Ultrasound of Neck Plaques Combined With Heart Stress Testing
Tests neck ultrasound and stress echo to find people at risk of heart attack.
Plain-language title generated from the registry record
Registry title: Carotid Intraplaque Neovascularization Combined With Stress Echo
Key facts
- Where
- Calgary, Edmonton, Halifax, Kingston, and Toronto, CanadaSee the 6 sites
Where in Canada
- University Of CalgaryCalgary, CanadaTaking people
- University of AlbertaEdmonton, CanadaNot yet recruiting
- Dalhousie UniversityHalifax, CanadaTaking people
- Queen's University, Cardiovascular Imaging Network at Queen's (CINQ)Kingston, CanadaTaking people
- The Kingston Heart ClinicKingston, CanadaTaking people
- Unity Health TorontoToronto, CanadaTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Dr. Amer Johri
- Trial code
- NCT05416385
- Record updated
- 6 February 2025
- Original description
The root cause of heart attacks and strokes is atherosclerosis, the hardening and thickening of blood vessels due to the presence of "plaque" which is a build-up of fat and cholesterol in the walls of vessels. To diagnose heart disease, patients receive a stress test to find out if they require surgery. Up to 52% of patients receiving an angiogram (surgery) to look at plaque blockages in the heart are found to be normal (no blockage). Patients who are suspected of having heart disease often undergo a stress test, which helps cardiologists decide if the patient has heart disease, but stress tests can give false results. In Ontario alone, 90% are stress tests are found to be normal and patients are sent home with little follow-up. Of these 3-5% (~4,000 patients/year) will have a major cardiovascular event (heart attack, surgery, or death) within 3 years. We need to improve the stress test accuracy to reduce cardiac outcome. We now know that it is not just the total amount of plaque that leads to heart attacks and strokes, but the composition of the plaque that can lead to breakage causing a heart attack. Plaques are soft and fragile, and typically contain fat and small leaky blood vessels within their cores. If we are able to identify patients that have leaky plaques using ultrasound, we may be able to improve the accuracy of stress testing. We propose a study looking at the combination of stress testing (assessing heart function) and neck ultrasound (assessing plaque composition), to identify patients at risk for cardiovascular events (heart attacks and death). We will enrol patients from 6 sites across Canada and follow-them for cardiac outcome for 3 years.Read full original descriptionShow less
Combining Intraplaque Neovascularization With Risk Stratification by Carotid Stress ECHO
The root cause of heart attacks and strokes is atherosclerosis, the hardening and thickening of blood vessels due to the presence of "plaque" which is a build-up of fat and cholesterol in the walls of vessels. To diagnose heart disease, patients receive a stress test to find out if they require surgery. Up to 52% of patients receiving an angiogram (surgery) to look at plaque blockages in the heart are found to be normal (no blockage). Patients who are suspected of having heart disease often undergo a stress test, which helps cardiologists decide if the patient has heart disease, but stress tests can give false results. In Ontario alone, 90% are stress tests are found to be normal and patients are sent home with little follow-up. Of these 3-5% (~4,000 patients/year) will have a major cardiovascular event (heart attack, surgery, or death) within 3 years. We need to improve the stress test accuracy to reduce cardiac outcome. We now know that it is not just the total amount of plaque that leads to heart attacks and strokes, but the composition of the plaque that can lead to breakage causing a heart attack. Plaques are soft and fragile, and typically contain fat and small leaky blood vessels within their cores. If we are able to identify patients that have leaky plaques using ultrasound, we may be able to improve the accuracy of stress testing. We propose a study looking at the combination of stress testing (assessing heart function) and neck ultrasound (assessing plaque composition), to identify patients at risk for cardiovascular events (heart attacks and death). We will enrol patients from 6 sites across Canada and follow-them for cardiac outcome for 3 years.
Inclusion: Men and women >18 years; Referred for a clinically indicated SE for assessment of ischemia and risk stratification; Able and willing to give informed consent.
Exclusion: Previous enrolment into the study; Emergency procedure, or active acute coronary syndrome (active chest pain, ischemic electrocardiogram changes, or cardiac enzyme elevation); Referral for viability, pulmonary hypertension, or valve assessment; History of significant CAD: percutaneous coronary intervention (PCI), coronary artery bypass graft (GABG), or coronary angioplasty; History of stroke or myocardial infarction (MI); Known or documented hypersensitivity or allergy to perflutren (DEFINITY® contrast agent); Known or documented allergy to Polyethylene Glycol (Peg) a component of DEFINITY®; History of carotid surgery (endarterectomy or stenting); Any serious medical condition or complication from the stress test that according to the investigator could interfere with the carotid scan or optimal care; Referral outside of the normal working hours; Currently pregnant or breastfeeding.