Trial Outcomes & Findings for Half-Dose Radiopharmaceutical in Wide Beam Reconstruction (NCT NCT01499654)

NCT ID: NCT01499654

Last Updated: 2016-02-24

Results Overview

Left ventricular myocardium was divided into standardized 17-segments with 6 equiangular segments in the basal region, 6 equiangular segments in the mid region, 4 equiangular segments in the apical regions, and 1 region in the apex (Cerqueira MD, et al., J Nucl Cardiol 2002;9:240-5). Each segment was scored on a scale from 0 to 4 to indicate the severity of the perfusion defect (0=no perfusion defect; 1=mild perfusion defect; 2=moderate perfusion defect; 3=severe perfusion defect; and 4=absent perfusion). The scores over 17 segments were summed to report the Sum Rest Score (SRS), ie. the greater the SRS, the larger the perfusion defect.

Recruitment status

TERMINATED

Study phase

NA

Target enrollment

64 participants

Primary outcome timeframe

Baseline

Results posted on

2016-02-24

Participant Flow

Prospectively enroll patients with history of severe myocardial infarction, cardiomyopathy, heart failure or prior nuclear scans with resting perfusion defects. Patients were approached in the nuclear stress lab prior to scheduled stress test. Recruitment period was between 3/20/2012 and 2/14/2014.

Participant milestones

Participant milestones
Measure
Study Group
Entire cohort
Overall Study
STARTED
64
Overall Study
COMPLETED
64
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Half-Dose Radiopharmaceutical in Wide Beam Reconstruction

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Study Group
n=64 Participants
Entire cohort
Age, Continuous
66 years
STANDARD_DEVIATION 11 • n=5 Participants
Sex: Female, Male
Female
16 Participants
n=5 Participants
Sex: Female, Male
Male
48 Participants
n=5 Participants
Height
68.0 inches
STANDARD_DEVIATION 4.1 • n=5 Participants
Weight
198.4 pounds
STANDARD_DEVIATION 40.0 • n=5 Participants
Body mass index
30.2 kg/m^2
STANDARD_DEVIATION 6.0 • n=5 Participants
Indications for stress test
Chest pain
16 participants
n=5 Participants
Indications for stress test
Dyspnea
9 participants
n=5 Participants
Indications for stress test
Prior Myocardial Infarct
7 participants
n=5 Participants
Indications for stress test
Prior Coronary Disease
18 participants
n=5 Participants
Indications for stress test
Cardiomyopathy
5 participants
n=5 Participants
Indications for stress test
CHF
6 participants
n=5 Participants
Indications for stress test
Prior CABG
8 participants
n=5 Participants
Indications for stress test
Prior PCI
5 participants
n=5 Participants
Indications for stress test
Other
9 participants
n=5 Participants
History
Hypertension
58 participants
n=5 Participants
History
Hypercholesterolemia
52 participants
n=5 Participants
History
Tobacco smoking (prior or current)
24 participants
n=5 Participants
History
Diabetes mellitus
21 participants
n=5 Participants
History
Family history of CAD
19 participants
n=5 Participants
History
Prior Myocardial Infarct
28 participants
n=5 Participants
History
Coronary artery disease
46 participants
n=5 Participants
History
Coronary artery bypass surgery
27 participants
n=5 Participants
Previous nuclear stress
39 participants
n=5 Participants
Medications
ACE inhibitors/ARB
33 participants
n=5 Participants
Medications
Beta-blockers
56 participants
n=5 Participants
Medications
Ca-channel blockers
19 participants
n=5 Participants
Medications
Aspirin
51 participants
n=5 Participants
Medications
Anti-platelet
21 participants
n=5 Participants
Medications
Statin
53 participants
n=5 Participants
Medications
Nitrates
11 participants
n=5 Participants
Medications
Diuretic
24 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline

Left ventricular myocardium was divided into standardized 17-segments with 6 equiangular segments in the basal region, 6 equiangular segments in the mid region, 4 equiangular segments in the apical regions, and 1 region in the apex (Cerqueira MD, et al., J Nucl Cardiol 2002;9:240-5). Each segment was scored on a scale from 0 to 4 to indicate the severity of the perfusion defect (0=no perfusion defect; 1=mild perfusion defect; 2=moderate perfusion defect; 3=severe perfusion defect; and 4=absent perfusion). The scores over 17 segments were summed to report the Sum Rest Score (SRS), ie. the greater the SRS, the larger the perfusion defect.

