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CompletedNCT02157662CAPIREUpdated Sep 18, 2023

GISSI Outliers CAPIRE

An observational study in Atherosclerosis, sponsored by Gruppo di Ricerca GISSI. Completed at 10 sites in 2 countries. Open to participants aged 45 Years to 75 Years. Per ClinicalTrials.gov, last updated 2023-09-18.

Sponsored by Gruppo di Ricerca GISSI · Observational

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
544
Ages
45 Years to 75 Years
Sex
All
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Study summary

The risk of developing clinical manifestations of ischemic heart disease is currently assessed by using integrated multifactorial prediction models based on the presence of non-modifiable risk factors, such as age, gender and a family history of early ischemic heart disease along with risk factors which are defined as conventional, such as arterial hypertension, hypercholesterolemia, cigarette smoking and diabetes mellitus.

However, if the relationship between risk factors and ischemic heart disease clinical manifestations shows some limitations, the relation between risk factors and the coronary atherosclerosis process underlying most ischemic syndromes seems to be even weaker.

In fact there is significant individual variability and the limits of such relationship are demonstrated by a non negligible number of subjects at the outliers of mean behaviour of the prediction model. At one outlier, in the presence of multiple risk factors, these subjects do not develop neither coronary events nor coronary atherosclerosis whereas, at the other, coronary events and disease occur in the absence of risk factors.This study aims at detecting new protection and susceptibility factors, thus enabling to formulate new etiopathogenetic hypotheses concerning coronary atherosclerosis and to identify new therapeutic targets.

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Conditions studied

  • Atherosclerosis

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In context

Atherosclerosis

1,567 studies on the registry are indexed under Atherosclerosis; 264 are open to participants now.

This study's enrollment of 544 is above the median of 223 across 571 observational studies indexed under Atherosclerosis.

Browse Atherosclerosis studies →

Lead sponsor

Gruppo di Ricerca GISSI is the lead sponsor of 4 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
45 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

Male and female subjects between 45 and 75 years old who, in the absence of any previous clinical manifestations of ischemic heart disease, will undergo coronary arteries study.

Inclusion criteria

  • Group A: subjects with total absence of coronary atherosclerosis and 3 or more risk factors (reported by the subject or documented at the MDCT)
  • Group B: subjects with diffuse coronary atherosclerosis extended to more than 5 of the 16 segments according to the American Heart Association classification and 0-1 risk factor (reported by the subject or documented at the MDCT) with the exclusion of patients with type 1 or type 2 diabetes mellitus as single risk factor.

Using the same criteria, two control populations will be selected, with a case:control 1:1 ratio, consisting in:

  • Group C: subjects with total absence of coronary atherosclerosis and 0-1 risk factor (reported by the subject or documented at the MDCT)
  • Group D: subjects with diffuse coronary atherosclerosis extended to more than 5 of the 16 segments according to the American Heart Association classification and 3 or more risk factors (reported by the subject or documented at the MDCT) with the exclusion of patients with type 1 or type 2 diabetes mellitus as single risk factor.

Exclusion criteria

Exclusion Criteria:

  • common contraindications to MDCT (chronic renal failure with serum creatinine > 2.0 mg/dl, suspected pregnancy, arrhythmias, body mass index > 40, allergy to iodized contrast agent).
  • previous cardiovascular events (heart failure, acute myocardial infarction, unstable angina, chronic stable angina, previous percutaneous or surgery coronary revascularization) both clinically evident and found by conventional diagnostic methods previous performed.
  • subjects which MDCT does not meet the quality control criteria defined below in the protocol.
  • patients with previous documented or identified at the moment of MDCT such as dilated cardiomyopathy regardless of etiology, obstructive hypertrophic cardiomyopathy, atrial fibrillation, myocarditis and inflammatory vascular disease.
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Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
544 participants (actual)
Patient registry
No
Biospecimen retention
Samples with dna

Groups and cohorts

  • No coronary disease and risk factors >=3
  • Coronary disease and risk factors 0-1

    Diffuse coronary atherosclerosis extended to more than 5 of the 16 segments according to the American Heart Association classification38 and 0-1 risk factor (reported by the subject or documented at the MDCT) with the exclusion of patients with type 1 or type 2 diabetes mellitus as single risk factor.

