ULTIMATE Trial
Research type
Research Study
Full title
Carotid Ultrasound Vs Computed Tomography (CT) Coronary Calcium Scoring to Reclassify Symptomatic Patients with Suspected Chronic Coronary Syndrome using Risk Factor Clinical Likelihood for Obstructive Coronary Artery Disease
IRAS ID
364694
Contact name
Roxy Senior
Contact email
Sponsor organisation
London North West University Healthcare NHS Trust
Duration of Study in the UK
1 years, 6 months, 0 days
Research summary
Coronary artery disease (CAD) is characterised by atherosclerosis where there is build-up of fatty material in the lumen of heart arteries, which overtime can compromise blood flow leading to angina and heart attacks.
Worldwide there are currently over 600 million people living with cardiovascular disease (CVD) and this figure is likely to continue increasing due to changing lifestyles, an ageing and growing global population, along with improved survival rates from heart attacks and strokes. Each year there are approximately 67 million new cases of CVD across the world, while CAD alone accounts for an estimated nine million deaths annually. In the United Kingdom (UK), there are around 100,000 hospital admissions each year due to heart attacks, that is equivalent to one every five minute. This is in addition to the 1.4 million people who have already survived a heart attack.The European society of cardiology (ESC) recommends categorising symptomatic patients into very low, low and moderate risk factor clinical likelihood (RF-CL) for obstructive CAD based on their symptoms and risk factors. Patients with low RF-CL are investigated by Computed Tomography Coronary Angiogram (CTCA) with calcium scoring. Patients are then reclassified depending on their CT scan results into very low, low, intermediate, or high probability for obstructive CAD categories. Some are reassured while others need further assessments.
In recent years, studies have shown promising results associating atherosclerosis between the carotid and heart arteries in asymptomatic patients. There is also growing evidence that carotid atherosclerosis can predict CAD by using a combination of variables and aid in risk stratifying patients.
This study aims to investigate 225 symptomatic patients, to determine whether carotid ultrasound scan can accurately reclassify low-risk patients (5–15% RF-CL) into very low-risk category as currently done by CT calcium scoring without compromising CVD event rates, thus allowing safe reassurance and avoiding unnecessary CT scans.
REC name
East of England - Cambridge South Research Ethics Committee
REC reference
26/EE/0139
Date of REC Opinion
9 Jun 2026
REC opinion
Favourable Opinion