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Coronary Artery DiseaseEPIPHANYNCT05877768

Evaluation of PCD-CT Based Image Parameters in the Assessment and Quantification of Coronary Artery Disease

An observational study of Coronary Artery Disease, run by University Medical Center Mainz at 1 site in Germany.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The goal of this observational study is to learn about a new type of computed tomography (Photon-Counting Detector CT) in patients with coronary artery disease. The main questions it aims to answer are: How good is the image quality for the new CT How accurate are measurements in the images of the new CT Is there a… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Coronary Artery Disease
What is being tested?
Photon Counting Detector Coronary Computed Tomography Angiography
How many people
3,000 participants
Where
1 siteGermany
Study dates
30 Jun 2023to 30 Jun 2033
How long will I take part?
5 Years
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: The study population screened for inclusion criteria will be patients referred for CCTA for suspected coronary artery disease and those with known coronary artery disease and the suspicion of progressive disease.

Who may be able to join

  • Clinical indication for a coronary computed tomography angiography (CCTA) for the suspicion of coronary artery disease or the progression thereof
  • Written informed consent

Who cannot join

  • Contraindications preventing the execution of the CCTA (e.g., pregnancy)

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Germany1 site
  • University Medical Center Mainz

    Mainz, Rhineland-Palatinate, 55116

    Tilman Emrich, MD, +49613117 ext. 7358, Tilman.Emrich@unimedizin-mainz.de

    Moritz C Halfmann, MD, +49613117 ext. 5719, Moritz.Halfmann@unimedizin-mainz.de

Other trials in Germany

About this study

Official title: PCD-CT Registry: Evaluation of Photon Counting Detector-CT Based Image Parameters in the Assessment and Quantification of Coronary Artery Disease (EPIPHANY)

The goal of this observational study is to learn about a new type of computed tomography (Photon-Counting Detector CT) in patients with coronary artery disease.

The main questions it aims to answer are:

Read more
  • How good is the image quality for the new CT
  • How accurate are measurements in the images of the new CT
  • Is there a relationship between measurements in the images and the management of the disease (e.g. new medication or additional investigations)
  • Is there a relationship between measurements in the images and the results of follow-up investigations
  • Is there a relationship between measurements in the images and the patient outcome

Participants will undergo normal clinical assessment of coronary artery disease and all data from the CT scan and additional investigations will be collected. There will be no additional investigations for the purpose of the study. After 1, 2 and 5 years, participants will be asked to answer a health questionaire.

Being tested
Photon Counting Detector Coronary Computed Tomography Angiography
Medical subject headings
Coronary Artery Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Photon Counting Detector Coronary Computed Tomography AngiographyDiagnostic test

    Also called Photon-Counting Detector CT (Naeotom Alpha, Siemens Healthineers)

    Clinically indicated Photon Counting Detector Coronary Computed Tomography Angiography for the suspicion of coronary artery disease or the progression thereof.

Study groups in NCT05877768
Study groupRoleWhat they receive
Coronary Artery DiseasePatients with suspected coronary artery disease and those with known coronary artery disease and the suspicion of progressive disease who undergo clinically indicated Coronary Computed Tomography Angiography on the Photon-Counting Detector CT will be enrolled after written consent. All data from the CT scan and potential additional investigations (e.g. invasive coronary angiographies) will be collected. There will be no additional investigations for the purpose of the study. After 1, 2 and 5 years, participants will be asked to answer a health questionaire.
Receives: Diagnostic Test: Photon Counting Detector Coronary Computed Tomography Angiography

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Major Adverse Cardiac Events

    Composite endpoint: major adverse cardiovascular event (MACE); defined as at least one of the following: cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.

    Measured: From inclusion to a maximum follow-up of 5 years

Secondary outcomes (43)
  1. Objective Image Noise of Photon-Counting Detector Coronary Computed Tomography Angiography (PCD-CCTA)

    Image Noise of PCD-CCTA measured objectively using measurements of CT values (HU).

    Measured: during the PCD-CCTA examination

  2. Objective Assessment of Noise-Power Spectra of PCD-CCTA

    Image Noise of PCD-CCTA measured objectively using noise-power spectra (W/Hz).

    Measured: during the PCD-CCTA examination

  3. Subjective Image Noise of PCD-CCTA

    Image Noise of PCD-CCTA judged subjectively on a 5-point Likert scale.

    Measured: during the PCD-CCTA examination

  4. Objective Vessel sharpness in PCD-CCTA

    Vessel sharpness in PCD-CCTA measured objectively using the slope of fitted double sigmoid curves (1/mm)

    Measured: during the PCD-CCTA examination

  5. Subjective Vessel sharpness in PCD-CCTA

    Vessel sharpness in PCD-CCTA judged subjectively on a 5-point Likert scale.

