CCT for Comprehensive Risk Stratification Following STEMI
Cardiac Computed Tomography for Comprehensive Risk Stratification of Arrhythmic, Atherothrombotic and Heart Failure Events Following Reperfused ST-segment Elevation Myocardial Infarction
University of Turin, Italy
200 participants
Nov 8, 2023
INTERVENTIONAL
Conditions
Summary
The CT-STEMI study aims to evaluate a comprehensive cardiac computed tomography (CCT) protocol for assessing the risk of heart failure (HF), life-threatening arrhythmias (LTA), and atherothrombotic events following ST-elevation myocardial infarction (STEMI). This multicenter, prospective study has three main objectives: 1. Comparing the diagnostic accuracy of the comprehensive CCT protocol with cardiac magnetic resonance (CMR), considered the non-invasive gold standard. 2. Determining the prognostic value of CCT in assessing myocardial tissue adverse features related to STEMI. 3. Evaluating the atherosclerotic burden in patients with post-acute STEMI. Two hundred patients will undergo both CCT and CMR in the post-acute phase, and their follow-up will focus on monitoring HF, LTA, and ischemic events. The CT-STEMI study represents the first attempt to assess the potential of CCT in providing a comprehensive risk assessment following STEMI in a large contemporary population. The findings of this study have the potential to revolutionize post-STEMI risk stratification practices.
Eligibility
Inclusion Criteria4
- Signed informed consent
- STEMI diagnosis
- Primary Percutaneous Coronary Intervention (PCI) <24h from symptom onset
- Hemodynamic stability without inotropic support within 4 days from the index event
Exclusion Criteria7
- Known chronic kidney disease with estimated Glomerular Filtration Rate (GFR) < 30 mL/min/1.73mq
- History of allergic reaction to CCT or CMR contrast media
- Inability or unwilling to undergo CCT or CMR scanning
- Pregnancy or breast-feeding
- Severe atrial or ventricular arrhythmia burden
- Severe valvular stenosis or regurgitation
- Prior clinical congestive HF diagnosis (asymptomatic LV dysfunction can be included)
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Interventions
A comprehensive CCT protocol will be performed in the post-acute phase of STEMI. Specifically, the CCT protocol will include a pre-contrast scan and an angiographic scan ( also set up to assess ventricular volume and function) followed by late contrast enhancement scan.
A comprehensive CMR protocol will be performed in the post-acute phase of STEMI. Specifically, the CMR protocol is designed for morpho-functional analysis and tissue characterisation (including assessment of late gadolinium enhancement and mapping). CMR will be considered the gold standard.
Locations(3)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT06020209