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Trial registered on ANZCTR
Registration number
ACTRN12621001478808p
Ethics application status
Submitted, not yet approved
Date submitted
9/09/2021
Date registered
28/10/2021
Date last updated
28/10/2021
Date data sharing statement initially provided
28/10/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
The utility of coronary artery calcium scoring in myocardial perfusion scan
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Scientific title
Correlation of coronary artery calcium scores on myocardial perfusion scans and computed tomography coronary angiography in patients with low to intermediate risk cardiac chest pain.
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Secondary ID [1]
305281
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Nil Known
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Universal Trial Number (UTN)
U1111-1269-3705
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Trial acronym
CAMPS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Ischaemic Heart Disease
323580
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Chest Pain
323581
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Condition category
Condition code
Cardiovascular
321129
321129
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
To assess the correlation between the coronary artery calcium score on myocardial perfusion scans versus on dedicated computed tomography coronary angiography, participants who have had myocardial perfusion imaging will be required to subsequently have a dedicated computed tomography coronary angiography scan for coronary artery calcium scoring.
The additional computed tomography coronary angiography has additional radiation exposure. The radiation exposure involved in myocardial perfusion imaging has been found to be between 10-20 millisieverts, whereas the radiation exposure for a dedicated coronary artery calcium score CT is 1 millisievert. The average Australian background radiation exposure per year is 1.5-2milliseverts.
Participants will undergo the dedicated computed tomography coronary angiography within 2 weeks of having their myocardial perfusion scan. The computed tomography coronary angiography will be undertaken at the same centre (Tamworth Rural Referral Hospital), and take approximately 30 minutes. The scan will be completed by a trained diagnostic radiographer at the centre. The computed tomography coronary angiography includes the administration of a contrast agent Iohexol (Omnipaque Trade Name) via intravenous infusion. The administered dose will be between 0 to 100mls and be determined by the diagnostic radiographer at the time of the scan and based on patients body habitus, to ensure an optimal scan. Participants may also require the administration of a heart rate controlling medication, metoprolol, to achieve an optimal heart rate of approximately 60 beats per minute for the scan.
The computed tomography coronary angiography and myocardial perfusion computed tomography scans will be assessed at the same centre by the researchers to determine whether there is a correlation between the two coronary artery calcium scores.
Patients who do not undergo the dedicated computed tomography coronary angiography will be excluded from the study. This will be determined by the absence of a dedicated computed tomography coronary angiography at the time of conducting the coronary artery calcium scores on the respective images.
All participants will undergo the same intervention. The amount of the contrast agent, the requirement for metoprolol for rate control and the dose of radiation from the computed tomography scan will vary between patients. Each of these will be noted in the data collection and in the reporting of the study.
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Intervention code [1]
321686
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Diagnosis / Prognosis
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Intervention code [2]
321687
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Early detection / Screening
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Comparator / control treatment
Each participants will have the myocardial perfusion scan as their standard investigation for underlying coronary artery disease. All participants will the subsequently have the computed tomography coronary angiography. This will enable the calculation of the coronary artery calcium score in both image modalities to assess the correlation between imaging modalities.
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Control group
Active
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Outcomes
Primary outcome [1]
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The validity of the coronary artery calcium score on myocardial perfusion scans, assessing that it correlates with the coronary artery calcium score on computed tomography coronary angiography. This will be assessed for accuracy and sensitivity.
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Assessment method [1]
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Timepoint [1]
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At time of reporting of the coronary artery calcium score on both the myocardial perfusion scan computed tomography and on the computed tomography coronary angiography, approximately 2-4 weeks after patients undergo both scans.
