PericOronary INflammaTion in Non-Obstructive Coronary Artery Disease (POINT-NOCAD)

  • STATUS
    Recruiting
  • End date
    Dec 27, 2024
  • participants needed
    100
  • sponsor
    NYU Langone Health
Updated on 4 October 2022

Summary

Among patients with ischemic heart disease who are referred for coronary angiography, a substantial proportion have non-obstructive coronary artery disease (CAD). Myocardial infarction (MI) with non-obstructive coronary artery disease (MINOCA) accounts for 5-20% of patients with MI and preferentially affects women. MINOCA pathogenesis is varied and may include atherosclerotic plaque rupture, plaque erosion with thrombosis, vasospasm, embolization, dissection or a combination of mechanisms. Other patients may have clinically unrecognized myocarditis, or takotsubo syndrome masquerading as MI. Among patients referred for coronary angiography for the evaluation of stable ischemic heart disease, non-obstructive CAD is present in up to ~30% of men and ~60% of women. Stable ischemia with non-obstructive coronary arteries (INOCA) may be due to coronary microvascular dysfunction in up to 40% of these patients. Our understanding of mechanisms of MINOCA and INOCA remain incomplete. Coronary inflammation has been hypothesized as a potential mechanism contributing to coronary spasm in MINOCA and microvascular disease in INOCA.

Description

The PericOronary INflammaTion in Non-Obstructive Coronary Artery Disease (POINT-NOCAD) study is a single-center diagnostic, observational study enrolling men and women with MINOCA or INOCA who are planned to undergo (or underwent) clinically indicated coronary angiography. The research plan is to evaluate coronary inflammation, as measured by the perivascular coronary fat attenuation index from non-invasive coronary computed tomography angiography (CCTA), in patients with MINOCA and INOCA.

Details
Condition Non-Obstructive Coronary Atherosclerosis
Treatment Metoprolol, nitroglycerin, Coronary Computed Tomography Angiography (CCTA), Isovue
Clinical Study IdentifierNCT05031520
SponsorNYU Langone Health
Last Modified on4 October 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Adult age ≥18 years referred for clinically indicated coronary angiography
Stable ischemic heart disease OR acute myocardial infarction as the indication for coronary angiography

Exclusion Criteria

Clinical Exclusion criteria
Estimated glomerular filtration rate < 45 mL/min
History of allergic reaction to iodinated contrast media
Pregnancy
Angiographic / Post-Cath Exclusion criteria
Obstructive CAD (≥50% luminal obstruction in ≥1 major epicardial coronary arteries by invasive coronary angiography)
Allergic reaction to iodinated contrast media
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