Research on Infarction With Open Arteries Using OCT and CMR
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 21 - 99 |
| Updated: | 2/1/2019 |
| Start Date: | April 2014 |
| End Date: | December 31, 2019 |
Research on Infarction With Open Arteries Using OCT and CMR (RIO)
The purpose of this study is to determine the prevalence of plaque disruption and to assess
the composition of disrupted plaques in patients with myocardial infarction (MI) and
non-obstructive coronary artery disease (CAD) using optical coherence tomography (OCT).
Additionally, cardiac magnetic resonance imaging (CMR) will be used to detect myocardial
abnormalities, which will be correlated to OCT findings to gain insight into the mechanisms
of MI in patients with non-obstructive coronary artery disease (i.e. "open arteries").
the composition of disrupted plaques in patients with myocardial infarction (MI) and
non-obstructive coronary artery disease (CAD) using optical coherence tomography (OCT).
Additionally, cardiac magnetic resonance imaging (CMR) will be used to detect myocardial
abnormalities, which will be correlated to OCT findings to gain insight into the mechanisms
of MI in patients with non-obstructive coronary artery disease (i.e. "open arteries").
In this single center, observational study, patients of both sexes with MI who are referred
for cath will be enrolled. Those who have no obstructive CAD on clinically indicated coronary
angiography, defined as no stenosis of >50% in any major epicardial vessel, will undergo
coronary OCT just after the clinically indicated diagnostic angiogram, and CMR within 1 week,
typically within 72-96 hours. Participants will be followed for clinical events for at least
1 year. 20 fully eligble participants will be recruited at NYU Langone Medical Center and
Bellevue Hospital Center among a projected 200 enrolled patients.
for cath will be enrolled. Those who have no obstructive CAD on clinically indicated coronary
angiography, defined as no stenosis of >50% in any major epicardial vessel, will undergo
coronary OCT just after the clinically indicated diagnostic angiogram, and CMR within 1 week,
typically within 72-96 hours. Participants will be followed for clinical events for at least
1 year. 20 fully eligble participants will be recruited at NYU Langone Medical Center and
Bellevue Hospital Center among a projected 200 enrolled patients.
Inclusion Criteria:
- Acute ischemic symptoms compatible with diagnosis of acute coronary syndrome (ACS)
(chest pain or anginal equivalent symptoms at rest or new onset exertional anginal
equivalent symptoms)
- Objective evidence of myocardial infarction (either or both of the following):
Elevation of troponin to above the laboratory upper limit of normal (ULN) or ST
segment elevation of ≥1mm on 2 contiguous ECG leads
- Willing to provide informed consent and comply with all aspects of the protocol
- Age ≥ 21 years
Exclusion Criteria:
- Stenosis ≥50% of any major epicardial vessel on invasive angiography, as determined by
the angiographer at the time of clinically ordered cardiac cath.
- History of known obstructive CAD at angiography, including history of percutaneous
coronary intervention (PCI) or coronary artery bypass grafting (CABG)
- Recent use of vasospastic agents, such as cocaine, triptans, ergot alkaloids (≤1
month)
- Alternate explanation for troponin elevation, such as hypertensive urgency, acute
exacerbation of heart failure, chronic elevation due to kidney disease, pulmonary
embolism, cardiac trauma
- Coronary dissection apparent on angiography
- Excessive coronary tortuosity which, in the opinion of the angiographer, increases the
risks of OCT
- eGFR<30 or contraindication to additional contrast needed for OCT in the opinion of
the angiographer or treating physician
- Contraindication to MRI (including but not limited to MRI-incompatible metal implants
or foreign bodies)
- Pregnancy
- Thrombolytic therapy for STEMI (qualifying event)
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