An interventional study of CTCA in Coronary Heart Disease, sponsored by Queen Mary University of London. Recruiting at 1 site in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-06-05.
Sponsored by Queen Mary University of London · Not applicable, Interventional, and Diagnostic
The goal of this clinical trial is to evaluate whether a coronary computed tomography angiography (CTCA)-guided strategy can reduce the risk of death, heart attack, stroke, and hospital admissions in patients experiencing angina or myocardial infarction following coronary artery bypass graft (CABG) surgery. The main questions it aims to answer are:
Participants will:
Patients with prior coronary artery bypass graft (CABG) surgery frequently present with recurrent angina or acute coronary syndromes due to progressive native coronary artery disease or graft failure. Invasive coronary angiography remains the standard diagnostic approach but is technically challenging in this population due to variable graft anatomy, leading to prolonged procedure times, increased radiation exposure, higher contrast volumes, and elevated risk of procedural complications.
Computed Tomography Coronary Angiography (CTCA) offers a non-invasive alternative with high diagnostic accuracy for graft patency and coronary anatomy. Prior observational data (e.g., BYPASS-CTCA study) suggest that CTCA performed prior to invasive angiography may improve procedural efficiency and safety. However, whether CTCA can guide clinical decision-making to avoid unnecessary angiography and improve long-term outcomes remains unproven.
This multi centre, randomised controlled trial will enrol 1,000 patients with prior CABG presenting with angina or myocardial infarction. Participants will be randomised to either a CTCA-guided strategy or standard care involving direct invasive coronary angiography. In the CTCA arm, angiography may be deferred if CTCA findings support medical management. The primary outcome is the composite rate of major adverse cardiovascular events (MACE), including death, myocardial infarction, stroke, and hospitalisation for unstable angina. Secondary outcomes include procedural metrics, patient-reported quality of life, cost-effectiveness, and healthcare resource utilization.
Clinical data will be collected through patient questionnaires, procedural records, and central registry downloads. The study incorporates patient and public involvement throughout its design and implementation. Results will be disseminated via peer-reviewed publications, public-facing reports, and digital platforms.
1,520 studies on the registry are indexed under Coronary Disease; 167 are open to participants now.
This study's planned enrollment of 1,000 is above the median of 160 across 778 interventional studies indexed under Coronary Disease.
Browse Coronary Disease studies →Queen Mary University of London is the lead sponsor of 253 studies on the registry; 58 are open to participants now.
Counted across the registry records on this site, refreshed daily.
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.
An indication for coronary angiography
Exclusion Criteria:
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.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Life expectancy
The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Invasive coronary angiogram (ICA) performed only.
Computed Tomography Cardiac Angiography (CTCA) with or without invasive coronary angiogram (ICA)
Diagnostic Test: CTCA
Computed Tomography Cardiac angiography (CTCA) performed prior to invasive coronary angiogram (ICA).
Also known as: Computed Tomography Cardiac angiography
Composite major adverse cardiovascular events (MACE): all-cause mortality, non-fatal stroke, non-fatal myocardial infarction, and cardiovascular hospitalisation
Clinical events will be assessed from randomisation until the final patient completes 6 months of follow-up. The composite endpoint includes all-cause mortality, non-fatal stroke, non-fatal myocardial infarction, and cardiovascular hospitalisation. Based on a 2-year recruitment period, individual follow-up will range from 0.5 to 2.5 years, with an estimated median follow-up of 18 months.
Time frame: Up to 2.5 years post-randomisation (median follow-up: 18 months)
Fluoroscopy time during coronary angiography
Unit of Measure: Minutes
Time frame: During coronary angiography procedure
Incidence of procedural complications during coronary angiography
Unit of Measure: Number of participants with event
Time frame: During coronary angiography procedure
Radiation dose during coronary angiography
Unit of Measure: Milligray (mGy)
Time frame: During coronary angiography procedure
Contrast dose administered during coronary angiography
Unit of Measure: Milliliters (mL)
Time frame: During coronary angiography procedure
Procedural duration during coronary angiography
Unit of Measure: Minutes Unit of Measure: Milliliters (mL)
Time frame: During coronary angiography procedure
Health-related quality of life (EQ-5D-5L)
Assessed using the EQ-5D-5L questionnaire at baseline and every 6 months during follow-up.
Time frame: Baseline, 6 months, 12 months, 18 months, and 24 months
Cost-effectiveness and productivity loss
Evaluated using patient questionnaires capturing healthcare resource use and productivity loss at baseline and every 6 months.
Time frame: Baseline and every 6 months during follow-up
Days alive and out of hospital
Total number of days the participant is alive and not admitted to hospital during the follow-up period. Unit of Measure: Days
Time frame: From randomisation until end of follow-up (up to 2.5 years)
Length of hospital stay
Cumulative duration of hospital admissions during the follow-up period Unit of Measure: Days
Time frame: From randomisation until end of follow-up (up to 2.5 years)
Major Adverse Cardiovascular Events (MACE) - Individual components
Cumulative duration of hospital admissions during the follow-up period Unit of Measure: Number of events
Time frame: From randomisation until end of follow-up (up to 2.5 years)
Composite two-point MACE (death and MI)
Includes death and myocardial infarction as a simplified composite cardiovascular endpoint.
Time frame: From randomisation until end of follow-up (up to 2.5 years)
Major Adverse Cardiovascular Events (MACE) - Cumulative incidence
Total number of MACE events per participant during the follow-up period. Unit of Measure: Number of events
Time frame: From randomisation until end of follow-up (up to 2.5 years)
Unplanned revascularisation
Number of unplanned coronary revascularisation procedures performed during follow-up. Unit of Measure: Number of procedures
Time frame: From randomisation until end of follow-up (up to 2.5 years)
Cardiovascular imaging utilisation
Number and type of cardiovascular imaging procedures performed during follow-up. Unit of Measure: Number of procedures
Time frame: From randomisation until end of follow-up (up to 2.5 years)
Plan to share: Yes — Data sharing available from corresponding author upon reasonable request and with approval from trial steering committee.
Supporting information: Study protocol
Time frame: 2028
Access criteria: Freely available via journal
No publications or documents are linked to this record.
Started Apr 2026 (actual). Primary completion is estimated for Jul 2029, 39 months after the start.
Of 178 non-industry interventional studies with no phase under Coronary Disease, half reached primary completion within 26 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 51. This study's planned 39 months is above that.
Counting every sponsor, half of 200 studies reached it within 25 months; a quarter within 14 and three quarters within 51.
How these figures are worked out, and which studies are left out of them.
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