title: Computed tomographic coronary angiography for patients with heart failure (CTA-HF): a randomized controlled trial (IMAGE HF Project 1-C).
abstract: BACKGROUND
  The prevalence of heart failure (HF) is rising in industrialized and developing countries. Though invasive coronary angiography (ICA) remains the gold standard for anatomical assessment of coronary artery disease in HF patients, alternatives are being sought. Computed tomographic coronary angiography (CTA) has emerged as an accurate non-invasive diagnostic tool for coronary artery disease (CAD) and has been demonstrated to have prognostic value. Whether or not CTA can be used in HF patients is unknown. Acknowledging the aging population, the growing prevalence of HF and the increasing financial burden of healthcare, we need to identify non-invasive diagnostic tests that are available, safe, accurate and cost-effective.
  
  
  METHODS
  The proposed study aims to provide insight into the efficacy of CTA in HF patients. A multicenter randomized controlled trial will enroll 250 HF patients requiring coronary anatomical definition. Enrolled patients will be randomized to either CTA or ICA (n = 125 per group) as the first test to define coronary anatomy. The primary outcomes will be collected to determine downstream resource utilization. Secondary outcomes will include the composite clinical events and major adverse cardiac events. In addition, the accuracy of CTA for detecting coronary anatomy and obstruction will be assessed in patients who subsequently undergo both CTA and ICA. It is expected that CTA will be a more cost-effective strategy for diagnosis: yielding similar outcomes with fewer procedural risks and improved resource utilization.
  
  
  BACKGROUND
  ClinicalTrials.gov, NCT01283659. Team grant #CIF 99470.
authors.affiliation: Department of Medicine, Division of Cardiology, (including Cardiac Imaging, The Heart Failure Program, and the Cardiac ResearchMethods Centre), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada. bchow@ottawaheart.ca.
authors.forename: Benjamin J W
authors.initials: BJ
authors.lastname: Chow
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Green
authors.forename: Doug
authors.initials: D
authors.lastname: Coyle
authors.forename: Mika
authors.initials: M
authors.lastname: Laine
authors.forename: Helena
authors.initials: H
authors.lastname: Hanninen
authors.forename: Hanna
authors.initials: H
authors.lastname: Leskinen
authors.forename: Miroslav
authors.initials: M
authors.lastname: Rajda
authors.forename: Eric
authors.initials: E
authors.lastname: Larose
authors.forename: Juha
authors.initials: J
authors.lastname: Hartikainen
authors.forename: Marja
authors.initials: M
authors.lastname: Hedman
authors.forename: Lisa
authors.initials: L
authors.lastname: Mielniczuk
authors.forename: Eileen
authors.initials: E
authors.lastname: O'Meara
authors.forename: Robert A
authors.initials: RA
authors.lastname: deKemp
authors.forename: Ran
authors.initials: R
authors.lastname: Klein
authors.forename: Ian
authors.initials: I
authors.lastname: Paterson
authors.forename: James A
authors.initials: JA
authors.lastname: White
authors.forename: Seppo
authors.initials: S
authors.lastname: Yla-Herttuala
authors.forename: Alex
authors.initials: A
authors.lastname: Leber
authors.forename: Vikas
authors.initials: V
authors.lastname: Tandon
authors.forename: Ting
authors.initials: T
authors.lastname: Lee
authors.forename: Abdul
authors.initials: A
authors.lastname: Al-Hesayen
authors.forename: Renee
authors.initials: R
authors.lastname: Hessian
authors.forename: Taylor
authors.initials: T
authors.lastname: Dowsley
authors.forename: Malek
authors.initials: M
authors.lastname: Kass
authors.forename: Cathy
authors.initials: C
authors.lastname: Kelly
authors.forename: Linda
authors.initials: L
authors.lastname: Garrard
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tardif
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
authors.forename: Rob S
authors.initials: RS
authors.lastname: Beanlands
authors.forename: George A
authors.initials: GA
authors.lastname: Wells
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D003625:Data Collection; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D017063:Outcome Assessment, Health Care; D018401:Sample Size; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods*