Risk Stratification of Non ST Elevation ACS With Computed Tomographic Angiography (REACT)
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The purpose of this project is to examine the effectiveness of computed tomographic angiography (CTA) in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). People who are hospitalized with this situation often require an angiogram to assess the heart and its arteries.
Recent advancements in technology have enabled CTA to clearly define coronary artery anatomy with great accuracy and to guide treatment strategies in select patient populations. We are investigating that CTA may be used, as an alternative to conventional angiograms, for the risk stratification of patients with high risk NSTE-ACS.
Patients eligible for the study will be high risk NSTE-ACS and awaiting an angiogram. Enrolled patients will undergo CTA prior to the angiogram. With each CTA the patient will be injected with a small dose of an X-ray dye and will be asked to lie still on the "scanning bed" for a period of 5-10 minutes.
Condition | Intervention |
---|---|
Acute Coronary Syndrome Non-ST-Elevation Myocardial Infarction Unstable Angina |
Procedure: Computed Tomographic Angiography |
Study Type: | Interventional |
Study Design: | Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Diagnostic |
Official Title: | Risk Stratification of Non ST Elevation ACS With Computed Tomographic Angiography (REACT) |
- Operating Characteristics of CTA [ Time Frame: 1 month ] [ Designated as safety issue: No ]
- To compare the accuracy of CTA to CICA in predicting the mode of revascularization (PCI versus CABG) in NSTE-ACS patients. [ Time Frame: 1 month ] [ Designated as safety issue: No ]
- To determine the number of "avoidable" CICA (i.e. those accurately designated to medical therapy or surgery with CTA). [ Time Frame: 1 month ] [ Designated as safety issue: No ]
Enrollment: | 107 |
Study Start Date: | September 2006 |
Study Completion Date: | December 2010 |
Primary Completion Date: | December 2008 (Final data collection date for primary outcome measure) |
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Procedure: Computed Tomographic Angiography
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
High risk ACS
- Angina [accelerating pattern or prolonged episode (> 20 minutes) or recurrent episode at rest or with minimal effort within preceding 24 hours]; and (13)
- Elevated Troponin - T (≥0.1 ug/L) or ECG changes consistent with ischemia [ST depression ≥ 0.1 mV, transient ST segment elevation ≥ 0.1 mV (< 20 minutes)]) (11;13)
- Planned conventional invasive coronary angiography
Exclusion Criteria:
- Age < 18 years or lack of consent
- Renal Insufficiency (GFR < 60 ml/min)
- Allergy to contrast agent
- Refractory angina requiring urgent/emergent coronary angiography (as per treating physician)
- Contraindication to radiation exposure (e.g. pregnancy)
- Uncontrolled HR
- Previous CABG or PCI/Stent
- Atrial fibrillation, frequent atrial or ventricular ectopy (> 1 / minute)
- Unable to perform 20 second breath-hold
Canada, Ontario | |
University of Ottawa Heart Institute | |
Ottawa, Ontario, Canada, K1Y 4W7 |
Study Director: | Carole Dennie, MD | The Ottawa Hospital |
Study Director: | Derek So, MD | University of Ottawa Heart Institute |
Study Director: | Chris Glvoer, MD | Univeristy of Ottawa Heart Institute |
Principal Investigator: | Benjamin JW Chow, MD | University of Ottawa Heart Institute |
Additional Information:
No publications provided
Responsible Party: | Benjamin Chow, Dr Benjamin Chow, University of Ottawa Heart Institute |
ClinicalTrials.gov Identifier: | NCT00449826 History of Changes |
Other Study ID Numbers: | UOHI 2006361-01H |
Study First Received: | March 20, 2007 |
Last Updated: | January 25, 2012 |
Health Authority: | Canada: Ethics Review Committee |
Keywords provided by University of Ottawa Heart Institute:
ACS Unstable Angina NSTEMI |
Additional relevant MeSH terms:
Angina, Unstable Infarction Myocardial Infarction Acute Coronary Syndrome Angina Pectoris Myocardial Ischemia Heart Diseases Cardiovascular Diseases |
Vascular Diseases Chest Pain Pain Signs and Symptoms Ischemia Pathologic Processes Necrosis |
ClinicalTrials.gov processed this record on October 01, 2012