Stress Echocardiography with Carotid Ultrasound vs Routine CT Coronary Angiography in suspected Chronic Coronary Syndrome for the detection of obstructive coronary artery disease and prevention of adverse outcomes.
London North West University Healthcare NHS Trus
Duration of Study in the UK
1 years, 6 months, 0 days
Diseases of the heart and circulation are known as cardiovascular diseases, and they cause over 160,000 deaths each year.
Coronary heart disease (CHD) is the most common cardiovascular disease. This is due to a build-up of fatty material, known as atherosclerosis, in the blood vessels supplying blood to the heart muscle. This can cause chest pain or if blocked, can cause a heart attack.
Two of the main non-invasive tests to look for coronary heart disease are Computed Tomography Coronary Angiography (CTCA) and Stress Echocardiography (Ultrasound scan).
CTCA shows the arteries and allows us to see small amounts of disease that may not yet be causing any symptoms. However, if there’s lots of disease and calcification, it becomes difficult to tell how severe it is, which means several tests may be needed. Stress Echocardiography tells us if enough blood is reaching the heart muscle, so can show if there is severe disease that needs treatment. However, it can’t see the arteries so doesn’t tell us about small disease that may benefit from tablet treatment. We do not yet have an effective non-invasive combined test that can tell us all this information in one go.
Studies have shown that if there’s atherosclerosis in another artery, you are very likely to have coronary atherosclerosis as well. Carotid atherosclerosis, in the neck arteries, can be seen with ultrasound similar to stress echocardiography. So, by combining these two tests we want to see if we can see severe as well as small areas of disease in one test, to provide better treatment.
The study will enrol 2,000 participants, who need investigation for CHD, equally randomised to CTCA or stress echocardiography with carotid ultrasound. We will follow these participants for 5 years and observe for any adverse outcomes and ask them to complete a questionnaire.
West of Scotland REC 1
Date of REC Opinion
4 Aug 2023
Further Information Favourable Opinion