Outcome measures

Outcome measures
Measure
Half-dose WBR
n=64 Participants
Half-dose Tc-99m sestamibi reconstructed using wide beam reconstruction (WBR)
Half-dose FBP
n=64 Participants
Half-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Full-dose FBP
n=64 Participants
Full-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Sum Rest Score
8.1 units on a scale
Standard Deviation 5.9
6.7 units on a scale
Standard Deviation 5.1
6.5 units on a scale
Standard Deviation 6.1

PRIMARY outcome

Timeframe: Baseline

Left ventricular myocardium was divided into standardized 17-segments with 6 equiangular segments in the basal region, 6 equiangular segments in the mid region, 4 equiangular segments in the apical regions, and 1 region in the apex (Cerqueira MD, et al., J Nucl Cardiol 2002;9:240-5). Each segment was scored on a scale from 0 to 4 to indicate the severity of the perfusion defect (0=no perfusion defect; 1=mild perfusion defect; 2=moderate perfusion defect; 3=severe perfusion defect; and 4=absent perfusion). The number of segments with a score of 1 or greater were summed to obtain the number of segments with a resting perfusion defect.

Outcome measures

Outcome measures
Measure
Half-dose WBR
n=64 Participants
Half-dose Tc-99m sestamibi reconstructed using wide beam reconstruction (WBR)
Half-dose FBP
n=64 Participants
Half-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Full-dose FBP
n=64 Participants
Full-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Segments With Resting Perfusion Defect
4.6 segments
Standard Deviation 2.4
4.0 segments
Standard Deviation 2.2
3.8 segments
Standard Deviation 2.6

SECONDARY outcome

Timeframe: Baseline

Each reconstructed image was subjectively scored by the expert readers to determine the overall image quality. The Image Quality Score of the reconstructed images were graded on a 4-point scale. (1=Poor; 2=Fair; 3=Good; and 4=Excellent).

Outcome measures

Outcome measures
Measure
Half-dose WBR
n=64 Participants
Half-dose Tc-99m sestamibi reconstructed using wide beam reconstruction (WBR)
Half-dose FBP
n=64 Participants
Half-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Full-dose FBP
n=64 Participants
Full-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Image Quality Score
2.3 units on a scale
Standard Deviation 0.8
2.6 units on a scale
Standard Deviation 0.6
3.0 units on a scale
Standard Deviation 0.7

SECONDARY outcome

Timeframe: Baseline

Each reconstructed image was subjectively scored by the expert readers to determine the expert reader's diagnostic confidence in scoring and interpreting the perfusion scores. The Diagnostic Confidence Score of the reconstructed images were graded on a 4-point scale. (1=Poor; 2=Fair; 3=Good; and 4=Excellent).

Outcome measures

Outcome measures
Measure
Half-dose WBR
n=64 Participants
Half-dose Tc-99m sestamibi reconstructed using wide beam reconstruction (WBR)
Half-dose FBP
n=64 Participants
Half-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Full-dose FBP
n=64 Participants
Full-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Diagnostic Confidence Score
2.5 units on a scale
Standard Deviation 0.8
2.7 units on a scale
Standard Deviation 0.9
3.0 units on a scale
Standard Deviation 0.8

POST_HOC outcome

Timeframe: Baseline

Population: Entire Cohort

Amount of the standard, clinically-accepted, full-dose Tc-99m sestamibi dose administered

Outcome measures

Outcome measures
Measure
Half-dose WBR
n=64 Participants
Half-dose Tc-99m sestamibi reconstructed using wide beam reconstruction (WBR)
Half-dose FBP
Half-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Full-dose FBP
Full-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Resting Full-Tracer Dose
9.08 millicurie
Standard Deviation 0.46

POST_HOC outcome

Timeframe: Baseline

Time in minutes between doses of resting Tc-99m sestamibi doses and image scanning.

Outcome measures

Outcome measures
Measure
Half-dose WBR
n=64 Participants
Half-dose Tc-99m sestamibi reconstructed using wide beam reconstruction (WBR)
Half-dose FBP
n=64 Participants
Half-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Full-dose FBP
n=64 Participants
Full-dose Tc-99m sestamibi reconstructed using filtered back projection (FBP)
Injection and Scan Times
30.0 minutes
Standard Deviation 5.4
33.1 minutes
Standard Deviation 13.1
56.7 minutes
Standard Deviation 8.2

Adverse Events

Study Group

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Edwin Wu, MD

Northwestern University

Phone: 847-535-7270

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place