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A CCTA Guided Management Strategy Versus a Standard of Care Strategy in Type 2 NSTEMI

Withdrawn
Conditions
Myocardial Injury
Registration Number
NCT06382402
Lead Sponsor
University of Louisville
Brief Summary

This study design is a prospective randomized control trial to compare outcomes between the utilization of coronary computed tomography angiography (CCTA) vs conservative treatment in type 2 NSTEMI. The targeted population is expectedly heterogeneous and inpatient setting who are admitted and diagnosed with type 2 NSTEMI.

Detailed Description

This study design is a prospective randomized control trial to compare outcomes between the utilization of coronary computed tomography angiography (CCTA) vs conservative treatment in type 2 NSTEMI. The targeted population is expectedly heterogeneous and inpatient setting who are admitted and diagnosed with type 2 NSTEMI. Patients are randomized into 2 groups. Group 1 undergoes coronary 64-detector row computed tomography angiography (CCTA) and Group 2 receives conservative management and treatment for underlying conditions. The investigators will evaluate cross-sectional and time-varying clinical, laboratory, and imaging characteristics in association with clinical events. The exclusion criteria are an absence of information for follow-up of clinical events, and patients who have absolute and relative contraindications for CCTA. Absolute contraindications are a patient history of severe or anaphylactic reaction to iodinated contrast, inability to cooperate with scan protocols, hemodynamic instability, decompensated heart failure, acute myocardial infarction, and renal impairment with GFR \< 30. Relative contraindications include pregnancy, inability to tolerate heart rate-slowing medications or nitroglycerin, recent phosphodiesterase inhibitor use, severe aortic stenosis, bronchospastic disease, and patient's weight and height.

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
700
Inclusion Criteria
  • Inpatient with type 2 NSTEMI
  • Aged 18-70 years old
  • At the University of Louisville and Jewish hospitals
Exclusion Criteria
  • History of severe or anaphylactic reaction to iodinated contrast
  • Inability to cooperate with scan protocols
  • Hemodynamic instability
  • Decompensated heart failure
  • Acute myocardial infarction
  • Renal impairment with GFR < 30
  • Pregnancy
  • Inability to tolerate heart rate-slowing medications or nitroglycerin
  • Recent phosphodiesterase inhibitor use
  • Severe aortic stenosis
  • Bronchospastic disease
  • Patient's weight and height

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Cardiovascular (CV) mortalityanytime within 3 years

Cardiovascular (CV) mortality Unit: no unit (yes/no)

Nonfatal MI, strokeanytime within 3 years

Nonfatal MI, stroke Unit: no unit (yes or no)

Hospitalization for unstable anginaanytime within 3 years

Hospitalization for unstable angina Unit: no unit (yes or no)

Hospitalization for heart failureanytime within 3 years

Hospitalization for heart failure Unit: no unit (yes or no)

MACEanytime within 3 years

Time to the first major adverse cardiac event (MACE) at 3 years between 2 groups.

Unit: no unit (yes/no)

Unplanned revascularizationanytime within 3 years

Unplanned revascularization Unit: no unit (yes or no)

Secondary Outcome Measures
NameTimeMethod
Diagnostic certainty scoresanytime within 3 years

Diagnostic certainty scores Unit: The numeric rating scores

All-cause mortalityanytime within 3 years

All-cause mortality Unit: no unit (yes or no)

In-hospital and 90-day costsanytime within 90 days

In-hospital and 90-day costs Unit: US dollars

Patient quality of life at 90 daysanytime within 90 days

Patient quality of life at 90 days Unit: The numeric rating scales

Individual components of the primary endpointanytime within 3 years

Individual components of the primary endpoint Unit: no unit (yes or no)

Trial Locations

Locations (1)

University of Louisville School of Medicine, Division of Cardiovascular Diseases

🇺🇸

Louisville, Kentucky, United States

University of Louisville School of Medicine, Division of Cardiovascular Diseases
🇺🇸Louisville, Kentucky, United States
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