Using cardiac MRI before invasive coronary angiography for suspected NSTEMI patients
The Karolinska Pilot Study for Cardiac Magnetic Resonance Imaging Prior to Invasive Coronary Angiography in Patients With Suspected Non-ST-Elevation Myocardial Infarction
This study is testing if doing a cardiac MRI before an invasive heart procedure can help doctors better diagnose NSTEMI in patients and possibly reduce the need for that procedure.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 150 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Region Stockholm Government |
| Locations | 1 site (Stockholm) |
| Trial ID | NCT06566625 on ClinicalTrials.gov |
What this trial studies
This observational pilot study, conducted at Karolinska University Hospital, aims to evaluate the effectiveness of performing cardiac MRI (CMR) prior to planned invasive coronary angiography (ICA) in patients suspected of having non-ST-elevation myocardial infarction (NSTEMI). The study will include 150 patients, both with and without a history of myocardial infarction, and will utilize standard CMR protocols alongside novel techniques such as magnetic resonance angiography. The findings from the CMR will be kept blinded from the treating physicians to ensure unbiased clinical decisions, except in cases of unexpected adverse findings. The goal is to determine if a CMR-first approach can accurately diagnose NSTEMI and potentially reduce the need for ICA.
Who should consider this trial
Good fit: Ideal candidates are adults aged 18 and older who exhibit signs of acute coronary syndrome with an initial ECG showing no ST-elevation and are scheduled for invasive coronary angiography.
Not a fit: Patients with contraindications for CMR, such as severe renal impairment or certain arrhythmias, will not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could lead to more accurate diagnoses and reduced unnecessary invasive procedures for patients with NSTEMI.
How similar studies have performed: While the approach of using CMR prior to ICA is gaining traction, this specific study is among the first to validate this method in a Swedish healthcare setting.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * ≥18 years of age Suspected NSTEMI (signs and symptoms suggest of ACS with initial ECG showing no ST-elevation) * Planned ICA where CMR can be performed without delaying ICA * Able to provide written informed consent Exclusion Criteria: * Contraindications for CMR examination with gadolinium contrast (claustrophobia, eGFR \<30ml/min/1.73m2, contrast allergy, and non-MRI compatible implants) * Arrythmias which hinder CMR examination * Previous CABG * Hemodynamic instability * Myocardial infarction \<6 months prior to inclusion
Where this trial is running
Stockholm
- Karolinska University Hospital — Stockholm, Sweden (Recruiting)
Study contacts
- Principal investigator: Marcus E Carlsson, Professor — Karolinska Insitutet and Karolinska University Hospital
- Study coordinator: Daniel F Andersson, M.D.
- Email: daniel.f.andersson@ki.se
- Phone: +46 735958647
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.