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An International Study to Evaluate Diagnostic Efficacy of Flurpiridaz (18F) Injection PET MPI in the Detection of Coronary Artery Disease (CAD)

Phase 3
Completed
Conditions
Coronary Artery Disease (CAD)
Interventions
Drug: PET MPI
Drug: SPECT MPI
Drug: Pharmacological stress agents
Registration Number
NCT03354273
Lead Sponsor
GE Healthcare
Brief Summary

This is a Phase 3, prospective, open-label, international, multicentre study of Flurpiridaz (18F) Injection for PET MPI in patients referred for ICA because of suspected CAD.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
730
Inclusion Criteria
  • The participant was a man or woman ≥18 years of age.
  • The participant had read, signed, and dated an informed consent form (ICF) prior to any study procedures being performed.
  • At the time of enrolment, the participant had been scheduled via written documentation to undergo an ICA for the assessment of CAD.
  • The participant had undergone a clinically indicated SPECT OR the participant was willing to undergo SPECT MPI for the purposes of the clinical study.
  • The participant was male or was a nonpregnant, nonlactating female who was either surgically sterile or was post-menopausal.
  • The participant was able and willing to comply with all study procedures as described in the protocol.
Exclusion Criteria
  • Participants who were pregnant, may possibly be pregnant, or wish (including their partners) to became pregnant during the study period, or were lactating.

  • Participants who were unable to undergo all of the imaging procedures.

  • Participants who had an established diagnosis of CAD as confirmed by any of the following:

    1. Previous myocardial infarction (MI);
    2. Previous cardiac catheter angiography showing ≥50% stenosis;
    3. Previous coronary revascularisation, such as percutaneous coronary intervention (PCI), thrombolysis or coronary artery bypass graft (CABG) placement.
  • Participants incapable of undergoing either exercise or pharmacological cardiac stress testing.

  • Participants who had a current illness or pathology that, in the opinion of the investigator, would pose a significant safety risk for the participant during cardiac stress testing.

  • Documented history of heart failure and/or cardiomyopathy and/or prior LV ejection fraction (LVEF) <50%).

  • Participants scheduled for or planning to undergo any cardiac interventional procedures between enrolment and ICA.

  • Participants undergoing evaluation for heart transplantation or with history of heart transplantation.

  • Participants enrolled in another clinical study within the 30 days prior to being enrolled in this study or scheduled to participate in another clinical study during the 7-day follow-up period of this study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
1Pharmacological stress agentsFlurpiridaz PET MPI (following off-study SPECT MPI)
1SPECT MPIFlurpiridaz PET MPI (following off-study SPECT MPI)
1PET MPIFlurpiridaz PET MPI (following off-study SPECT MPI)
Primary Outcome Measures
NameTimeMethod
Sensitivity and Specificity of Flurpiridaz (18F) Injection Positron Emission Tomography (PET) Myocardial Perfusion Imaging (MPI) in the Detection of Significant Coronary Artery Disease (CAD) as Defined by Cardiac CatheterizationUp to 60 days

Sensitivity was defined as true positives (TP)/(TP+false negatives \[FN\]). TP was participants with abnormal PET MPI and disease positive by truth standard and FN was participants with normal PET MPI and disease positive by truth standard. Specificity defined as true negatives (TN)/(TN+ false positives \[FP\]). TN was participants with normal PET MPI and disease negative by truth standard and FP was participants with abnormal PET MPI and disease negative by truth standard. Truth standard was presence of CAD as evidenced by presence of stenosis of \>=50 percent (%) in \>=1 coronary artery or major branch of a coronary artery as determined by quantitative coronary angiography (QCA) analysis. Participants were considered to have CAD if QCA revealed \>=50% stenosis of \>=1 major coronary artery or major branch. Sensitivity and specificity were calculated for 3 readers and majority rule using each participant judgement (positive or negative) by at least 2 of 3 readers.

