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| ID | Type | Description | Link |
|---|---|---|---|
| 10-MYO-003 | Other Grant/Funding Number | GE Healthcare |
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Nuclear stress testing evaluates whether the heart receives enough blood, by injection of a nuclear isotope during a stress on the heart that permits taking pictures of the heart muscle. A low-radiation-dose protocol for nuclear stress testing involves injecting less of the nuclear isotope than standard protocols, by utilizing a new, more efficient camera (called an Alcyone camera) which could decrease radiation dose to patients while still providing excellent clinical information. Subjects will undergo imaging under the Alcyone camera after undergoing stress testing with exercise or a standard medication simulating exercise, and then at rest if needed. Subjects will have follow-up to measure events occurring after the test, such as death, heart attack, unstable angina, repeat emergency department visit for chest pain evaluation, or repeat imaging needed to evaluation for coronary artery disease. Radiation doses and quality of the images from the imaging with the new protocol will be recorded to compare to those used in standard nuclear imaging protocols. The primary study hypothesis is that greater than 90% of patients who have a normal very low dose stress first myocardial perfusion scintigraphy (MPS) will be free at 3 months after study of death, nonfatal myocardial infarction, unstable angina, and repeat emergency department visit for chest pain evaluation or repeat anatomical or functional cardiac imaging.
See brief summary above.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Very low dose stress test protocol | Patients admitted to New York Presbyterian Hospital (NYPH)-Columbia University Medical Center with chest pain but normal or nondiagnostic electrocardiograms and at least 3 negative troponins taken 4 or more hours apart, and undergo exercise or pharmacologic stress testing using a very low dose (<6 mCi) of Tc99m tetrofosmin or sestamibi with imaging performed using acquisitions with an Alcyone camera. |
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| Measure | Description | Time Frame |
|---|---|---|
| Percentage of patients free of composite endpoint | Composite endpoint consists of:
| 3 months after MPS and hospital discharge (an expected average of 12 hours after MPS) |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of patients for whom rest imaging is needed. | 12 months after MPS and hospital discharge (an expected average of 12 hours after MPS) | |
| Image quality on a 5 point scale | Imagine quality is assessed by 2 readers and is scored on a 5-point scale: excellent, very good, good, fair, poor. |
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Inclusion Criteria:
Exclusion Criteria:
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Study subjects will be patients who have presented to NYPH- Columbia University Medical Center with chest pain.
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| Name | Affiliation | Role |
|---|---|---|
| Andrew J Einstein, MD, PhD | NYPH- Columbia University Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| New York Presbyterian Hospital- Columbia University Medical Center | New York | New York | 10032 | United States |
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| ID | Term |
|---|---|
| D002637 | Chest Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Up to 12 months after MPS and hospital discharge (an expected average of 12 hours after MPS) |
| Average effective dose of radiation received by all patients. | Up to 12 months after MPS and hospital discharge (an expected average of 12 hours after MPS) |
| Average effective dose received by patients for whom stress-only MPS is performed. | Up to 12 months after MPS and hospital discharge (an expected average of 12 hours after MPS) |
| Duration of stress test | Up to 12 months after MPS and hospital discharge (an expected average of 12 hours after MPS) |
| Duration of hospitalization | Up to 12 months after MPS and hospital discharge (an expected average of 12 hours after MPS) |