The goal of this prospective study is to evaluate the role of cardiovascular magnetic resonance (CMR) in patients with suspected non-ST elevation myocardial infarction (NSTEMI). The main endpoint is the reclassification rate, defined as the number of patients in whom the information provided by pre-angiography CMR affects the revascularization strategy or the final diagnosis. Participants will undergo to CMR before invasive coronary angiography (ICA).
All patients with NSTEMI eligible for the study undergo CMR prior to ICA. To avoid any delay in patients' treatment all examination will be analyzed by local trained staff at each center. All patients will thereafter undergo ICA and the standard of care (SOC) decision-making on revascularization strategy and diagnosis will be declared by the treating physician, which will be blinded to the participation of the patients in the study and about CMR results. The treating physician will also declare patient's next management according to ICA results. After having declared the diagnosis, the treating physician will then be informed about the CMR findings. Therefore, according to CMR results the treating physician may eventually modify the initial diagnosis and management. Treatment plan modifications include difference in the identification of the culprit lesion, referring the patient to medical therapy instead of a revascularization procedure or viceversa, switching from a percutaneous to a surgical revascularization procedure or viceversa, or need for further cardiac or non-cardiac investigations. Initial diagnosis includes confirmed NSTEMI or all other possible alternative diagnosis and proposed additional diagnostic examination(s) for further differential diagnosis. The CMR-modified SOC (CMR-SOC) and diagnosis made considering CMR results will be collected.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
120
All NSTEMI patients will undergo to CMR before invasive coronary intervention.
Istituto Cardiocentro Ticino
Lugano, Canton Ticino, Switzerland
RECRUITINGReclassification rate
number of patients in whom the information provided by CMR affects the final diagnosis
Time frame: immediately after invasive coronary angiography
Culprit lesion identification
ability of CMR to detect culprit lesion
Time frame: during invasive coronary angiography
Revascularization strategy
number of patients in whom CMR affects the revascularization strtegy
Time frame: immediately after invasive coronary angiography
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