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Computed tomographic coronary angiography for patients with heart failure (CTA-HF): A randomized controlled trial (IMAGE HF Project 1-C)
Authors
Abdul Al-Hesayen
Alex Leber
+29 more
Benjamin JW Chow
Cathy Kelly
Doug Coyle
Eileen O’Meara
Eric Larose
George A Wells
Hanna Leskinen
Helena Hanninen
Ian Paterson
James A White
Jean-Claude Tardif
Juha Hartikainen
Juhani Knuuti
Linda Garrard
Lisa Mielniczuk
Malek Kass
Marja Hedman
Mika Laine
Miroslav Rajda
null null
Rachel E Green
Ran Klein
Renee Hessian
Rob S Beanlands
Robert A deKemp
Seppo Yla-Herttuala
Taylor Dowsley
Ting Lee
Vikas Tandon
Publication date
1 January 2013
Publisher
'Springer Science and Business Media LLC'
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PubMed
Abstract
© 2013 Chow et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: The prevalence of heart failure (HF) is rising in industrialized and developing countries. Though invasive coronary angiography (ICA) remains the gold standard for anatomical assessment of coronary artery disease in HF patients, alternatives are being sought. Computed tomographic coronary angiography (CTA) has emerged as an accurate non-invasive diagnostic tool for coronary artery disease (CAD) and has been demonstrated to have prognostic value. Whether or not CTA can be used in HF patients is unknown. Acknowledging the aging population, the growing prevalence of HF and the increasing financial burden of healthcare, we need to identify non-invasive diagnostic tests that are available, safe, accurate and cost-effective. Methods/Design: The proposed study aims to provide insight into the efficacy of CTA in HF patients. A multicenter randomized controlled trial will enroll 250 HF patients requiring coronary anatomical definition. Enrolled patients will be randomized to either CTA or ICA (n = 125 per group) as the first test to define coronary anatomy. The primary outcomes will be collected to determine downstream resource utilization. Secondary outcomes will include the composite clinical events and major adverse cardiac events. In addition, the accuracy of CTA for detecting coronary anatomy and obstruction will be assessed in patients who subsequently undergo both CTA and ICA. It is expected that CTA will be a more cost-effective strategy for diagnosis: yielding similar outcomes with fewer procedural risks and improved resource utilization.Trial registration: ClinicalTrials.gov, NCT01283659 Team grant #CIF 9947
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