  • No coronary disease and risk factors 0-1
  • Coronary disease and risk factors >=3

    Subjects with diffuse coronary atherosclerosis extended to more than 5 of the 16 segments according to the American Heart Association classification38 and 3 or more risk factors (reported by the subject or documented at the MDCT) with the exclusion of patients with type 1 or type 2 diabetes mellitus as single risk factor

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What researchers measure

Primary outcomes

  1. Number of patients in each Group with a cardiovascular Event

    Time frame: 5 years

Secondary outcomes

  1. Polymorphisms associated with chromosome 9 in each patient

    Time frame: At enrollment visit

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Study locations

10 sites
  • Nuovo Ospedale Versilia - SC Cardiologia
    Lido Di Camaiore, Lucca, Italy
  • Ospedale Santa Croce - U.O.C. Cardiologia
    Fano, PU, Italy
  • Ospedale Civile Augusto Murri - U.O. Cardiologia
    Fermo, Italy
  • IFC CNR - Ospedale Pasquinucci - U.O. Cardiologia Adulti
    Massa, Italy
  • Ospedale Policlinico - Divisione di Cardiologia
    Modena, Italy
  • Az. Ospedaliera Universitaria di Parma - U.O. Cardiologia
    Parma, Italy
  • Azienda Ospedaliero Universitaria Pisana - U.O. Radiodiagnostica I
    Pisa, Italy
  • IFC CNR Fondazione Toscana G. Monasterio - S.A. Emodinamica
    Pisa, Italy
  • AOU Santa Maria della Misericordia - Angiografia e Radiologia Interventistica
    Udine, Italy
  • Cardiocentro Ticino - SRC
    Lugano, Switzerland
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References and documents

Publications

  • Magnoni M, Andreini D, Gorini M, Moccetti T, Modena MG, Canestrari M, Berti S, Casolo G, Gabrielli D, Marraccini P, Pontone G, Masson S, Latini R, Maggioni AP, Maseri A; CAPIRE Study Group. Coronary atherosclerosis in outlier subjects at the opposite extremes of traditional risk factors: Rationale and preliminary results of the Coronary Atherosclerosis in outlier subjects: Protective and novel Individual Risk factors Evaluation (CAPIRE) study. Am Heart J. 2016 Mar;173:18-26. doi: 10.1016/j.ahj.2015.11.017. Epub 2015 Dec 17. PubMed 26920592 ↗
  • Magnoni M, Masson S, Andreini D, Moccetti T, Modena MG, Canestrari M, Berti S, Casolo G, Gabrielli D, Marraccini P, Pontone G, Latini R, Maggioni AP, Maseri A; CAPIRE Study Group. Usefulness of High-Sensitivity Cardiac Troponin T for the Identification of Outlier Patients With Diffuse Coronary Atherosclerosis and Low-Risk Factors. Am J Cardiol. 2016 May 1;117(9):1397-404. doi: 10.1016/j.amjcard.2016.02.002. Epub 2016 Feb 17. PubMed 26976791 ↗
  • Andreini D, Magnoni M, Conte E, Masson S, Mushtaq S, Berti S, Canestrari M, Casolo G, Gabrielli D, Latini R, Marraccini P, Moccetti T, Modena MG, Pontone G, Gorini M, Maggioni AP, Maseri A; CAPIRE Investigators. Coronary Plaque Features on CTA Can Identify Patients at Increased Risk of Cardiovascular Events. JACC Cardiovasc Imaging. 2020 Aug;13(8):1704-1717. doi: 10.1016/j.jcmg.2019.06.019. Epub 2019 Aug 14. PubMed 31422137 ↗
  • Ferrannini G, Manca ML, Magnoni M, Andreotti F, Andreini D, Latini R, Maseri A, Maggioni AP, Ostroff RM, Williams SA, Ferrannini E. Coronary Artery Disease and Type 2 Diabetes: A Proteomic Study. Diabetes Care. 2020 Apr;43(4):843-851. doi: 10.2337/dc19-1902. Epub 2020 Jan 27. Erratum In: Diabetes Care. 2021 Apr;44(4):1071. doi: 10.2337/dc21-er04a. PubMed 31988066 ↗
  • Conte E, Andreini D, Magnoni M, Masson S, Mushtaq S, Berti S, Canestrari M, Casolo G, Gabrielli D, Latini R, Marraccini P, Moccetti T, Modena MG, Pontone G, Gorini M, Maggioni AP, Maseri A; CAPIRE Investigators, Steering Committee; Imaging Core Laboratory; Centralized biobank and biomarker core laboratory; Central ECG Reading; Psychologists CRF Group; Participating Centers and Investigators. Association of high-risk coronary atherosclerosis at CCTA with clinical and circulating biomarkers: Insight from CAPIRE study. J Cardiovasc Comput Tomogr. 2021 Jan-Feb;15(1):73-80. doi: 10.1016/j.jcct.2020.03.005. Epub 2020 Jun 11. PubMed 32563713 ↗
  • Ferrannini E, Manca ML, Ferrannini G, Andreotti F, Andreini D, Latini R, Magnoni M, Williams SA, Maseri A, Maggioni AP. Differential Proteomics of Cardiovascular Risk and Coronary Artery Disease in Humans. Front Cardiovasc Med. 2022 Feb 4;8:790289. doi: 10.3389/fcvm.2021.790289. eCollection 2021. PubMed 35187107 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 18, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02157662
Lead sponsor
Gruppo di Ricerca GISSI
Responsible party
Sponsor
First posted
Jun 6, 2014
Start date
Jan 2011
Primary completion
Jul 2013
Completion
Sep 13, 2023
Last update
Sep 18, 2023

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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