Non-invasive Coronary Thrombus Imaging to Define These Cause of Acute Myocardial Infarction

Sponsor
University of Edinburgh
Study ID
NCT06113510
Status
Recruiting
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Conditions

  • Myocardial Infarction
  • Thrombosis

Eligibility Criteria

Sex
ALL
Age
18 Years - N/A
Healthy Volunteers
Not accepted

Interventions

  • Hybrid 18F-GP1 positron emission tomography and coronary computed tomography coronary angiography — RADIATION
    18F-GP1 will be synthesized by our radiochemistry facility, the Edinburgh Imaging Facility Radiochemistry (EIFR), which is co-located within our Edinburgh Imaging Facility, Queens Medical Research Institute (EIF QMRI) using our well-established protocols. Each patient will undergo 18F-GP1 PET/CT coronary angiography imaging on our hybrid scanner (Biograph mCT, Siemens) as soon as practical after their index event and within a maximum of 7 days from symptom onset. Patients will initially be injected with 250 MBq 18F-GP1, before resting in a quiet environment for 60 min. A low-dose attenuation correction CT scan (120 kV, 50 mAs, 5/3 mm) will be followed by acquisition of PET data in list mode using a two 20-min bed position centred on the thoracic aorta and heart. A contrast-enhanced CT coronary angiogram will then be performed.

Study Details

We now have very sensitive blood tests that can pick up damage to the heart and find patients who have had a heart attack. However, whilst this is welcome, it does not identify what causes the heart attack and can sometimes pick up other conditions that cause a strain on the heart. The classic cause of a heart attack is when a blood clot forms on fatty deposits within the heart arteries. This leads to treating patients with blood thinning medication, and this is very effective and saves lives. However, many apparent heart attacks are not caused by blood clots and some may be caused by blood clots but pass unrecognised. In this proposal, we will test an exciting new imaging test that can 'see' from outside the body whether there is a blood clot in the heart arteries. This could provide a major new way of assessing patients to ensure they get the right diagnosis and the right treatment. This could ultimately improve the outcomes of or patients with heart attacks. We will recruit 80 patients in total who have recently been diagnosed with a heart attack from the cardiology department at the Royal Infirmary of Edinburgh. The research team will review patient's medical records to determine eligibility for the study. The research study involves participants undertaking the following research procedures and assessments: 1. A combined Positron Emission Tomography and Computed Tomography (PET-CT) scan of the heart 2. Ultrasound scan of the heart (Echocardiogram) 3. MRI scan of the heart 4. A blood test - a total of up to four tablespoons (60 mL) of blood will be taken for immediate testing and the remaining blood will be stored for future ethically approved studies 5. A follow up questionnaire 6 -12 months following the heart attack

Key Dates

First listed
Nov 2, 2023
Start date
Jan 6, 2025
Status verified
Mar 2026
Primary completion
Aug 31, 2026
Completion
Apr 1, 2028

Study Design

Enrollment
80 participants (estimated)

Arms

  • Arm: 1
    50 patients with myocardial infarction and non-obstructive coronary arteries
  • Arm: 2
    10 patients with suspected coronary thromboembolism 10 patients with suspected spontaneous coronary artery dissection 10 patented with iatrogenic spontaneous coronary artery dissection

Primary Outcome Measure

The primary endpoint will be the degree and location of platelet activation as determined by the target to background ratio of 18F-GP1 [ Time Frame: 3 years ]

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