DEFINing the PrEvalence and Characteristics of Coronary Artery Disease Among Patients With TYPE 2 Myocardial Infarction Using CT-FFR

RECRUITMENT

Patients in the Emergency Department or admitted to Massachusetts General Hospital with an elevated high-sensitivity cardiac troponin will be identified daily by the Clinical Core Laboratory at Massachusetts General Hospital. The study investigators will then review the electronic medical record for each of these patients to determine if the cause of the patients' elevated high-sensitivity troponin is a type 2 myocardial infarction. If so, their record will be reviewed to determine if they meet the inclusion criteria for enrollment and to ensure no exclusion criteria are present. Patients with a type 2 MI who are eligible for enrollment, will then be approached during their hospital stay to discuss the study and their interest in consenting and enrolling in our study. Prior to approaching the patient, the responding clinician treating the patient will be contacted to obtain the primary team's approval before approaching the patient. In addition to confirming that the patient is an acceptable candidate for the research, a clinician from the primary team must introduce the study to the patient and obtain the patient's permission prior to being contacted by our study staff. 50 patients will be enrolled.

STUDY PROCEDURES

1. Study visits and parameters to be measured (e.g. laboratory tests, x-rays, and other testing) Patients who enroll in the study will undergo a CT coronary angiogram during their index admission. In addition, patients will have the option of providing a blood sample for future research. These biorepository samples may be used in the future for biomarker analysis to examine associations between serum biomarkers of cardiac injury, inflammation, and atherosclerosis, and coronary plaque presence/ severity and for predicting future cardiovascular events up to 1-year. Genetic testing will not be performed on these samples. There will be no required follow-up visits following their index admission.
2. Drugs to be used (dose, method, schedule of administration, dose modifications, toxicities).

Patients will receive nitroglycerin prior to their CT coronary angiogram in the form of a transdermal patch (0.8 mg/h [2 x 0.4 mg/h]; Nitro-Dur, Merck & Co. Inc., White-House Station, New Jersey). Nitroglycerin will be administered at least 45 minutes before electrocardiography-gated coronary CTA.