Secondary Outcome Measures
NameTimeMethod
Sensitivity and Specificity of Flurpiridaz (18F) Injection PET MPI Compared SPECT MPI for All Participants When the Diagnosis of CAD by ICA Was the Standard of TruthUp to 60 days

Sensitivity:TP/(TP+FN). TP:participants with abnormal PET MPI and disease positive by truth standard and FN:participants with normal PET MPI and disease positive by truth standard. Specificity:TN/(TN+ FP). TN:participants with normal PET MPI and disease negative by truth standard and FP:participants with abnormal PET MPI and disease negative by truth standard. Truth standard was presence of CAD as evidenced by presence of stenosis of \>=50% in \>=1 coronary artery or major branch of coronary artery as determined by QCA analysis. Participants considered to have CAD if QCA revealed \>=50% stenosis of \>=1 major coronary artery or major branch. Sensitivity, specificity was calculated for 3 readers and majority rule using each participant judgement (positive or negative) by at least 2 of 3 readers. Sensitivity, specificity of Flurpiridaz (18F) PET MPI compared to SPECT MPI with QCA as standard of truth at \>=50% stenosis threshold for all participants was reported by reader and majority rule.

Sensitivity and Specificity of Flurpiridaz (18F) Injection PET MPI Compared SPECT MPI for Female Participants When the Diagnosis of CAD by ICA Was the Standard of TruthUp to 60 days

Sensitivity:TP/(TP+FN). TP:participants with abnormal PET MPI and disease positive by truth standard and FN:participants with normal PET MPI and disease positive by truth standard. Specificity:TN/(TN+ FP). TN:participants with normal PET MPI and disease negative by truth standard and FP:participants with abnormal PET MPI and disease negative by truth standard. Truth standard was presence of CAD as evidenced by presence of stenosis of \>=50% in \>=1 coronary artery or major branch of a coronary artery as determined by QCA analysis. Participants considered to have CAD if QCA revealed \>=50% stenosis of \>=1 major coronary artery or major branch. Sensitivity, specificity calculated for 3 readers and majority rule using each participant judgement (positive or negative) by at least 2 of 3 readers. Sensitivity, specificity of Flurpiridaz (18F) PET MPI compared to SPECT MPI with QCA as standard of truth at \>=50% stenosis threshold for female participants was reported by reader and majority rule.

Sensitivity and Specificity of Flurpiridaz (18F) Injection PET MPI Compared SPECT MPI for Participants With Body-mass Index (BMI) >=30 Kilograms Per Square Meter (kg/m^2) When the Diagnosis of CAD by ICA Was the Standard of TruthUp to 60 days

Sensitivity:TP/(TP+FN). TP:participants with abnormal PET MPI and disease positive by truth standard and FN:participants with normal PET MPI and disease positive by truth standard. Specificity:TN/(TN+ FP). TN:participants with normal PET MPI and disease negative by truth standard and FP:participants with abnormal PET MPI and disease negative by truth standard. Truth standard was presence of CAD as evidenced by presence of stenosis of \>=50% in \>=1 coronary artery or major branch of coronary artery determined by QCA analysis. Participants considered to have CAD if QCA revealed \>=50% stenosis of \>=1 major coronary artery or major branch. Sensitivity, specificity calculated for 3 readers and majority rule using each participant judgement (positive or negative) by at least 2 of 3 readers. Sensitivity, specificity of Flurpiridaz (18F) PET MPI compared to SPECT MPI with QCA as standard of truth at \>=50% stenosis threshold for participants(BMI\>=30 kg/m\^2) reported by reader and majority rule.

Sensitivity and Specificity of Flurpiridaz (18F) Injection PET MPI Compared SPECT MPI for Diabetic Participants When the Diagnosis of CAD by ICA Was the Standard of TruthUp to 60 days

Sensitivity:TP/(TP+FN). TP:participants with abnormal PET MPI and disease positive by truth standard and FN:participants with normal PET MPI and disease positive by truth standard. Specificity:TN/(TN+ FP). TN:participants with normal PET MPI and disease negative by truth standard and FP:participants with abnormal PET MPI and disease negative by truth standard. Truth standard was presence of CAD as evidenced by presence of stenosis of \>=50% in \>=1 coronary artery or major branch of coronary artery determined by QCA analysis. Participants considered to have CAD if QCA revealed \>=50% stenosis of \>=1 major coronary artery or major branch. Sensitivity and specificity calculated for 3 readers and majority rule using each participant judgement (positive or negative) by at least 2 of 3 readers. Sensitivity, specificity of Flurpiridaz (18F) PET MPI compared to SPECT MPI with QCA as standard of truth at \>=50% stenosis threshold for diabetic participants was reported by reader and majority rule.