    Measured: during the PCD-CCTA examination

  6. Objective Image Quality in PCD-CCTA

    Objective Image Quality in PCD-CCTA measured objectively by contrast-to-noise ratio (HU/HU)

    Measured: during the PCD-CCTA examination

  7. Subjective Image Quality in PCD-CCTA

    Subjective Image Quality in PCD-CCTA judged subjectively on a 5-point Likert scale.

    Measured: during the PCD-CCTA examination

  8. Influence of BMI on image quality of the PCD-CCTA

    Influence of Body Mass Index (BMI, kg/m^2) on image quality of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  9. Influence of biological sex on image quality of the PCD-CCTA

    Influence of patients biological sex (male/female) on image quality of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  10. Influence of monoenergetic energy levels on image quality of the PCD-CCTA

    Influence of monoenergetic energy levels (keV) on image quality of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  11. Influence of slice thickness of reconstruction on image quality of the PCD-CCTA

    Influence of slice thickness of reconstruction (mm) on image quality of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  12. Influence of reconstruction kernel on image quality of the PCD-CCTA

    Influence of reconstruction kernel (Bv/Br/Qr) on image quality of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  13. Influence of kernel sharpness level on image quality of the PCD-CCTA

    Influence of kernel sharpness level (40-90) on image quality of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  14. Influence of radiation dose on image quality of the PCD-CCTA

    Influence of radiation dose (mGy) on image quality of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  15. Influence of the patients heart rate on image quality of the PCD-CCTA

    Influence of the patients maximum, minimum and average heart rate (1/min) on image quality of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  16. Influence of the acquisition type on image quality of the PCD-CCTA

    Influence of the acquisition type (Sequential, Spiral, Ultra-High Resolution, Spectral) on image quality of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  17. Quantitative analysis of Coronary Calcium Scoring from PCD-CCTA

    Quantitative analysis of Coronary Calcium volume (mm^3), mass (g) and resulting score according to the Agatston classification.

    Measured: during the PCD-CCTA examination

  18. Analysis of Stenosis Classification from PCD-CCTA

    Analysis of Coronary stenosis classification according to the Coronary Artery Disease-Reporting and Data System (CAD-RADS, 0-5, higher numbers indicating more severe stenosis).

    Measured: during the PCD-CCTA examination

  19. Quantitative analysis of Coronary Diameter Stenoses from PCD-CCTA

    Quantitative analysis of Coronary Diameter Stenoses (%) from PCD-CCTA

    Measured: during the PCD-CCTA examination

  20. Quantitative analysis of Coronary Area Stenoses from PCD-CCTA

    Quantitative analysis of Coronary Area Stenoses (%) from PCD-CCTA

    Measured: during the PCD-CCTA examination

  21. Quantitative analysis of computed Fractional Flow Reserve from PCD-CCTA

    Quantitative analysis of computed Fractional Flow Reserve (absolute number) from PCD-CCTA.

    Measured: during the PCD-CCTA examination

  22. Quantitative analysis of myocardial density from PCD-CCTA

    Quantitative analysis of myocardial density (HU) from PCD-CCTA.

    Measured: during the PCD-CCTA examination

  23. Quantitative analysis of myocardial iodine content from PCD-CCTA

    Quantitative analysis of myocardial iodine content (µg/cm^3) from PCD-CCTA.

    Measured: during the PCD-CCTA examination

  24. Quantitative analysis of extracellular volume fraction from PCD-CCTA

    Quantitative analysis of the extracellular volume fraction (%) from PCD-CCTA.

    Measured: during the PCD-CCTA examination

  25. Influence of BMI on quantitative parameters of the PCD-CCTA

    Influence of Body Mass Index (BMI, kg/m^2) on quantitative parameters of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  26. Influence of biological sex on quantitative parameters of the PCD-CCTA

    Influence of patients biological sex (male/female) on quantitative parameters of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  27. Influence of monoenergetic energy levels on quantitative parameters of the PCD-CCTA

    Influence of monoenergetic energy levels (keV) on quantitative parameters of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  28. Influence of slice thickness of reconstruction on quantitative parameters of the PCD-CCTA

    Influence of slice thickness of reconstruction (mm) on quantitative parameters of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  29. Influence of reconstruction kernel on quantitative parameters of the PCD-CCTA

    Influence of reconstruction kernel (Bv/Br/Qr) on quantitative parameters of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  30. Influence of kernel sharpness level on quantitative parameters of the PCD-CCTA

    Influence of kernel sharpness level (40-90) on quantitative parameters of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  31. Influence of radiation dose on quantitative parameters of the PCD-CCTA

    Influence of radiation dose (mGy) on quantitative parameters of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  32. Influence of the patients heart rate on quantitative parameters of the PCD-CCTA

    Influence of the patients maximum, minimum and average heart rate (1/min) on quantitative parameters of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  33. Influence of the acquisition type on quantitative parameters of the PCD-CCTA

    Influence of the acquisition type (Sequential, Spiral, Ultra-High Resolution, Spectral) on quantitative parameters of the PCD-CCTA

    Measured: during the PCD-CCTA examination

  34. Rates of patients undergoing further cardiac diagnostics

    Rates of patients undergoing further cardiac diagnostics, such as additional CT or Invasive Coronary Angiography (ICA), Electrocardiography (ECG), Exercise ECG, Echo, Stress Echo, Magnetic Resonance Imaging (MRI) within 3 months following PCD-CCTA (defined as: related to these tests) and more than 3 months after PCD-CCTA until follow-up (unrelated to these tests).

