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    Computed tomographic coronary angiography for patients with heart failure (CTA-HF): a randomized controlled trial (IMAGE HF Project 1-C)

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    Date
    2013-12-26
    Author
    Chow, Benjamin JW
    Green, Rachel E
    Coyle, Doug
    Laine, Mika
    Hanninen, Helena
    Leskinen, Hanna
    Rajda, Miroslav
    Larose, Eric
    Hartikainen, Juha
    Hedman, Marja
    Mielniczuk, Lisa
    O’Meara, Eileen
    deKemp, Robert A
    Klein, Ran
    Paterson, Ian
    White, James A
    Yla-Herttuala, Seppo
    Leber, Alex
    Tandon, Vikas
    Lee, Ting
    Al-Hesayen, Abdul
    Hessian, Renee
    Dowsley, Taylor
    Kass, Malek
    Kelly, Cathy
    Garrard, Linda
    Tardif, Jean-Claude
    Knuuti, Juhani
    Beanlands, Rob S
    Wells, George A
    on behalf of the IMAGE-HF Investigators
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    Abstract
    Abstract Background The prevalence of heart failure (HF) is rising in industrialized and developing countries. Though invasive coronary angiography (ICA) remains the gold standard for anatomical assessment of coronary artery disease in HF patients, alternatives are being sought. Computed tomographic coronary angiography (CTA) has emerged as an accurate non-invasive diagnostic tool for coronary artery disease (CAD) and has been demonstrated to have prognostic value. Whether or not CTA can be used in HF patients is unknown. Acknowledging the aging population, the growing prevalence of HF and the increasing financial burden of healthcare, we need to identify non-invasive diagnostic tests that are available, safe, accurate and cost-effective. Methods/Design The proposed study aims to provide insight into the efficacy of CTA in HF patients. A multicenter randomized controlled trial will enroll 250 HF patients requiring coronary anatomical definition. Enrolled patients will be randomized to either CTA or ICA (n = 125 per group) as the first test to define coronary anatomy. The primary outcomes will be collected to determine downstream resource utilization. Secondary outcomes will include the composite clinical events and major adverse cardiac events. In addition, the accuracy of CTA for detecting coronary anatomy and obstruction will be assessed in patients who subsequently undergo both CTA and ICA. It is expected that CTA will be a more cost-effective strategy for diagnosis: yielding similar outcomes with fewer procedural risks and improved resource utilization. Trial registration ClinicalTrials.gov, NCT01283659 Team grant #CIF 99470
    URI
    http://hdl.handle.net/1993/23410
    DOI
    10.1186/1745-6215-14-443
    Collections
    • Rady Faculty of Health Sciences Scholarly Works [1296]
    • University of Manitoba Scholarship [1978]

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