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Detection of Coronary Artery Calcifications by Whole Blood Transcriptome Analyzed by Artificial InTelligence Algorithms

Completed
Conditions
Atherosclerotic Plaque
Atheroscleroses, Coronary
Atherosclerosis
Registration Number
NCT05619042
Lead Sponsor
Santiago Gabriel Miriuka
Brief Summary

The goal of this observational study is to determine the diagnostic accuracy of peripheral whole blood transcriptomes analyzed by an artificial intelligence algorithm to detect the presence and extent of coronary calcification in individuals without a history of known cardiovascular disease.

The main question it aims to answer is:

1. Will the proposed method predict the presence and extent of coronary artery calcification from the peripheral whole-blood transcriptomes?

Detailed Description

This study will be a prospective observational single-site study. A convenience sample will be carried out to include 800 patients who attend the Clinic, to undergo a cardiac CT without contrast (coronary calcium score), either for a medical indication or volunteers for an assessment of cardiovascular risk. The study will have a baseline stage in which a clinical evaluation will be performed, blood samples will be drawn for transcriptome analysis and laboratory analysis. Then, a DNA sample obtained by swabbing the buccal mucosa will be taken. Subsequently, a non-contrast gated cardiac CT will be performed to assess the presence and extent of coronary calcification and other outcomes of interest. At the end of patient enrollment, biological samples will be sequenced for in silico evaluation of the results. Finally, a 5-year clinical (telephone) follow-up will be carried out to collect data on the incidence of fatal and non-fatal cardiovascular events.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
800
Inclusion Criteria
  • Men and women between 30 and 75 years attending the institution for a non-contrast cardiac CT scan (coronary calcium score) either by medical indication or voluntary for cardiovascular risk assessment.
  • Signature of the informed consent form
Exclusion Criteria
  • Previously known chronic renal or hepatic insufficiency.
  • Active chronic lung disease, defined as exacerbated asthma, exacerbated chronic obstructive pulmonary disease (COPD), or pulmonary fibrosis.
  • Active and/or previous cardiovascular disease, defined as previous acute myocardial infarction, stable or unstable angina, cerebrovascular accident, history of vascular interventions (coronary or another territory), heart failure, severe cardiomyopathies, or valvulopathies.
  • Uncontrolled hyper or hypothyroidism.
  • Suprarenal insufficiency.
  • Previous surgeries in the last 3 months.
  • Severe trauma in the last 6 months, defined as one that involved bone fractures and/or surgical interventions.
  • Known active cancer disease or under treatment (acute or preventive), or history of cancer disease without criteria for a cure.
  • Known autoimmune disease active or in treatment.
  • Ongoing pregnancy, postpartum period of fewer than 12 months, or breastfeeding.
  • Other serious illnesses with an estimated life expectancy of fewer than 12 months (according to the investigators).
  • Temperature greater than 37.5°C recorded by a thermometer or any acute infection caused by viruses or bacteria confirmed by a health professional in the previous 30 days.
  • Pathologies under immunosuppressive treatment

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Coronary artery calcium scoreAt baseline (cross-sectional assessment)

Coronary artery calcium (CAC) score (Agatston units) stratified with increasing risk according to the Society of Cardiovascular Computed Tomography Guidelines as CAC=0; CAC 1-99; CAC 100-299; and CAC≥300.

Secondary Outcome Measures
NameTimeMethod
Epicardial adipose tissue (density)At baseline (cross-sectional assessment)

density, Q1-Q4: quartiles percentage

Coronary artery calcium scoreAt baseline (cross-sectional assessment)

Percentile Agatston score: according to age and sex with a increasing risk ranging from 1 to 99 th percentile.

Epicardial adipose tissue (volume)At baseline (cross-sectional assessment)

cm2/m2

Fatty liverAt baseline (cross-sectional assessment)

liver attenuation \<48 Hounsfield units

Canceryear 1 through 5

Number of participants with new diagnosis of any type of cancer

Aortic valve calciumAt baseline (cross-sectional assessment)

Aortic valve calcification score (Agatston units) as a continuous variable with increasing risk and without preestablished thresholds

Thoracic aorta calciumAt baseline (cross-sectional assessment)

Thoracic aorta calcification score (Agatston units) as a continuous variable with increasing risk and without preestablished thresholds

High-sensitive C reactive protein (CRP)At baseline (cross-sectional assessment)

mg/dl

Repolarization abnormalitiesAt baseline (cross-sectional assessment)

Number of participants with repolarization abnormalities on a 12-lead ECG, defined as ST segment depression or pathological T wave inversion.

Vascular revascularizationyear 1 through 5

Number of participants with performance of myocardial revascularization surgery, coronary angioplasty or peripheral vascular angioplasty

Neutrophil to lymphocyte ratioAt baseline (cross-sectional assessment)

hematological parameter for systemic inflammation and stress

Intraventricular conduction abnormalitiesAt baseline (cross-sectional assessment)

Number of participants with intraventricular conduction abnormalities on a 12-lead ECG, stratified by the presence of left bundle branch

block; right bundle branch block and left posterior fascicular block; right bundle branch block and left anterior fascicular block or right bundle branch block; or left anterior fascicular block.

Percent electron density relative to water (%EDW)At baseline (cross-sectional assessment)

percent electron density relative to water, available for direct evaluation with dedicated software in all scans acquired using a dual-layer spectral CT scanner).

Deathyear 1 through 5

Number of participants with report of death from any cause

Coronary artery calcium score (number of segments)At baseline (cross-sectional assessment)

Number of segments with coronary calcifications ranging from 0 to 17 segments.

Acute ischemic syndromeyear 1 through 5

Number of participants with non fatal diagnosis of acute myocardial infarction or unstable angina

Left ventricular hypertrophyAt baseline (cross-sectional assessment)

Number of participants with left ventricular hypertrophy on a 12-lead ECG, defined by positive Sokolow-Lyon or Cornell criteria.

cerebrovascular eventyear 1 through 5

Number of participants with non fatal diagnosis of cerebrovascular accident ("stroke") or transient ischemic attack

Heart failureyear 1 through 5

Number of participants with non fatal new diagnosis of heart failure with preserved or impaired ventricular function

Trial Locations

Locations (1)

Clinica Sagrada Familia

🇦🇷

Ciudad Autonoma de Buenos Aires, Argentina

Clinica Sagrada Familia
🇦🇷Ciudad Autonoma de Buenos Aires, Argentina

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