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This study involves the use of Magnetic Resonance Imaging (MRI) to determine whether blood clots can be identified within the blood vessels supplying blood to the heart in patients with angina and who have recently suffered a heart attack.
The majority of heart attacks are caused as a result of small blood clots forming within the blood vessels supplying blood to the heart, obstructing blood flow to the heart muscle. Research has also shown that blood clots may form in the blood vessels of the heart without causing a heart attack. At present, blood clots may be identified by techniques used during invasive coronary angiography, but we wish to determine whether a non-invasive test (MRI scanning) can be used to detect small blood clots within the blood vessels supplying blood to the heart muscle.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1 (Stable Angina) | Active Comparator | 20 patients with stable angina planned to undergo elective coronary angiography will be recruited and each participant will undergo magnetic resonance imaging (MRI) prior to invasive coronary angiography. During the angiogram, Optical Coherence Tomography (OCT) may be used to identify thrombus within the coronary arteries. |
|
| Cohort 2 (Acute Coronary Syndrome) | Active Comparator | 20 patients diagnosed with acute coronary syndrome will be recruited and each participant will undergo magnetic resonance imaging (MRI) prior to invasive coronary angiography. During the angiogram, Optical Coherence Tomography (OCT) may be used to identify thrombus within the coronary arteries. If thrombus is identified, participants will be asked to undergo a repeat MRI scan at one and three months. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Magnetic Resonance Imaging | Other | Each participant will undergo at least one MRI scan. A small number will be asked to undergo repeat MRI scanning at one and three months following the initial scan. |
| Measure | Description | Time Frame |
|---|---|---|
| Evidence of high intensity signals within the coronary arteries on T1 weighted magnetic resonance imaging. | Within 72 hours prior to angiography |
| Measure | Description | Time Frame |
|---|---|---|
| The correlation between high risk plaques as determined on MRI with culprit plaques on invasive angiography in patients with acute coronary syndrome (ACS). | Through study completion, an average of 1 year | |
| Incidence of intracoronary thrombosis, as detected by magnetic resonance imaging, in patients with stable coronary artery disease. |
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Inclusion Criteria:
Aged over 18 years
Previously diagnosed coronary artery disease undergoing elective invasive angiography (Cohort 1) OR
Admitted with Acute Coronary Syndrome (ACS) diagnosed by two of the following criteria;
Planned invasive coronary angiography
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mhairi K Doris, MBChB | University of Edinburgh/NHS Lothian | Principal Investigator |
| David E Newby, PhD | University of Edinburgh/NHS Lothian | Study Director |
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| ID | Term |
|---|---|
| D000787 | Angina Pectoris |
| D060050 | Angina, Stable |
| D000789 | Angina, Unstable |
| D009203 | Myocardial Infarction |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| D009682 | Magnetic Resonance Spectroscopy |
| D041623 | Tomography, Optical Coherence |
| ID | Term |
|---|---|
| D013057 | Spectrum Analysis |
| D002623 | Chemistry Techniques, Analytical |
| D008919 | Investigative Techniques |
| D041622 | Tomography, Optical |
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| Optical Coherence Tomography | Device | Participants may undergo Optical Coherence Tomography (OCT) during the angiogram procedure in order to detect thrombus within the coronary arteries. |
|
| Invasive Coronary Angiography | Procedure | This will be performed as part of usual care and does not constitute part of the research project. |
|
| Through study completion, an average of 1 year |
| The change in plaque signal intensity on magnetic resonance imaging at one month following acute coronary syndrome (ACS). | Baseline and 1 month |
| The change in plaque signal intensity on magnetic resonance imaging at three months following acute coronary syndrome (ACS). | Baseline and 3 months |
| D002637 |
| Chest Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007238 | Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D009336 | Necrosis |
| D061848 | Optical Imaging |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D014054 | Tomography |