Risk Stratification of Non ST Elevation ACS With Computed Tomographic Angiography (REACT)

University of Ottawa Heart Institute

Status

Completed

Conditions

Unstable Angina

Acute Coronary Syndrome

Non-ST-Elevation Myocardial Infarction

Treatments

Procedure: Computed Tomographic Angiography

Study type

Interventional

Funder types

Other

Identifiers

NCT00449826

UOHI 2006361-01H

Details and patient eligibility

About

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.

Enrollment

107 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

High risk ACS
1. Angina [accelerating pattern or prolonged episode (> 20 minutes) or recurrent episode at rest or with minimal effort within preceding 24 hours]; and (13)
2. 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