Markers of Coronary Artery Disease During Exercise Testing

Oslo University Hospital327 enrolled

Overview

The main purpose of this study is to examine whether changes in biomarkers during exercise are related to coronary artery disease demonstrated by coronary angiography or echocardiography.

Chest pain/discomfort is a common patient complaint in patients referred to outpatient clinics and emergency departments. The initial goal of evaluation is to exclude potential life threatening conditions like coronary artery disease. Exercise stress testing is a widely available non-invasive test in patients with chest pain and suspected coronary artery disease. However, the sensitivity and specificity of the test is relatively low. Exercise seems to cause an increase in the secretion of B-type natriuretic peptide (BNP), and myocardial ischemia may lead to an even more pronounced increase. Investigators aim to examine whether changes in bloodborne biomarkers such as NT-pro-BNP during exercise may improve the accuracy of exercise stress testing in patients with chest pain/discomfort and a clinical suspicion of coronary artery disease. Also, investigators aim to examine whether changes in biomarkers during exercise are related to cardiac disease demonstrated by echocardiography. It is known that sudden heavy physical load can trigger myocardial infarction, especially in untrained individuals. The underlying mechanisms are poorly understood and may partly be related to changes in inflammation and haemostasis in patients with coronary artery disease. By measuring markers of inflammation and haemostasis during exercise stress testing, investigators hope to gain new insights into mechanisms responsible for exercise-related myocardial infarction. Investigators also aim to do a follow-up study to investigate whether results of the initial examinations can relate to future risk of cardiovascular morbidity and mortality.

Study Type

OBSERVATIONAL

Enrollment

327

Conditions

Coronary Artery Disease Cardiovascular Disease

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion criteria * Patients referred to Oslo University Hospital Ullevål with chest pain/discomfort of unknown etiology and and a clinical suspicion of coronary artery disease. * Intermediate or high pre test probability of coronary artery disease. * Able to give informed, written consent. Exclusion criteria * Not able to perform the exercise test. * Evidence of acute coronary syndrome. * Known coronary artery stenosis where exercise testing is contraindicated. * The presence of known moderate to severe valvular heart disease. * Known heart failure or obvious clinical signs of heart failure. * Ongoing atrial fibrillation or atrial flutter. * Complete or partial bundle branch block. * Digitoxin therapy. * Pacemaker. * Renal insufficiency (S-creatinine \>150 micromol/L). * Known pregnancy.

Locations (1)

Oslo University Hospital

Oslo, Norway

Outcomes

Primary Outcomes

Coronary artery disease demonstrated by coronary angiography

Time frame: baseline

Secondary Outcomes

Future cardiovascular morbidity and mortality

Investigators aim to do a follow-up study some years after enrollment to examine whether the results of the initial examinations can relate to future cardiovascular morbidity or mortality.

Time frame: Up to 29 years

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.