heart failure, cancer, or inflammatory disease arrythmia intolerant to treatment with beta-blockers claustrophobia, pregnancy, breast-feeding previous bypass surgery or PCI continuing breast pain
Arms & Interventions
UAP, SAP
Intervention: Blood sample (Procedure)
UAP, SAP
Intervention: Coronary angiography (CAG) (Procedure)
UAP, SAP
Intervention: Intravascular ultrasound (Procedure)
UAP, SAP
Intervention: Multidetector computed tomography scanning (Radiation)
Outcomes
Primary Outcomes
Ability to identify and characterise atherosclerotic plaques by multidetector CT
Time Frame: immediately after the CT-scanning
Secondary Outcomes
- The impact of different CT-parameters on the ability to identify and characterise atherosclerotic plaques(immediately after the CT-scanning)
- the growth/development of atherosclerosis(one year)