Evaluating AI-Gatekeeper Software in Coronary Artery Stenosis Screening: a Multicenter RCT

NCT ID: NCT06178900

Last Updated: 2025-03-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

450 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-01

Study Completion Date

2025-02-28

Brief Summary

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The purpose of this study is to determine the efficacy, safety, and cost-effectiveness of AI-Gatekeeper software to assist clinicians in the diagnosis of coronary artery disease by predicting coronary artery stenosis (≥50%) from a multimodal AI technology that integrates clinical risk factors and baseline blood tests, including chest X-ray, electrocardiogram, and echocardiogram, in patients with suspected coronary artery disease (coronary stenosis).

Detailed Description

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Coronary artery disease (CAD) is a leading cause of global mortality, accounting for over 50% of heart disease-related deaths. Initial evaluations for CAD typically involve chest X-rays, electrocardiograms (ECG), risk factor assessments, and basic blood tests. However, these primary tests can't conclusively diagnose CAD. When CAD is suspected, coronary CTA (CCTA) or invasive coronary angiography (ICA) is performed, determining the need for procedures like stenting or revascularization.

Interestingly, over 50% of patients undergoing CCTA or ICA don't require treatment, as CAD is either absent or not severe enough. This leads to unnecessary procedures and significant healthcare costs. For instance, in the U.S., the cost of unnecessary ICAs reaches billions annually, with similar trends in South Korea.

AI-Gatekeeper software assists clinicians in diagnosing coronary artery disease by predicting coronary artery stenosis (≥50%) using multimodal AI technology. It integrates clinical risk factors and baseline blood tests, including chest X-ray, electrocardiogram, and echocardiogram, in patients with suspected coronary artery disease The purpose of this study is to determine the efficacy, safety, and cost-effectiveness of the AI-Gatekeeper software in a prospective, multicenter, randomized control trial.

Conditions

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Coronary Artery Disease Diagnosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Assisted by the AI-Gatekeeper software group

After a baseline examination (chest X-ray, electrocardiogram, echocardiogram, clinical risk factors and blood test), the AI-Gatekeeper software will be used to guide clinical care.

Group Type EXPERIMENTAL

Assisted by the AI-Gatekeeper software group

Intervention Type DIAGNOSTIC_TEST

The group will be received a AI-Gatekeeper software report on the probability of having coronary artery stenosis (≥50%) based on the routine test.

Usual care group

The usual care group will be managed based on established guidelines.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Assisted by the AI-Gatekeeper software group

The group will be received a AI-Gatekeeper software report on the probability of having coronary artery stenosis (≥50%) based on the routine test.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* A patient with symptoms such as chest pain suggestive of coronary artery disease, who underwent routine evaluations including blood tests, electrocardiogram, chest X-ray, and echocardiography
* Low to Intermediate risk of pretest probabilities of obstructive CAD
* Voluntarily agreed to participate in this clinical trial and signed the written consent form

Exclusion Criteria

* Acute chest pain (in patients who have not been ruled out for ACS)
* Previously diagnosed and treated coronary artery disease (myocardial infarction, PCI, CABG)
* Patients with a life expectancy of less than 2 years due to conditions other than heart disease
* Those who have not consented to the protocol
* Participated in a drug or medical device clinical trial within the last 3 months
* Pregnant or lactating women
* Allergic to iodine preparations
* Serum creatine level greater than 1.5 mg/dL or eGFR less than 30 mL/min
* Baseline irregular and uncontrolled heart rhythm
* Heart rate greater than 100 beats/minute
* Systolic blood pressure of 90 mm Hg or less
* Contraindications to beta blockers or nitroglycerin
* Patients with complex congenital heart disease
* Body mass index greater than or equal to 35
Minimum Eligible Age

19 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Korea Medical Device Development Fund

UNKNOWN

Sponsor Role collaborator

INFINITT Healthcare

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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In Hyun Jung, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Yongin Severance Hospital, Yonsei University College of Medicine

Locations

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Soonchunhyang University Bucheon Hospital

Bucheon-si, Gyeonggi-do, South Korea

Site Status

Seoul National University Bundang Hospital

Seongnam-si, Gyeonggi-do, South Korea

Site Status

Yongin Severance Hospitall, Yonsei University College of Medicine

Yongin, Gyeonggi-do, South Korea

Site Status

Catholic Kwandong University International St. Mary's Hospital

Incheon, , South Korea

Site Status

Hanyang University Seoul Hospital

Seoul, , South Korea

Site Status

Countries

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South Korea

References

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Writing Committee Members; 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. J Am Coll Cardiol. 2021 Nov 30;78(22):e187-e285. doi: 10.1016/j.jacc.2021.07.053. Epub 2021 Oct 28.

