Coronary Artery Computed Tomography as the First-Choice Imaging Diagnostics in Patients With High Pre-Test Probability of Coronary Artery Disease
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Coronary Artery Disease
- Sponsor
- National Institute of Cardiology, Warsaw, Poland
- Enrollment
- 120
- Locations
- 1
- Primary Endpoint
- The average number of invasive procedures (coronary angiography/PCI) in the arm: A. Angio - CT versus B. Classic diagnostics (superiority)
- Last Updated
- 10 years ago
Overview
Brief Summary
To evaluate the safety and effectiveness of computed tomography angiography in the diagnostic and therapeutic cycle as the first-choice method of imaging in the diagnosis of patients with a high probability of stable coronary artery disease according to European Society of Cardiology recommendations.
Detailed Description
A prospective, randomized open-label, single center trial to evaluate superiority of angio-CT to a classic coronary angiography (concerning effectiveness and safety) in the diagnosis of stable coronary artery disease in patients with indications for invasive coronary angiography.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age \>18 years
- •Patients providing written informed consent
- •Indications for elective invasive coronary angiography defined by European Society of Cardiology as:
- •Left ventricle ejection fraction \<50% and typical angina symptoms,
- •Probability of coronary artery disease due to criteria of age, sex and symptoms \>85%, or
- •Probability of coronary artery disease due to criteria of age, sex and symptoms 50-85% with positive or moderate cardiac stress test.
Exclusion Criteria
- •No Consent to the study
- •Acute coronary syndrome
- •Recurrence of typical angina symptoms 1 year after the last percutaneous coronary revascularization,
- •Contraindications to invasive coronary angiography
- •GFR \<60 ml/min/1.73m2
- •Significant arrhythmia
- •BMI \>35 kg/m2
Outcomes
Primary Outcomes
The average number of invasive procedures (coronary angiography/PCI) in the arm: A. Angio - CT versus B. Classic diagnostics (superiority)
Time Frame: up to 3 months (until the last diagnostic/therapeutic procedure; it is assumed it will be completed within 3 months of the participants study entry).
The proportion of "avoidable" invasive diagnostic procedures (coronary angiographies not followed by an intervention) in the arm: A. Angio-CT versus B. Classic diagnostics (superiority)
Time Frame: up to 3 months (until the last diagnostic/therapeutic procedure; it is assumed it will be completed within 3 months of the participants study entry).
Composite outcome of: myocardial infarction, death, acute coronary syndrome, unplanned coronary revascularization, hospitalization for cardiovascular reason, stroke
Time Frame: up to 3 months (until the last diagnostic/therapeutic procedure; it is assumed it will be completed within 3 months of the participants study entry).
Secondary Outcomes
- composite outcome: number of serious adverse events during diagnosis and treatment of coronary artery disease(up to 36 months (through study completion))
- Time to occurrence of composite outcome of: myocardial infarction, death, acute coronary syndrome, unplanned coronary revascularization (including restenosis), urgent hospitalization for cardiovascular reason, stroke(up to 36 months (through study completion))
- Number of angioplasty procedures performed in accordance with ESC recommendations where the treatment planned on the basis of CT angiography by an interventional cardiologist is not treated ad-hoc.(up to 3 months (until the last diagnostic/therapeutic procedure; it is assumed it will be completed within 3 months of the participants study entry).)
- Average number of therapeutic procedures (PCI/CABG).(up to 3 months (until the last diagnostic/therapeutic procedure; it is assumed it will be completed within 3 months of the participants study entry).)
- Average time to complete diagnostic and therapeutic cycle (from the first examination of the coronary arteries to termination or disqualification from the surgical treatment).(up to 3 months (until the last diagnostic/therapeutic procedure; it is assumed it will be completed within 3 months of the participants study entry).)
- Average consumption of resources (comparison of coronary artery disease diagnosis and treatment costs in accordance to National Health Service and Institute of Cardiology price lists.(up to 3 months (until the last diagnostic/therapeutic procedure; it is assumed it will be completed within 3 months of the participants study entry).)
- Average number of days of hospitalization required to complete the diagnostic and therapeutic cycle.(up to 3 months (until the last diagnostic/therapeutic procedure; it is assumed it will be completed within 3 months of the participants study entry).)