    Measured: 2 weeks after initial PCD-CCTA, 1-year follow-up, 2-year follow-up and final follow-up up to a max of 5 years

  35. Rates of patients undergoing cardiac interventions

    Cardiac interventions such as coronary revascularization by ICA, coronary artery bypass grafting (CABG), Valve replacement (operatively and interventional), other cardiothoracic surgeries, implantation of an cardioverter/defibrillator or cardiac resynchronization device, ablation, others

    Measured: 2 weeks after initial PCD-CCTA, 1-year follow-up, 2-year follow-up and final follow-up up to a max of 5 years

  36. Correlation and agreement of quantitative measurements from PCD-CCTA with ICA

    Correlation and agreement of percent diameter stenosis quantification by PCD-CCTA in comparison to quantitative assessment from ICA.

    Measured: ICA within 3 months of initial PCD-CCTA

  37. Correlation and agreement of non-invasive Fractional Flow Reserve from PCD-CCTA with invasive Fractional Flow Reserve from ICA

    Correlation and agreement of non-invasively estimated Fractional Flow Reserve by Computed Tomography with invasive Fractional Flow Reserve

    Measured: ICA within 3 months of initial PCD-CCTA

  38. Correlation and agreement of Percent diameter stenosis measurement from PCD-CCTA with Fractional Flow Reserve from ICA

    Correlation and agreement of stenosis quantification by PCD-CCTA and invasive Fractional Flow Reserve.

    Measured: ICA within 3 months of initial PCD-CCTA

  39. Correlation and agreement of Plaque composition assessment from PCD-CCTA with intracoronary techniques

    Correlation and agreement of Plaque composition assessment from PCD-CCTA in comparison to intracoronary techniques such as optical coherence tomography (OCT) in patients who had both tests done.

    Measured: ICA within 3 months of initial PCD-CCTA

  40. Correlation of quantitative PCD-CCTA parameters with the results of additional imaging ischemia tests

    Correlation of quantitative PCD-CCTA parameters with imaging ischemia tests in patients who had both PCD-CCTA and one of the following tests done: stress echo, stress Single Photon Emission Computed Tomography (SPECT), stress Positron Emission Tomography (PET), and stress MRI.

    Measured: Imaging ischemia tests within 3 months of initial PCD-CCTA

  41. Correlation of quantitative PCD-CCTA parameters with the results of additional other imaging tests

    Correlation of quantitative PCD-CCTA parameters with imaging tests in patients who had both PCD-CCTA and one of the following tests done: transthoracic echo, transesophageal echo, cardiac MRI.

    Measured: Imaging tests within 3 months of initial PCD-CCTA

  42. Patient management

    Recommended and actually performed management based on PCD-CCTA

    Measured: at baseline, 1-year follow-up, 2-year follow-up and final follow-up up to a max of 5 years

  43. Analysis of occurrence in Major Adverse Cardiac Events in subgroups

    Composite outcome: Analysis of occurrence in MACE as a secondary outcome in following subgroups:

    CT plaque characteristic groups: high risk versus other plaques versus no plaques; Plaque burden groups: P1 vs. P2 vs. P3 vs. P4 according to the CAD-RADS 2.0 classification; Gender: male versus female; Age: occurrence of MACE in patient a) under 45 years, b) between 45 and 65 years and c) over 65 years; BMI: Patients with BMI a) under 25, b) between 25 and 30 and c) over 30;

    Measured: at baseline, 1-year follow-up, 2-year follow-up and final follow-up up to a max of 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 May 2023
  2. Study start30 Jun 2023 (estimated)
  3. Primary completion30 Jun 2033 (estimated)
  4. Study completion30 Jun 2033 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
3,000 participants (estimated)
Target duration
5 Years
IDs, dates and publications
ClinicalTrials.gov ID
NCT05877768
Sponsor's protocol ID
PCD-CT Registry
Acronym
EPIPHANY
Status last verified
May 2023
First submitted
10 May 2023
Last updated
26 May 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Coronary Artery Disease, run by University Medical Center Mainz at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 26 May 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Tilman Emrich, MD (+49613117 ext. 7358, Tilman.Emrich@unimedizin-mainz.de), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Major Adverse Cardiac Events (time frame: From inclusion to a maximum follow-up of 5 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 May 2023.

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