RIPCORD 2: A randomised controlled trial to compare routine pressure wire assessment with conventional angiography in the management of patients with coronary artery disease.
University Hospital Southampton NHS Foundation Trust
Duration of Study in the UK
3 years, 9 months, 0 days
Patients currently investigated for chest pain maybe referred for a number of diagnostic tests. Some tests provide physiological information as to whether blood flow to the heart muscle is reduced - ischaemia - others describe the coronary artery anatomy without this functional information. The most frequently used test to outline the anatomy of the heart arteries is the coronary angiogram. This test demonstrates narrowings in the arteries but fails to provide information as to whether the narrowings are sufficiently severe to cause symptoms.\n\nThe pressure wire (PW) is a diagnostic tool used at the time of coronary angiography to provide specific information on whether narrowings are restricting blood flow sufficiently to require treatment. There is evidence to show better treatment plans are made for individuals using the PW at the time of the coronary angiogram. With the PW patients are offered more appropriate treatment for narrowings (surgery, stenting or tablets). This leads to improved targeting of resources and improved clinical outcomes.\n\nCurrently the PW is more often used to guide coronary stenting following a treatment decision. As yet there is insufficient data to establish whether there is value in the early use of PW at the diagnostic phase leading to individually tailored treatment plans. To recommend all patients undergo PW assessment at diagnostic angiography for individualised treatment plans requires evidence of not purely clinical benefit but also cost effectiveness.\n\nRIPCORD 2 is funded by a company called Boston Scientific plc. It will compare two strategies for managing patients undergoing routine coronary angiography for potential coronary artery disease. Patients scheduled for routine coronary angiograms will be invited to participate by their hospital. Eligible patients will be randomised to either conventional angiography alone or angiography with PW assessment at the time of their initial diagnostic procedure. Each participant will be followed in the study for 12 months.
London - Brighton & Sussex Research Ethics Committee
Date of REC Opinion
20 Apr 2016