Functional vs Anatomical Investigations of Coronary Artery Disease - 1
Research type
Research Study
Full title
Accuracy of Functional versus Anatomical Investigations in Predicting Coronary Artery Disease in a District Hospital
IRAS ID
200125
Contact name
Michael Henein
Contact email
Sponsor organisation
Luton and Dunstable University Hospital NHS Foundation Trust
Duration of Study in the UK
4 years, 5 months, 14 days
Research summary
Coronary artery disease (CAD) is the commonest presentation to a district hospital. Patients presenting with exertional chest pain are usually managed as outpatients for additional investigations.
The aim of this project is to assess the accuracy of functional versus anatomical investigations of CAD in a district hospital. The first study is to evaluate the accuracy of various stress echo modalities in diagnosing significant CAD compared with conventional angiography. The second and third studies evaluate accuracy of stress echocardiography against other anatomical (Computerised Tomography Coronary Angiography - CTCA) and functional (myocardial perfusion) tests, conventionally used in such patients.
While significant number of publications has already compared stress echocardiography with angiography in the nineties, only few have compared it with myocardial perfusion and CTCA.
Anonymized patients will be recruited retrospectively. Data will be collected from patients who had undergone a stress echocardiogram at the Luton and Dunstable Hospital, mostly referred from the ‘Rapid Access Chest Pain Clinic’ because of history of chest pain, between 2012 and 2015. Patients will be coded in order to secure their animosity. Demographic data will be collected from the patients’ notes as well as conventional risk factors and any relevant cardiac history. Patients will be stratified into groups according to any other relevant cardiac investigation. Stress echocardiographic findings will be compared with the results of those investigations according to the design of different studies with coronary angiography being the gold standard for diagnosing significant CAD.
Patients with the following conditions will be excluded from the study: more than mild valve disease, heart failure, atrial fibrillation as well as those with suboptimal echocardiographic image quality.
We are expecting to analyse approximately 500-600 patients who had undergone stress echocardiogram between 2012 and 2015, excluding those who fall within the exclusion criteria. We envisage to find an estimation of 200 of these patients who had undergone additional invasive coronary angiography. We anticipate to include a total of approximately 100 patients who were submitted for CTCA assessment and, due to inconclusive findings, were sent for stress echocardiography assessment. We also predict to find around 100 patients who had Myocardial Perfusion assessment.
The analysis of the results will contribute to produce a clinical and scientific PhD thesis.REC name
North West - Liverpool Central Research Ethics Committee
REC reference
16/NW/0247
Date of REC Opinion
1 Apr 2016
REC opinion
Favourable Opinion