Coronary CT Angiography in Non ST-elevation Myocardial Infarction

Summary

Non ST-elevation myocardial infarction (NSTEMI) represents 70-75% of all myocardial infarctions. Current guidelines recommend invasive angiography and this patient group represents a major burden on the invasive catheterization laboratories and the health care system.

The coronary pathology found in NSTEMI-patients varies substantially, ranging from structurally normal vessels, non-obstructive atherosclerosis to severe multivessel disease. 30-40 % of patients with NSTEMI undergoing invasive coronary angiography do not undergo revascularization. If these patients could be identified by a non-invasive method like coronary CT angiography (CCTA), an invasive procedure with the potential risk for complications could be avoided. Furthermore, less patients would need transfer to an invasive center. Both for patients and for health care costs this would be of major benefit.

The quality of CCTA images has improved during the years, and radiation dose has decreased. Due to technological development it is now possible to perform high quality coronary CCTA with a very low radiation dose (1-1.5 mSv) compared to a radiation dose of 3-4 mSv for invasive coronary angiography.

The overall aim of the project is to define a subpopulation of NSTEMI patients that preferably should undergo CCTA as the first step in imaging of the coronary arteries and thus potentially be saved from an unnecessary invasive investigation. This would result in less patient discomfort, less patient risk and reduced health care costs. Patients with a clinical indication for invasive angiography according to current guidelines will undergo CCTA prior to the invasive investigation. The ability of CCTA to identify those with no need for revascularization will be assessed using invasive angiography as the gold standard.

Conditions

• Non-ST Elevated Myocardial Infarction

Interventions

PROCEDURE

Coronary CT angiography

all patients being included will undergo CCTA before invasive coronary angiography

PROCEDURE

Invasive coronary angiography

all patients being included will undergo CCTA before invasive coronary angiography

Sponsors & Collaborators

• Norwegian University of Science and Technology

  collaborator OTHER

• Helse Nord-Trøndelag HF

  collaborator OTHER

• Namsos Hospital

  collaborator OTHER

• Volda Hospital

  collaborator OTHER

• Kristiansund Hospital

  collaborator OTHER

• Molde Hospital

  collaborator OTHER

• Alesund Hospital

  collaborator OTHER

• St. Olavs Hospital

  lead OTHER

Principal Investigators

• Rune Wiseth, prof dr md · St Olavs Hospital, Clinic of Cardiology

• Øystein Risa · Norwegian University of Science and Technology, ISB

Study Design

Allocation

NA

Purpose

DIAGNOSTIC

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Max Age

75 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2020-10-24

Primary Completion

2024-05-31

Completion

2027-06-30

Countries

• Norway

Study Locations