Reference Type BACKGROUND
PMID: 34756653 (View on PubMed)

Genders TS, Steyerberg EW, Hunink MG, Nieman K, Galema TW, Mollet NR, de Feyter PJ, Krestin GP, Alkadhi H, Leschka S, Desbiolles L, Meijs MF, Cramer MJ, Knuuti J, Kajander S, Bogaert J, Goetschalckx K, Cademartiri F, Maffei E, Martini C, Seitun S, Aldrovandi A, Wildermuth S, Stinn B, Fornaro J, Feuchtner G, De Zordo T, Auer T, Plank F, Friedrich G, Pugliese F, Petersen SE, Davies LC, Schoepf UJ, Rowe GW, van Mieghem CA, van Driessche L, Sinitsyn V, Gopalan D, Nikolaou K, Bamberg F, Cury RC, Battle J, Maurovich-Horvat P, Bartykowszki A, Merkely B, Becker D, Hadamitzky M, Hausleiter J, Dewey M, Zimmermann E, Laule M. Prediction model to estimate presence of coronary artery disease: retrospective pooled analysis of existing cohorts. BMJ. 2012 Jun 12;344:e3485. doi: 10.1136/bmj.e3485.

Reference Type BACKGROUND
PMID: 22692650 (View on PubMed)

Renker M, Schoepf UJ, Wang R, Meinel FG, Rier JD, Bayer RR 2nd, Mollmann H, Hamm CW, Steinberg DH, Baumann S. Comparison of diagnostic value of a novel noninvasive coronary computed tomography angiography method versus standard coronary angiography for assessing fractional flow reserve. Am J Cardiol. 2014 Nov 1;114(9):1303-8. doi: 10.1016/j.amjcard.2014.07.064. Epub 2014 Aug 12.

Reference Type BACKGROUND
PMID: 25205628 (View on PubMed)

Kamel PI, Yi PH, Sair HI, Lin CT. Prediction of Coronary Artery Calcium and Cardiovascular Risk on Chest Radiographs Using Deep Learning. Radiol Cardiothorac Imaging. 2021 Jun 17;3(3):e200486. doi: 10.1148/ryct.2021200486. eCollection 2021 Jun.

Reference Type BACKGROUND
PMID: 34235441 (View on PubMed)

Kwon JM, Lee SY, Jeon KH, Lee Y, Kim KH, Park J, Oh BH, Lee MM. Deep Learning-Based Algorithm for Detecting Aortic Stenosis Using Electrocardiography. J Am Heart Assoc. 2020 Apr 7;9(7):e014717. doi: 10.1161/JAHA.119.014717. Epub 2020 Mar 21.

Reference Type BACKGROUND
PMID: 32200712 (View on PubMed)

Min JK, Dunning A, Lin FY, Achenbach S, Al-Mallah MH, Berman DS, Budoff MJ, Cademartiri F, Callister TQ, Chang HJ, Cheng V, Chinnaiyan KM, Chow B, Delago A, Hadamitzky M, Hausleiter J, Karlsberg RP, Kaufmann P, Maffei E, Nasir K, Pencina MJ, Raff GL, Shaw LJ, Villines TC. Rationale and design of the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) Registry. J Cardiovasc Comput Tomogr. 2011 Mar-Apr;5(2):84-92. doi: 10.1016/j.jcct.2011.01.007. Epub 2011 Feb 1.

Reference Type BACKGROUND
PMID: 21477786 (View on PubMed)

Kim J, Lee SY, Cha BH, Lee W, Ryu J, Chung YH, Kim D, Lim SH, Kang TS, Park BE, Lee MY, Cho S. Machine learning models of clinically relevant biomarkers for the prediction of stable obstructive coronary artery disease. Front Cardiovasc Med. 2022 Jul 19;9:933803. doi: 10.3389/fcvm.2022.933803. eCollection 2022.

Reference Type BACKGROUND
PMID: 35928935 (View on PubMed)

Other Identifiers

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AI-Gatekeeper Pro

Identifier Type: -

Identifier Source: org_study_id

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