Contrast perfusion ultrasound to help diagnose heart attacks in patients with suspected NSTEMI
Contribution of Myocardial Perfusion Imaging in the Initial Assessment of Acute Coronary Syndromes Without ST Elevation for the Diagnosis of Myocardial Infarction or Differential Diagnoses
We will test whether contrast-enhanced myocardial perfusion ultrasound can identify heart attacks or alternative causes in adults hospitalized with suspected non‑ST‑elevation acute coronary syndrome who are planned for coronary angiography.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 100 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Fondation Hôpital Saint-Joseph Academic / other |
| Drugs / interventions | radiation |
| Locations | 1 site (Paris, Ilede France) |
| Trial ID | NCT07112820 on ClinicalTrials.gov |
What this trial studies
This intervention compares contrast-enhanced transthoracic myocardial perfusion ultrasound with coronary angiography and cardiac MRI in adults admitted for suspected NSTEMI. Eligible patients have elevated troponin above the 99th percentile and new segmental wall-motion abnormalities or ECG repolarization changes and are scheduled for angiography within 72 hours. The ultrasound exam uses an approved microbubble contrast agent to visualize myocardial perfusion and may help distinguish true infarction from mimics such as myocarditis or stress cardiomyopathy. Results will be compared against angiographic findings and MRI when available to determine diagnostic performance.
Who should consider this trial
Good fit: Adults (≥18) hospitalized at the participating center with suspected NSTEMI, troponin >99th percentile, new segmental kinetic abnormality or relevant ECG changes, not yet having undergone coronary angiography and able to consent in French are ideal candidates.
Not a fit: Patients who are hemodynamically or rhythmically unstable, allergic to ultrasound contrast, already undergone coronary angiography, or otherwise unable to undergo quality transthoracic imaging are unlikely to benefit.
Why it matters
Potential benefit: If successful, the approach could improve noninvasive diagnosis at the bedside and reduce unnecessary invasive coronary angiography for some patients.
How similar studies have performed: Previous studies have shown contrast echocardiography can visualize myocardial perfusion and improve image quality, but its ability to replace or reliably triage against coronary angiography in NSTEMI is not yet established.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patient over 18 years of age * Hospitalised in cardiology as an emergency for acute coronary syndrome without ST segment elevation with indication for coronary angiography within 72 hours of admission * Not yet undergone coronary angiography. * Troponin \>99th percentile, i.e. \>27ng/l (troponin I, hypersensitive, Abbott) * With de novo segmental kinetic disorder on TTE or ECG repolarisation disorder outside ST elevation * Patient affiliated with a health insurance scheme * French-speaking patient * Patient who has given their free, informed and written consent Exclusion Criteria: Haemodynamically unstable patient: HR \> 100 and/or systolic blood pressure \< 90 mmHg and/or diastolic blood pressure \< 60 mmHg and/or oxygen saturation \< 92% in AA and/or clinical signs of hypoperfusion (mottling, cyanosis) * Rhythmically unstable patient: sustained ventricular tachycardia, sudden death recovered. * Patient with a known allergy to ultrasound contrast medium * Patient with ST segment elevation. * Patient with a contraindication to MRI. * Patient with a caricatured picture of myocarditis (fever and/or significant biological inflammatory syndrome with CRP\>50mg/l) * Patients already included in a type 1 interventional research protocol (RIPH1) * Patients under guardianship or curatorship * Patients deprived of their liberty * Patients under judicial protection * Pregnant or breastfeeding patients (negative pregnancy test for women of childbearing age)
Where this trial is running
Paris, Ilede France
- Hospital Paris Saint-Joseph — Paris, Ilede France, France (Recruiting)
Study contacts
- Principal investigator: Yoann MOEUF, medical doctor — Hospital Paris Saint-Joseph
- Study coordinator: Yoann MOEUF, medical doctor
- Email: ymoeuf@ghpsj.fr
- Phone: +33 1 44 12 62 44
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.