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Secondary outcome [1]
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Nil
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Assessment method [1]
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Timepoint [1]
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Nil
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Eligibility
Key inclusion criteria
The inclusion criteria will include any patient over the age of 18 years of age, who has presented with symptoms of cardiac ischaemia that has been deemed to be low to intermediate risk.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
The exclusion criteria for this phase is any patient with known coronary artery disease defined as previous cardiac surgical intervention, percutaneous coronary intervention, any patient with a congenital cardiac condition, recent myocardial infarction defined by changes to electrocardiography and cardiac biomarkers, myocarditis and/or moderate to severe valve calcification which would impair coronary artery calcium scoring, as well as any condition that would prevent patients undergoing a myocardial perfusion or computed tomography.
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Correlation of coronary artery calcium score on myocardial perfusion scans and on computed tomography coronary angiography.
- Aim to enrol the least amount of patients to show correlation
- Aim to enrol 10-25 patients with the ability to increase to 50 if increased correlation coefficient required.
- Data analysis will be conducted using SPSS (TM) to assess the correlation coefficient.
- Demographic data of the included patients will be also assessed using means.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/11/2021
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
25
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Tamworth Rural Referral Hospital - Tamworth
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Recruitment postcode(s) [1]
35282
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2340 - Tamworth
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Funding & Sponsors
Funding source category [1]
309653
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Hospital
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Name [1]
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Tamworth Rural Referral Hospital
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Address [1]
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Dean Street, North Tamworth 2340
NSW
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Country [1]
309653
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Australia
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Primary sponsor type
Individual
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Name
Shanathan Sritharan
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Address
Tamworth Rural Referral Hospital
Dean Street
North Tamworth 2340
NSW
Australia
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
310669
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Address [1]
310669
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Country [1]
310669
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
309420
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Hunter New England Health Human Research Ethic Committee
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Ethics committee address [1]
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John Hunter Hospital Look Out Road New Lambton, 2305 NSW
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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13/09/2021
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Approval date [1]
309420
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Ethics approval number [1]
309420
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Summary
Brief summary
Nuclear medicine myocardial perfusion imaging is currently indicated in patients with symptoms of cardiac ischaemia, who have either failed a stress echocardiogram, are unable to exercise to the extent required to provide an adequate stress echocardiogram or have a body habitus or other physical condition that would prevent an adequate stress echocardiogram. A nuclear medicine myocardial perfusion scan consists of an intravenously administered radioisotope, which can then be assessed with either single photon emission computer tomography (SPECT) or positron emission tomography (PET). This allows the assessment of the underlying myocardium and the underlying coronary arteries. More recently coronary artery calcium (CAC) scoring has been developed to assess patients without known coronary artery disease who present with symptoms of acute ischaemia and are of low or intermediate risk, without electrocardiograph changes or elevation in cardiac biomarkers. As both investigations utilise computed tomography (CT), our aim is to assess the value of coronary artery calcium scoring on nuclear medicine myocardial perfusion scans, in order to improve the diagnosis and outcomes in patients with low to intermediate risk cardiac ischaemia. Currently there is no research available on the utility of coronary artery calcium scoring in myocardial perfusion scans. The investigators aim to show a correlation of the coronary artery calcium score between the computed tomography conducted for myocardial perfusion imaging and dedicated computed tomography imaging. This will then allow the assessment of the coronary artery calcium score retrospectively in participants who underwent myocardial perfusion imaging to assess the change in predefined outcomes when utilising the additional measure.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Shanathan Sritharan
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Address
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Tamworth Rural Referral Hospital
Dean Street
North Tamworth, 2340
NSW
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Country
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Australia
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Phone
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+61 0267677700
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Shanathan Sritharan
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Address
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Tamworth Rural Referral Hospital
Dean Street
North Tamworth, 2340
NSW
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Country
114099
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Australia
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Phone
114099
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+61 0267677700
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Fax
114099
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Email
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[email protected]
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Contact person for scientific queries
Name
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Shanathan Sritharan
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Address
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Tamworth Rural Referral Hospital
Dean Street
North Tamworth, 2340
NSW
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Country
114100
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Australia
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Phone
114100
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+61 0267677700
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Fax
114100
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Email
114100
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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