NCT03054324

Brief Summary

Coronary fraction flow reserve (FFR), the ratio of the mean coronary pressure distal to a coronary stenosis to the mean aortic pressure during maximal coronary blood flow (hyperemia), defines the hemodynamic significance of coronary artery narrowing. Noninvasive assessment of FFR via a combination of computational fluid dynamics (CFD) and coronary CT angiography CCTA (the so-called FFRCT) has potential. Coronary computed tomographic angiography is a noninvasive test for diagnosis of anatomic coronary stenosis (i.e., narrowing of a blood vessel). A new analytical model of FFR from the general Bernoulli equation (conservation of energy) (FFRB) is simple and has potential. A collaborator group has recently developed a new analytical model to quantify pressure drop, and hence FFR, based on lesion dimensions (i.e., the cross-section area along the lesion and the length of lesion) and coronary flow, with no empirical parameters. The investigators hypothesize that this new model will allow quantification of FFR (FFRB) in a cohort of human patients with intermediate coronary stenosis. The study will compare FFRB with invasive FFR measurements from invasive coronary angiography (ICAG).

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
132

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Sep 2016

Typical duration for all trials

Geographic Reach
1 country

2 active sites

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 2, 2016

Completed
5 months until next milestone

First Submitted

Initial submission to the registry

February 6, 2017

Completed
9 days until next milestone

First Posted

Study publicly available on registry

February 15, 2017

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2018

Completed
Last Updated

October 18, 2018

Status Verified

March 1, 2018

Enrollment Period

2.3 years

First QC Date

February 6, 2017

Last Update Submit

October 16, 2018

Conditions

Keywords

Cardiovascular DiseasesFractional Flow ReserveIschemic Heart DiseaseCT Angiogram

Outcome Measures

Primary Outcomes (1)

  • Diagnostic performance of FFRB to invasive FFR

    The diagnostic performance of FFRB with CCTA data in patients with intermediate coronary artery disease (CAD), as compared to an invasive FFR reference standard (FFR\<=0.80)

    6 months from CT Angiogram

Secondary Outcomes (2)

  • Diagnostic performance with FFRB for lesions of intermediate stenosis severity

    6 months from CT Angiogram

  • Per-vessel correlation of FFRB to invasive FFR

    6 months from CT Angiogram

Interventions

Coronary fraction flow reserve (FFR), the ratio of the mean coronary pressure distal to a coronary stenosis to the mean aortic pressure during maximal coronary blood flow (hyperemia), defines the hemodynamic significance of coronary artery narrowing.

Eligibility Criteria

Age21 Years - 98 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

132 patients scheduled to undergo clinically indicated invasive coronary angiography (ICAG) and who had CCTA performed within 180 days before the scheduled ICA, will be recruited.

You may qualify if:

  • Aged 21-98.
  • Underwent CCTA within 180 days and is scheduled to undergo coronary angiography and FFR in vessels having diameter stenosis between 30-90%, and deemed clinically indicated for evaluation.

You may not qualify if:

  • Previous PCI
  • Previous coronary artery bypass surgery
  • Contraindication to beta blockers , nitroglycerin or adenosine, including second- or third-degree heart block; sick sinus syndrome; long QT syndrome; severe hypotension; asthma, chronic obstructive pulmonary disease, heart rate \<50 beats/min.
  • Acute coronary syndrome (acute myocardial infarction, unstable angina or unstable arrhythmias) is suspected.
  • Had recent myocardial infarction within 30 days before CCTA or between CCTA and coronary angiography
  • Has known complex congenital heart disease.
  • Has had pacemaker or internal defibrillator leads implanted.
  • Has a prosthetic heart valve or significant valvular pathology.
  • Has tachycardia or significant arrhythmia; heart rate ≥ 100 beats/min; systolic blood pressure ≤90 mmHg.
  • Renal dysfunction (glomerular filtration rate (GFR) \<30 mL/min/1.73m2).
  • Allergy to iodinated contrast.
  • Individuals unable to provide informed consent.
  • Non-cardiac illness with life expectancy \<2 years.
  • Pregnant state.
  • Canadian Cardiovascular Society class IV angina.
  • +2 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

National University Hospital

Singapore, 119074, Singapore

RECRUITING

National Heart Centre Singapore

Singapore, 169609, Singapore

RECRUITING

Related Publications (1)

  • Wang C, Leng S, Tan RS, Chai P, Fam JM, Teo LLS, Chin CY, Ong CC, Baskaran L, Keng YJF, Low AFH, Chan MY, Wong ASL, Chua SJT, Wu Q, Tan SY, Lim ST, Zhong L. Coronary CT Angiography-based Morphologic Index for Predicting Hemodynamically Significant Coronary Stenosis. Radiol Cardiothorac Imaging. 2023 Dec;5(6):e230064. doi: 10.1148/ryct.230064.

MeSH Terms

Conditions

Coronary StenosisCardiovascular DiseasesMyocardial Ischemia

Interventions

Fractional Flow Reserve, Myocardial

Condition Hierarchy (Ancestors)

Coronary DiseaseHeart DiseasesVascular Diseases

Intervention Hierarchy (Ancestors)

Coronary CirculationBlood CirculationCardiovascular Physiological PhenomenaCirculatory and Respiratory Physiological Phenomena

Study Officials

  • Soo Teik Lim, MBBS

    National Heart Centre Singapore

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Soo Teik Lim, MBBS

CONTACT

Liang Zhong, Ph.D

CONTACT

Study Design

Study Type
observational
Observational Model
CASE ONLY
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 6, 2017

First Posted

February 15, 2017

Study Start

September 2, 2016

Primary Completion

December 31, 2018

Study Completion

December 31, 2018

Last Updated

October 18, 2018

Record last verified: 2018-03

Data Sharing

IPD Sharing
Will not share

Locations