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CompletedNCT05231161UZ ClearUpdated Feb 9, 2022

Diagnostic Performance of Exercise Stress Tests for the Detection of Epicardial and Microvascular Coronary Artery Disease

An observational study in Coronary Artery Disease, sponsored by Onze Lieve Vrouw Hospital. Completed at 1 site in Belgium. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2022-02-09.

Sponsored by Onze Lieve Vrouw Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
114
Ages
18 Years to 80 Years
Sex
All
01

Study summary

Prospective, single-arm, multicenter study of patients with an intermediate pre-test probability of CAD and positive exercise stress tests referred for invasive angiography. Patients underwent an invasive diagnostic procedure (IDP) with measurement of fractional flow reserve (FFR) and index of microvascular resistance (IMR) in at least one coronary vessel. The objective was to determine the false discovery rate (FDR) of cardiac exercise stress tests with both FFR and IMR as references.

Read the detailed description

The Redefining the Diagnostic Performance of Non-invasive Tests for the Detection of Coronary Artery Disease: UZ Clear is an investigator-initiated, single-arm, multicenter, prospective study of patients presenting with chest pain with an intermediate probability of CAD. The intermediate pre-test probability of CAD was defined based on the European Society of Cardiology Guidelines as a score between 15% and 85% based on age, sex, and the nature of symptoms. All patients had a positive exercise stress test and were referred for an invasive evaluation. Patients underwent a study protocol with an invasive diagnostic procedure (IDP) consisting of measurements of FFR and IMR in at least one coronary vessel. Exclusion criteria are acute coronary syndromes, known coronary artery disease, previous myocardial infarction, previous revascularization, and abnormal baseline electrocardiogram (ECG). All data were centrally collected and analyzed by the core laboratory.

The primary objective was to determine the false discovery rate of exercise stress tests using an interventional diagnostic procedure (IDP) with indexes of epicardial (FFR) and microvascular resistance (IMR) as clinical references. The secondary objective was to assess the impact of an IDP accounting for the presence of CMD on the accuracy of exercise stress tests.

02

Conditions studied

  • Coronary Artery Disease
03

In context

Coronary Artery Disease

4,857 studies on the registry are indexed under Coronary Artery Disease; 890 are open to participants now.

This study's enrollment of 114 is below the median of 320 across 1,687 observational studies indexed under Coronary Artery Disease.

Browse Coronary Artery Disease studies →

Lead sponsor

Onze Lieve Vrouw Hospital is the lead sponsor of 20 studies on the registry; 1 is open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Sampling method
Probability sample

Study population

Stable patients suspected of having coronary artery disease based on the presence of stable angina-like chest pain

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

    1. Stable angina-like chest pain (typical or atypical) with intermediate (15-85%) pre-test probability of coronary artery disease using the ESC criteria.
  1. Positive non-invasive exercise test, or inconclusive stress with additional positive imaging.

Exclusion criteria

Exclusion Criteria:

  1. Age \<30 or >80-year old
  2. Acute coronary syndromes.
  3. Known coronary artery disease
  4. Inability to perform exercise tests.
  5. Previous myocardial infarction.
  6. Previous CABG/PCI
  7. Left ventricular dysfunction EF \<35% or class III-IV
  8. Uncontrolled or recurrent ventricular tachycardia
  9. Atrial fibrillation
  10. Severe renal dysfunction, defined as an \<30 ml/min/1.73m2
  11. to adenosine (e.g. asthma bronchial, severe )
  12. Active cancer
  13. Recent stroke
  14. Cardiomyopathy (dilated, hypertrophic, amyloidosis, arrhythmogenic right ventricular dysplasia)
  15. Left Bundle Branch Block or baseline ST-segment depression >1mm.
  16. Congenital heart disease
  17. More than moderate valve disease
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
114 participants (actual)
Target follow-up
12 Months
Patient registry
Yes

Interventions

  • Diagnostic testIndex of Microvascular Resistance

    The invasive diagnostic procedure will be performed in at least one coronary artery. The left anterior descending coronary artery will be the preferred target vessel; however, if technical factors precluded guidewire-based assessment of this artery (e.g., tortuous anatomy), then the left circumflex or right coronary artery can be selected. In the case of multiple measurements per patient, the lowest FFR or highest IMR will be used for analysis. A coronary wire with a pressure and temperature sensor (PressureWire X, Abbott Vascular, Santa Clara, CA, USA) will be advanced to the mid to distal segment of the coronary artery. Bolus thermodilution technique with three 3-cc saline injections in rest and hyperemia will be used.

    Also known as: Fractional Flow Reserve

06

What researchers measure

Primary outcomes

  1. The primary objective was to determine the false discovery rate of exercise stress tests using an interventional diagnostic procedure (IDP) with indexes of epicardial (FFR) and microvascular resistance (IMR) as clinical references.

    Diagnostic performance of exercise tests with false discovery rate

    Time frame: Immediately post-procedural

Secondary outcomes

  1. to assess the impact of an IDP accounting for the presence of CMD on the accuracy of exercise stress tests.

    Comparison of false discovery rates using QCA, FFR and IMR as gold standards

    Time frame: Immediately post-procedural

07

Study locations

1 site
  • OLV Aalst
    Aalst, Oost Vlanderen 9300, Belgium
08

References and documents

Individual participant data

Plan to share: No — Sharing of IPD is not foressen

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 9, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05231161
Lead sponsor
Onze Lieve Vrouw Hospital
Collaborators
Centro Cardiologico Monzino
Responsible party
Carlos Collet (Co-director Cardiovascular Center OLV Aalst, Onze Lieve Vrouw Hospital) — Principal investigator
First posted
Feb 9, 2022
Start date
Dec 1, 2019
Primary completion
Nov 1, 2021
Completion
Dec 31, 2021
Last update
Feb 9, 2022

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jan 2022. You cannot join it, but the record below documents what was studied.

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