Comparing stress echocardiography and CT coronary angiography for chronic coronary syndrome

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial aims to evaluate the effectiveness of stress echocardiography combined with carotid ultrasound compared to routine CT coronary angiography in patients with chronic coronary syndrome. The study will involve patients over 18 years old who are suspected of having coronary artery disease (CAD) and require further imaging investigations. By assessing the severity of coronary disease through these non-invasive tests, the trial seeks to determine which method provides better diagnostic accuracy and patient outcomes.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Age \> 18 years old
2. Patients referred to RACPC and judged by the reviewer to require a further imaging investigation, either SE or CTCA, to evaluate a suspected diagnosis of CAD
3. AND

   1. Have a PTP score ≥ 5%, as calculated using ESC guidelines OR
   2. Have clinical history in keeping with 'typical' angina symptoms, as judged by the investigator, in patients with a PTP score \<5% - With 'typical' symptoms, as per ESC guidelines, being all three of the following

   i) Constricting symptoms in the front of the chest or in the neck, jaw, shoulder or arm ii) Precipitated by physical exertion iii) Relieved by rest or nitrates within 5 minutes
4. Able to give informed consent to participate in the study and its follow up

Exclusion Criteria:

1. Patients with diagnosed ACS that require urgent or emergency treatment or hospitalisation for inpatient investigations.
2. Known history of obstructive CAD (Previous MI, PCI or CABG) or previous invasive angiography with evidence of ≥ 50% stenosis in any epicardial vessel.
3. Patients who have undergone invasive or non-invasive, functional or anatomical (Including CAC score) testing for detection of CAD within the previous 1 year of clinical assessment.
4. Documented allergy to iodinated contrast or documented allergy to both ultrasound contrasts used at LNWH Trust; Luminity® (Perflutren) and SonoVue® (Sulphur Hexafluoride) or the constitutes
5. Contraindications to undergoing CTCA, including but not limited to;

   * eGFR \< 40 ml/min
   * Contraindications to beta-blockers including but not limited to, documented allergy or significant airways disease in the judgement of the investigator.
   * Exceeding CT scanner weight tolerance
6. Contraindications to undergoing SE, including but not limited to;

   * Known cardiomyopathic process (Hypertrophic cardiomyopathy (HCM)) with resting gradient \> 50mmHg or severe valvular lesion
   * Severe uncontrolled hypertension (≥180/100mmHg)
7. Known pregnancy
8. Unable to provide informed consent

Where it's running

• London North West University Healthcare NHS Trust
  Harrow, Middx, United Kingdom Recruiting

Study contacts

• Principal investigator: Prof Roxy Senior — LNWH Trust
• Study coordinator: Emma Howard
• Email: emma.howard16@nhs.net
• Phone: 0208 869 2548

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.