Active not recruitingOBSERVATIONAL

Predicting the Risk of Non-culprit Coronary Artery Disease After a Heart Attack

After a heart attack, where a blockage in one artery is fixed, doctors often find other narrowed arteries. Sometimes these narrowings are left alone because they don't seem severe, but they could cause problems later. Other times, narrowings that look bad are actually harmless. This study aims to find a better way to tell which narrowings are risky and need treatment, and which are stable and don't. By using special scans of the heart arteries (from inside during an angiogram, and a magnetic resonance angiogram), researchers hope to predict which narrowings are likely to get worse. This could help doctors make more accurate treatment decisions to prevent future heart attacks.

At a glance

Status

Active not recruiting

Sponsor

Guy's and St Thomas' NHS Foundation Trust

Enrolment target

Start

25 Apr 2023

Estimated completion

01 Sep 2028

Coronary Artery Disease ST Elevation Myocardial Infarction Ischemic Heart Disease

What is this study about?

When someone has a heart attack, it's usually because an artery supplying blood to the heart has become completely blocked. Doctors quickly treat this by clearing the blockage and often placing a small tube called a stent to keep the artery open. However, it's common for other arteries to also have narrowings, even if they weren't directly responsible for the heart attack itself. These are sometimes called 'non-culprit' narrowings.

Currently, it's tricky to know what to do with these other narrowings. Some that look severe might actually be stable and never cause a problem, meaning a stent would be an unnecessary procedure and risk. On the other hand, some narrowings that appear mild and are left untreated could get worse over time and lead to another heart attack. This study aims to shed light on this problem.

Researchers in this study will use advanced imaging techniques to get a very close look at these narrowed arteries. This includes a scan from inside the heart arteries during a procedure called an angiogram, and another special scan called a magnetic resonance angiogram (MRA). The goal is to see if these detailed scans can help doctors accurately predict which narrowings are likely to become a problem in the future and which are not. If successful, this research could help doctors make better decisions about who needs further treatment after a heart attack, potentially preventing future complications.

Key takeaways

New study to improve heart attack aftercare.
Focuses on predicting future problems from narrowed arteries.
Uses special internal and external heart scans.
Aims to help doctors make better treatment choices.
Could prevent unnecessary procedures or future heart attacks.

Who may be eligible?

You might be able to join this study if you've recently had a heart attack where a blockage was successfully treated with a stent. You also need to have other narrowed arteries that weren't directly involved in your heart attack, which your doctors are considering treating at a later stage. Importantly, you must be able to understand the study and agree in writing to take part.

However, you won't be able to join if you are very unwell with heart shock, have severe kidney problems, or have had previous heart bypass surgery. This study is also not for you if you're pregnant, have a very short life expectancy for other health reasons, or if your main heart artery is affected. Certain features in your arteries, like severe hardening or twisting that would make the special scans unsafe, would also prevent you from participating.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Have you recently had a heart attack treated with a stent?
Do you have other narrowed arteries the doctors are looking at?
Are you generally well and not in severe heart shock?
Do you not have severe kidney problems?
Are you not pregnant?

Answer every question to see your result.

What does participation involve?

This study does not specify the exact number of visits or the total duration. However, it mentions that participants will undergo special scans during an angiogram, which is a procedure where doctors look inside your heart arteries. You will also have a type of scan called a magnetic resonance angiogram (MRA). You won't be given any new medications specifically for this study. The main involvement will be these imaging tests, which will help researchers understand your heart arteries better.

Potential risks and benefits

Taking part in this study could help doctors better understand and treat heart conditions in the future, potentially benefitting many people. However, like any medical procedure, there are some small risks associated with the angiogram and MRA scans, primarily related to the procedures themselves. For example, fitting the special wires and catheters for the scans carries a very small risk. Remember, participation is completely voluntary, and you have the right to withdraw from the study at any time without affecting your medical care.

Locations (4)

Royal Bournemouth Hospital
Verified postcode
Bournemouth, United Kingdom
St Thomas' Hospital
Verified postcode
London, United Kingdom
King's College Hospital
Verified postcode
London, United Kingdom
Royal Bournemouth Hospital
Unverified
Bournemouth, UK

Common questions

What is a 'non-culprit' narrowing?

It's a narrowed artery in your heart that wasn't the direct cause of your recent heart attack, but was found during your check-up.

Why is it hard to know which narrowings to treat?

Some narrowings that look bad might be harmless, while some that look mild could become a problem later. It's difficult to predict their future behaviour.

What is an angiogram?

It's a medical procedure where doctors insert a thin tube into an artery, usually in your wrist or groin, and guide it to your heart to look at your arteries.

What is a magnetic resonance angiogram (MRA)?

This is a special type of scan that uses strong magnets and radio waves to create detailed pictures of your blood vessels, including those in your heart.

Will taking part change my heart attack treatment?

This study aims to improve future treatment decisions. Your current treatment will be based on what your doctors think is best for you.