CT vs IVUS for Coronary Artery Disease
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial examines two methods to guide a procedure for individuals with significant calcium build-up in their heart arteries. It compares CT scans, which provide detailed heart images, to IVUS, a method using sound waves from inside the arteries. The trial aims to determine if CT-guided percutaneous coronary intervention can enhance efficiency and effectiveness while maintaining the safety and success levels of IVUS-guided percutaneous coronary intervention. Suitable candidates for this trial include those with stable chest pain or silent heart issues who qualify for a heart artery procedure. As an unphased trial, this study offers a unique opportunity to advance medical knowledge and potentially improve future heart procedures.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What prior data suggests that these imaging strategies are safe for coronary artery disease?
Research has shown that using CT scans to guide heart procedures is generally safe. One study found that patients who underwent procedures with CT guidance had similar outcomes to those who received standard care, indicating that CT guidance is well-tolerated and does not add extra risk.
For intravascular ultrasound (IVUS), studies have shown positive results. Specifically, one study found that procedures guided by IVUS were associated with lower long-term death rates and fewer heart attacks compared to other methods. This suggests that IVUS is safe and may offer additional benefits.
Overall, both CT and IVUS-guided methods for treating heart disease have demonstrated good safety records. Studies comparing them to standard treatments have shown similar or better safety outcomes.12345Why are researchers excited about this trial?
Researchers are excited about this trial because it’s comparing two advanced imaging techniques to guide the treatment of coronary artery disease more effectively. Unlike traditional angiography, which is commonly used, CT (Computed Tomography) and IVUS (Intravascular Ultrasound) offer more detailed insights into the artery's condition before the procedure. CT can provide a non-invasive look at the lesions, possibly reducing the need for invasive steps, while IVUS offers a detailed, real-time view from inside the artery to better tailor the procedure. This trial could lead to more precise, personalized treatments, potentially improving patient outcomes by ensuring the right approach is used for each individual’s unique artery conditions.
What evidence suggests that this trial's imaging strategies could be effective for coronary artery disease?
This trial will compare CT-guided and IVUS-guided strategies for coronary artery disease. Research has shown that both CT scans and IVUS effectively guide procedures to open blocked heart arteries in patients with hardened arteries. The SCOT-HEART trial found that using CT scans for these procedures can lower the risk of dying from heart disease and having non-fatal heart attacks. Another study found that patients who had early CT scans experienced fewer heart problems over two years. IVUS, in contrast, has been shown to reduce the risk of death and major heart issues. Studies also indicate that using IVUS leads to better results compared to traditional methods. Both CT and IVUS offer significant benefits, but they work in slightly different ways to improve heart health. Participants in this trial will be assigned to either the CT-guided or IVUS-guided calcium modification strategy to determine which method provides better outcomes.26789
Are You a Good Fit for This Trial?
This trial is for adults aged 18-85 with myocardial ischemia or related heart conditions needing a procedure called PCI. Participants must have certain types of stable or unstable angina, NSTEMI without high-risk features, and target vessels suitable in size. They need to consent to study procedures.Inclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants undergo either CCTA-guided or IVUS-guided calcium modification strategy during PCI
Follow-up
Participants are monitored for target vessel failure and other clinical outcomes
Long-term Follow-up
Participants are monitored for stent thrombosis and residual angina
What Are the Treatments Tested in This Trial?
Interventions
- CT Guided Percutaneous Coronary Intervention
- IVUS Guided Percutaneous Coronary Intervention
Trial Overview
The OPTIMAL trial compares two ways to image hearts during PCI: using CT angiography (CCTA) versus the standard IVUS method. It aims to see if CCTA can make the procedure more efficient and effective while maintaining similar patient outcomes.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Pre-procedural CT will be used to determine lesion characteristics.
Pre-procedural IVUS will be used to determine lesion characteristics.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Fundación EPIC
Lead Sponsor
Citations
Health Status Outcomes With Percutaneous Coronary ...
Freedom from angina in the conservative, PCI, and CABG groups was noted in 61.4%, 73.3%, and 82.4% at 1 year and 70.4%, 76.1%, 81.4% at 3 years, ...
Long-term Health Outcomes and Cost-Effectiveness of ... - PMC
The major result is that the data suggest that an early coronary CTA strategy is cost-effective over a lifetime as compared to competing strategies, including ...
Clinical Outcomes Based on Coronary Computed ...
During a median follow-up of 744.4 days, adverse cardiac events had occurred in 20 patients (2.7%), including 1 cardiac death and 2 nonfatal ...
10-year outcomes from the SCOT-HEART randomised ...
The SCOT-HEART trial showed that CCTA-guided management led to a reduction in the primary endpoint of coronary heart disease death or non-fatal ...
CT or Invasive Coronary Angiography in Stable Chest Pain
Here, we report the comparative effectiveness of CT and ICA in preventing the primary outcome of major adverse cardiovascular events, defined ...
Computed tomography angiography-guided percutaneous ...
PCI was successful in 57 cases of CTOs (77.0%). According to the results, CTOs were divided into two groups: successful-PCI and failed-PCI. All coronary artery ...
1-Year Outcomes of FFRCT-Guided Care in Patients With ...
Care guided by CTA and selective FFR CT was associated with equivalent clinical outcomes and QOL, and lower costs, compared with usual care over 1-year follow- ...
Clinical Outcomes and Cost-Effectiveness of Fractional ...
Previous studies found that percutaneous coronary intervention (PCI) does not improve outcome compared with medical therapy (MT) in patients ...
Impact of Percutaneous Coronary Intervention on ...
PCI (compared with CABG) was associated with higher mortality (incidence rate ratio [IRR]: 1.38; 95% CI: 1.19 to 1.60), cardiac death (IRR: 1.61 ...
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