Trial Locations

Locations (53)

VA Greater Los Angeles Health Care System

🇺🇸

Los Angeles, California, United States

VA North Texas Health Care System - NAVREF - PPDS

🇺🇸

Dallas, Texas, United States

The Methodist Hospital Research Institute

🇺🇸

Houston, Texas, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

OhioHealth Research Institute

🇺🇸

Columbus, Ohio, United States

VA St. Louis Health Care System

🇺🇸

Saint Louis, Missouri, United States

Midwest Heart and Vascular Specialists

🇺🇸

Overland Park, Kansas, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Vascular Biology and Hypertension Program, University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

UCSF

🇺🇸

San Francisco, California, United States

Infinite Clinical Research

🇺🇸

Miami, Florida, United States

Allied Biomedical Research Institute

🇺🇸

Miami, Florida, United States

University of Cincinnati Medical Center

🇺🇸

Cincinnati, Ohio, United States

Hopital Cote de Nacre

🇫🇷

Caen, France

Universitätsklinikum Essen

🇩🇪

Essen, Germany

Amphia Ziekenhuis - WCN - PPDS

🇳🇱

Breda, Netherlands

Indago Research and Health Center

🇺🇸

Hialeah, Florida, United States

University of Tennessee Medical Center

🇺🇸

Knoxville, Tennessee, United States

Comprehensive Vascular Care PA

🇺🇸

Miami, Florida, United States

Optimus U Corp

🇺🇸

Miami, Florida, United States

Amavita Clinical Research, LLC

🇺🇸

North Miami Beach, Florida, United States

Center Hospitalier Universitaire de Sherbrooke CHUS

🇨🇦

Montreal, Quebec, Canada

Universitätsklinikum der RWTH Aachen

🇩🇪

Aachen, Germany

Zuyderland Medisch Centrum-WCN-PPDS

🇳🇱

Heerlen, Netherlands

Leids Universitair Medisch Centrum

🇳🇱

Leiden, Netherlands

University of Ottawa Heart Institute

🇨🇦

Ottawa, Ontario, Canada

VU Medisch Centrum

🇳🇱

Amsterdam, Netherlands

Hopitaux Universitaires de Geneve

🇨🇭

Geneva, Switzerland

Keck Hospital of USC

🇺🇸

Los Angeles, California, United States

University of California- Los Angeles

🇺🇸

Los Angeles, California, United States

VA San Diego Health System

🇺🇸

San Diego, California, United States

Tower Saint John's Imaging

🇺🇸

Santa Monica, California, United States

University Of Iowa Hospitals And Clinics

🇺🇸

Iowa City, Iowa, United States

St Louis University

🇺🇸

Saint Louis, Missouri, United States

Columbia University Medical Center/New York Presbyterian Hospital - Milstein Hospital Building

🇺🇸

New York, New York, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Berks Cardiologists, LTD

🇺🇸

Wyomissing, Pennsylvania, United States

University of Texas Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

Vital Heart & Vein

🇺🇸

Humble, Texas, United States

Memorial City and Katy Cardiology Associates

🇺🇸

Katy, Texas, United States

University of Virginia Health System

🇺🇸

Charlottesville, Virginia, United States

Roanoke Heart Institute

🇺🇸

Roanoke, Virginia, United States

Montreal Heart Institute

🇨🇦

Montréal, Quebec, Canada

Turku University Hospital

🇫🇮

Turku, Finland

Centre Cardiologique Du Nord

🇫🇷

Saint-Denis, France

Groupe Hospitalier Bichat Claude Bernard

🇫🇷

Paris, France

Catharina Hospital

🇳🇱

Eindhoven, Netherlands

Universitatsspital Zurich

🇨🇭

Zürich, Switzerland

Cardiology Physicians PA/Red Clay Research LLC

🇺🇸

Newark, Delaware, United States

Yale New Haven Hospital

🇺🇸

New Haven, Connecticut, United States

Saint Luke's Hospital of Kansas City

🇺🇸

Kansas City, Missouri, United States

University of Florida

🇺🇸

Gainesville, Florida, United States

Ochsner Clinic Foundation

🇺🇸

New Orleans, Louisiana, United States

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