Study Results
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Basic Information
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RECRUITING
350 participants
OBSERVATIONAL
2023-09-01
2024-07-31
Brief Summary
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Researchers will compare the Elucid plaque-based FFRct analysis to invasively measured FFR in patients who have previously undergone CCTA and invasively assessed FFR.
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Detailed Description
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Preliminary studies suggest that invasive FFR can be accurately estimated based on the quantification of coronary plaque burden and the assessment of plaque composition. Previously, the investigators have demonstrated that a novel plaque-based FFRct approach, using a histologically validated software (ElucidVivoTM) for the measurement of plaque morphology (volume, plaque risk characteristics, and stenosis) to train a deep-learning model, was shown to be accurate and superior to lumen stenosis for predicting invasive FFR in a single-site feasibility study.
In this study, the investigators seek to assess the diagnostic accuracy of the Elucid plaque-based FFRct software to estimate invasive FFR in patients at multiple centers.
Conditions
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Study Design
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COHORT
RETROSPECTIVE
Study Groups
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Low FFR
Invasive FFR \<= 0.80
ElucidVivo
Plaque morphology characterization on coronary CTA for predicting fractional flow reserve (FFRct)
High FFR
Invasive FFR \> 0.80
ElucidVivo
Plaque morphology characterization on coronary CTA for predicting fractional flow reserve (FFRct)
Interventions
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ElucidVivo
Plaque morphology characterization on coronary CTA for predicting fractional flow reserve (FFRct)
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
* History of myocardial infarction prior to CCTA and invasive FFR.
* Known complex congenital heart disease.
* Existing pacemaker or internal defibrillator lead implantation(s).
* Existing prosthetic heart valve.
* Absence of CCTA Digital Imaging and Communications in Medicine (DICOM) data for analysis.
* Absence of invasive coronary angiography imaging or adequate description defining the position of the invasive FFR wire location.
* Poor CCTA image quality that does not meet Elucid image processing requirements for plaque and FFRct.
* Absence of study date for CCTA or invasive FFR.
* Interval clinical myocardial infarction, diagnosis of decompensated heart failure, stroke, or coronary revascularization procedure between CCTA and invasive FFR.
* Non-diagnostic CCTA or invasive FFR. Studies where the results of the study were deemed non-diagnostic for clinical decision-making will be excluded.
* CCTA or invasive FFR studies performed prior to 1 January 2016.
18 Years
ALL
No
Sponsors
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Lundquist Institute at Harbor-UCLA Medical Center
UNKNOWN
Elucid Bioimaging Inc.
INDUSTRY
Responsible Party
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Principal Investigators
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Ziad Ali, MD
Role: PRINCIPAL_INVESTIGATOR
Catholic Health - St. Francis Hospital
Todd C Villines, MD
Role: PRINCIPAL_INVESTIGATOR
Elucid Bioimaging Inc.
Locations
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Cardiovascular Medical Group of Southern California
Beverly Hills, California, United States
Piedmont Healthcare
Atlanta, Georgia, United States
Parkview Health
Fort Wayne, Indiana, United States
Midwest Heart and Vascular Specialists
Overland Park, Kansas, United States
Valley Health System
Ridgewood, New Jersey, United States
Cleveland Clinic
Cleveland, Ohio, United States
Centennial Heart
Nashville, Tennessee, United States
Ascension Medical Group
Nashville, Tennessee, United States
University of Virginia
Charlottesville, Virginia, United States
Countries
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Central Contacts
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Facility Contacts
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Ronald P Karlsberg, MD
Role: primary
Venkateshwar Polsani, MD
Role: primary
Dustin Thomas, MD
Role: primary
Stephen A Bloom, MD
Role: primary
Himanshu Gupta, MD
Role: primary
Milind Desai, MD, MBA
Role: primary
David Huneycutt, MD
Role: primary
Andrew O Zurich, MD
Role: primary
Patricia Rodriguez-Lozano, MD
Role: primary
References
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Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, Bittl JA, Cohen MG, DiMaio JM, Don CW, Fremes SE, Gaudino MF, Goldberger ZD, Grant MC, Jaswal JB, Kurlansky PA, Mehran R, Metkus TS Jr, Nnacheta LC, Rao SV, Sellke FW, Sharma G, Yong CM, Zwischenberger BA. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 Jan 18;145(3):e4-e17. doi: 10.1161/CIR.0000000000001039. Epub 2021 Dec 9.
Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK, Blankstein R, Boyd J, Bullock-Palmer RP, Conejo T, Diercks DB, Gentile F, Greenwood JP, Hess EP, Hollenberg SM, Jaber WA, Jneid H, Joglar JA, Morrow DA, O'Connor RE, Ross MA, Shaw LJ. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021 Nov 30;144(22):e368-e454. doi: 10.1161/CIR.0000000000001029. Epub 2021 Oct 28.
Tesche C, De Cecco CN, Caruso D, Baumann S, Renker M, Mangold S, Dyer KT, Varga-Szemes A, Baquet M, Jochheim D, Ebersberger U, Bayer RR 2nd, Hoffmann E, Steinberg DH, Schoepf UJ. Coronary CT angiography derived morphological and functional quantitative plaque markers correlated with invasive fractional flow reserve for detecting hemodynamically significant stenosis. J Cardiovasc Comput Tomogr. 2016 May-Jun;10(3):199-206. doi: 10.1016/j.jcct.2016.03.002. Epub 2016 Mar 10.
Ahmadi A, Stone GW, Leipsic J, Serruys PW, Shaw L, Hecht H, Wong G, Norgaard BL, O'Gara PT, Chandrashekhar Y, Narula J. Association of Coronary Stenosis and Plaque Morphology With Fractional Flow Reserve and Outcomes. JAMA Cardiol. 2016 Jun 1;1(3):350-7. doi: 10.1001/jamacardio.2016.0263.
Diaz-Zamudio M, Dey D, Schuhbaeck A, Nakazato R, Gransar H, Slomka PJ, Narula J, Berman DS, Achenbach S, Min JK, Doh JH, Koo BK. Automated Quantitative Plaque Burden from Coronary CT Angiography Noninvasively Predicts Hemodynamic Significance by using Fractional Flow Reserve in Intermediate Coronary Lesions. Radiology. 2015 Aug;276(2):408-15. doi: 10.1148/radiol.2015141648. Epub 2015 Apr 17.
Varga-Szemes A, Schoepf UJ, Maurovich-Horvat P, Wang R, Xu L, Dargis DM, Emrich T, Buckler AJ. Coronary plaque assessment of Vasodilative capacity by CT angiography effectively estimates fractional flow reserve. Int J Cardiol. 2021 May 15;331:307-315. doi: 10.1016/j.ijcard.2021.01.040. Epub 2021 Jan 30.
Stuijfzand WJ, van Rosendael AR, Lin FY, Chang HJ, van den Hoogen IJ, Gianni U, Choi JH, Doh JH, Her AY, Koo BK, Nam CW, Park HB, Shin SH, Cole J, Gimelli A, Khan MA, Lu B, Gao Y, Nabi F, Nakazato R, Schoepf UJ, Driessen RS, Bom MJ, Thompson R, Jang JJ, Ridner M, Rowan C, Avelar E, Genereux P, Knaapen P, de Waard GA, Pontone G, Andreini D, Al-Mallah MH, Lu Y, Berman DS, Narula J, Min JK, Bax JJ, Shaw LJ; CREDENCE Investigators. Stress Myocardial Perfusion Imaging vs Coronary Computed Tomographic Angiography for Diagnosis of Invasive Vessel-Specific Coronary Physiology: Predictive Modeling Results From the Computed Tomographic Evaluation of Atherosclerotic Determinants of Myocardial Ischemia (CREDENCE) Trial. JAMA Cardiol. 2020 Dec 1;5(12):1338-1348. doi: 10.1001/jamacardio.2020.3409.
Lin A, van Diemen PA, Motwani M, McElhinney P, Otaki Y, Han D, Kwan A, Tzolos E, Klein E, Kuronuma K, Grodecki K, Shou B, Rios R, Manral N, Cadet S, Danad I, Driessen RS, Berman DS, Norgaard BL, Slomka PJ, Knaapen P, Dey D. Machine Learning From Quantitative Coronary Computed Tomography Angiography Predicts Fractional Flow Reserve-Defined Ischemia and Impaired Myocardial Blood Flow. Circ Cardiovasc Imaging. 2022 Oct;15(10):e014369. doi: 10.1161/CIRCIMAGING.122.014369. Epub 2022 Oct 13.
Buckler AJ, Sakamoto A, Pierre SS, Virmani R, Budoff MJ. Virtual pathology: Reaching higher standards for noninvasive CTA tissue characterization capability by using histology as a truth standard. Eur J Radiol. 2023 Feb;159:110686. doi: 10.1016/j.ejrad.2022.110686. Epub 2022 Dec 31.
Other Identifiers
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3-ST-03-03
Identifier Type: -
Identifier Source: org_study_id
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