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

NCT07112820 | Recruiting

• 1 other identifier: APRICOT
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

Patients with myocardial infarction require invasive treatment involving coronary angiography to confirm the diagnosis and, in most cases, treatment by angioplasty/stenting. Trans-thoracic ultrasound is central to the initial management of patients admitted to hospital with acute coronary syndrome without ST segment elevation. The aim of our study is therefore to compare perfusion ultrasound with coronary angiography and MRI in this population in order to determine whether the performance is satisfactory.

Conditions

Myocardial Infarction (MI)

Keywords

acute coronary syndrome without ST segment elevation; emergency cardiology

Outcome Measures

Primary Outcomes (1)

• Sensitivity (SE) and specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) (diagnosis obtained by consensus of two cardiologists based on all blinded examinations of the ultrasound results).

  Contrast-enhanced ultrasound (same measurements) according to recommendations, performed and interpreted by cardiologist 1, then reviewed and reinterpreted by the cardiologist. The reference diagnosis will be established by two cardiologists. The two cardiologists will therefore work blind to the examination being evaluated.

  inclusion visit

Secondary Outcomes (1)

• Concordance between the diagnosis of TET from perfusion and the 'gold standard' (diagnosis obtained by consensus of two cardiologists based on all blinded examinations of the echo results). Kappa coefficient

  visit inclusion

Interventions

perfusion ultrasound OTHER

During the examination, the power of the probe will be increased in order to assess myocardial perfusion. The contrast agent bubbles are destroyed by applying a 'flash', i.e. a temporary increase in the power of the ultrasound beam. Systole after systole, on a recorded loop, the filling velocity of the myocardium, which depends on myocardial blood flow, is analysed. The assessment of perfusion is visual and qualitative.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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)

Sponsors & Collaborators

• Fondation Hôpital Saint-Joseph: lead

Study Sites (1)

Hospital Paris Saint-Joseph

Paris, Ilede France, 75014, France

RECRUITING

MeSH Terms

Conditions

Myocardial Infarction

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis

Study Officials

• Yoann MOEUF, medical doctor

  Hospital Paris Saint-Joseph

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Yoann MOEUF, medical doctor

CONTACT

+33 1 44 12 62 44; ymoeuf@ghpsj.fr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: prospective single-centre cohort study for diagnostic purposes

Study Record Dates

• First Submitted: August 1, 2025
• First Posted: August 8, 2025
• Study Start: June 24, 2024
• Primary Completion (Estimated): July 31, 2026
• Study Completion (Estimated): November 30, 2026
• Last Updated: August 8, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)