Risk Stratification of Non ST Elevation ACS With Computed Tomographic Angiography (REACT)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Acute Coronary Syndrome
- Sponsor
- Ottawa Heart Institute Research Corporation
- Enrollment
- 107
- Locations
- 1
- Primary Endpoint
- Operating Characteristics of CTA
- Status
- Completed
- Last Updated
- 14 years ago
Overview
Brief Summary
The purpose of this project is to examine the effectiveness of computed tomographic angiography (CTA) in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). People who are hospitalized with this situation often require an angiogram to assess the heart and its arteries.
Recent advancements in technology have enabled CTA to clearly define coronary artery anatomy with great accuracy and to guide treatment strategies in select patient populations. We are investigating that CTA may be used, as an alternative to conventional angiograms, for the risk stratification of patients with high risk NSTE-ACS.
Patients eligible for the study will be high risk NSTE-ACS and awaiting an angiogram. Enrolled patients will undergo CTA prior to the angiogram. With each CTA the patient will be injected with a small dose of an X-ray dye and will be asked to lie still on the "scanning bed" for a period of 5-10 minutes.
Investigators
Benjamin Chow
Dr Benjamin Chow
Ottawa Heart Institute Research Corporation
Eligibility Criteria
Inclusion Criteria
- •High risk ACS
- •Angina \[accelerating pattern or prolonged episode (\> 20 minutes) or recurrent episode at rest or with minimal effort within preceding 24 hours\]; and (13)
- •Elevated Troponin - T (≥0.1 ug/L) or ECG changes consistent with ischemia \[ST depression ≥ 0.1 mV, transient ST segment elevation ≥ 0.1 mV (\< 20 minutes)\]) (11;13)
- •Planned conventional invasive coronary angiography
Exclusion Criteria
- •Age \< 18 years or lack of consent
- •Renal Insufficiency (GFR \< 60 ml/min)
- •Allergy to contrast agent
- •Refractory angina requiring urgent/emergent coronary angiography (as per treating physician)
- •Contraindication to radiation exposure (e.g. pregnancy)
- •Uncontrolled HR
- •Previous CABG or PCI/Stent
- •Atrial fibrillation, frequent atrial or ventricular ectopy (\> 1 / minute)
- •Unable to perform 20 second breath-hold
Outcomes
Primary Outcomes
Operating Characteristics of CTA
Time Frame: 1 month
Secondary Outcomes
- To compare the accuracy of CTA to CICA in predicting the mode of revascularization (PCI versus CABG) in NSTE-ACS patients.(1 month)
- To determine the number of "avoidable" CICA (i.e. those accurately designated to medical therapy or surgery with CTA).(1 month)