Comparison of Cardiac Computed Tomographic Angiography (CTA) to Tc-99m Single Photon Emission Computed Tomography (SPECT)

Study Overview
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Brief Summary
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Cardiovascular disease and ischemic heart disease is the #1 killer in Canada. Currently, Cardiac invasive catheterization angiography (CICA) is the gold standard for the assessment of the arteries in the heart. However, cardiac catheterization has risks which prohibit its use in all patients. These risks include: death, heart attack, stroke and bleeding. Cardiac computed tomography angiography (CTA) is a new non-invasive technology which may enable the evaluation of patients' coronary anatomy without exposing patients to the risks of invasive cardiac catheterization. The purpose of this project is to compare CT angiography (CTA) to Tc-99m single photon emission computed tomography (Tc-99m SPECT) We will enroll patients who are waiting for a CICA or who have been referred for a TC-99m SPECT or CTA scans at the University of Ottawa Heart Institute. Consenting patients who are waiting for a CICA will have both a CTA and a Tc-99m SPECT scan. Consenting patients referred for a CTA or Tc-99m SPECT will have both the CTA and Tc-99m SPECT in a random order but not CICA (unless ordered by your physician).

Official Title
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Comparison of Cardiac Computed Tomographic Angiography (CTA) to Tc-99m Single Photon Emission Computed Tomography (SPECT)

Conditions
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Coronary Artery Disease

Intervention / Treatment
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* Procedure: Computed Tomographic Angiography
* Procedure: Myocardial Perfusion Imaging Scan


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients referred for Tc-99m SPECT or CTA; or Patients referred for CICA without preceding (< 12 months) MPI or CTA Exclusion Criteria: Previous revascularization (PCI or CABG) Age < 18 years or lack of consent Renal Insufficiency (GFR < 60 ml/min) Allergy or contraindication to contrast agent or dipyridamole Refractory angina requiring urgent/emergent coronary angiography Contraindication to radiation exposure (e.g. pregnancy) Uncontrolled HR Atrial fibrillation, frequent atrial or ventricular ectopy (> 1/minute) Unable to perform 10 second breath-hold

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Computed Tomographic Angiography|CT scan|
|Procedure: Myocardial Perfusion Imaging Scan|SPECT|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To measure the accuracy of CTA to SPECT for the diagnosis of CAD |  | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To examine the accuracy of CTA predicting the mode of treatment: Medical therapy or revascularization (PCI versus CABG) |  | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cardiac Invasive Catheterization Angiography, Single Photon Emission Computed Tomography, Computed Tomography Angiography