Characteristics of Culprit Lesion and Changes in Plaque Composition During Follow up in NSTEMI. A Dual Energy Cardiac CT Study
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Coronary Arteriosclerosis
- Sponsor
- Odense University Hospital
- Enrollment
- 135
- Locations
- 1
- Primary Endpoint
- Description and characteristics of culprit lesion by DECT. (z-value)
- Last Updated
- 8 years ago
Overview
Brief Summary
Identifying patients who are at risk for a future myocardial infarction, is still one of the biggest challenges in cardiology.
In this study the investigators will investigate culprit lesion in patients with NSTEMI and the ability of cardiac CT with dual energy computed tomography (DECT) scanning to describe and identify plaques that may be vulnerable. The investigators will also describe changes in characteristic in both stable and unstable plaques during 1 year follow up of NSTEMI and a matching group of stable angina pectoris (SAP) patients.
Detailed Description
Patients with verified NSTEMI undergo contrast-enhanced coronary DECT before conventional coronary angiography (CAG), and DECT characteristics of the culprit lesion will be determined. All Non-culprit lesions will be observed during 2 month and 1 year follow up characteristics and changes in plaque composition, volume and core content will be assessed. Patients with SAP undergo a baseline DECT similar to NSTEMI group. Because the expected change in coronary plaques in SAP group is minimal, there is no need for follow up at 2 month.
Investigators
Hussam Mahmoud Sheta
MD
Odense University Hospital
Eligibility Criteria
Inclusion Criteria
- •Patients with NSTEMI and scheduled to CAG or patients with SAP
Exclusion Criteria
- •Not suitable to undergo CT with contrast agent:
- •Known allergy-like reactions to contrast or Claustrophobia
- •Atrial fibrillation or significant arrhythmia judged to potentially limit quality of CT
- •Known renal failure/insufficiency or s-creatinin\> 140 µmol/L.
- •Severe/symptomatic thyrotoxicosis
- •pacemaker
Outcomes
Primary Outcomes
Description and characteristics of culprit lesion by DECT. (z-value)
Time Frame: 72 hours
measure the z-value for the culprit lesion, by marking the culprit lesion with a region of interest (ROI) and the DECT will calculate the mean z-value by mg/mm\^3 in the marked ROI
Secondary Outcomes
- Measure the volume of the culprit lesion(72 hours)
- Determine the mean Z value for non-culprit plaques containing 3: calcified tissue(1 year)
- z value in myocardium related to culprit vessel compared to z-value in myocardium corresponded to non-culprit vessel(72 hours)
- Determine the mean Z value for non-culprit plaques containing 1: soft tissue(1 year)
- changes in non-culprit plaques during 1 year in comparison til patients with stable angina pectoris(1 year)
- Determine the mean Z value for non-culprit plaques containing 2: mixed tissue(1 year)
- Describe if the culprit lesion contains 1: soft 2: mixed or 3: calcified tissue(72 hours)
- Measure the remodeling index of culprit lesion(72 hours)