Bern Intracoronary Optical Coherence Tomography and Coronary Computed Tomography Angiography Registry

Official title

Bern Intarcoronary Optical Coherence Tomography and Coronary Computed Tomography Angiography Registry

Overview

Bern Intracoronary Optical Coherence Tomography and Coronary Computed Tomography Angiography Registry (BIOCORE) is a systematic institutional registry on patients undergoing paired CCTA and OCT for validation and development of advanced methods to determine coronary plaque morphology, lesion severity, PCI guidance, and it association with long-term clinical outcomes.

Detailed description

Intracoronary imaging represents the current gold standard for in-vivo assessment of plaque morphology and guidance of percutaneous coronary intervention (PCI). However, coronary computed tomography angiography (CCTA) plays an increasingly important role in the diagnostic pathway of CAD and represents a non-invasive procedure with wide availability, relatively low costs, and low radiation dose. Owing to its recent technical advances with the introduction of photon-counting CT with higher spatial resolution and diagnostic accuracy as compared to conventional CCTA, as well as recently developed artificial intelligence (AI)-guided analysis softwares, CCTA has the potential to provide more and more clinically essential information about coronary artery disease (CAD) with respect to plaque composition, lesion severity, need for intervention, and periprocedural planning that has traditionally been restricted to invasive coronary angiography and intracoronary imaging. Therefore, there is a timely need for systematic evaluation of advanced CCTA techniques against invasive gold standards. Furthermore, studies comparing CCTA to optical coherence tomography (OCT), the gold standard for plaque phenotyping, are scarce to date. Also, traditional treatment concepts of CAD that are based on obstructive stenosis and ischemia are currently challenged by an increasing body of evidence demonstrating the prognostic impact of plaque burden and composition independent of flow-limitation. Plaque burden and composition may emerge as the next treatment target in CAD. Therefore, the investigators established a systematic institutional registry on patients undergoing paired CCTA and OCT for validation and development of advanced methods to determine coronary plaque morphology, lesion severity, PCI guidance, and it association with long-term clinical outcomes.

Primary outcome measures

• Diagnostic accuracy in plaque phenotyping CCTA vs. OCT [Time frame: Baseline]
• PCI planning with CCTA vs. gold standard OCT [Time frame: Baseline]
• Photon-counting vs. conventional CCTA [Time frame: Baseline]

Eligibility criteria

Inclusion criteria

• ≥18 years of age
• Written informed consent
• CCTA within 3 months from invasive coronary angiography and OCT
• At least one vessel with ≥50% diameter stenosis on CCTA
• OCT performed in native coronary arteries (i.e. pre-PCI or no PCI)

Exclusion criteria

• CCTA performed more than 3 months from OCT
• Poor OCT quality
• Poor CCTA quality
• Coronary anomalies
• Prior PCI or CABG in the vessel imaged with OCT

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model

Cohort

Study locations

Switzerland · 1 center

• Department of Cardiology, Bern University Hospital Inselspital — Bern

Publications

• Raber L, Ueki Y, Otsuka T, Losdat S, Haner JD, Lonborg J, Fahrni G, Iglesias JF, van Geuns RJ, Ondracek AS, Radu Juul Jensen MD, Zanchin C, Stortecky S, Spirk D, Siontis GCM, Saleh L, Matter CM, Daemen J, Mach F, Heg D, Windecker S, Engstrom T, Lang IM, Koskinas KC; PACMAN-AMI collaborators. Effect of Alirocumab Added to High-Intensity Statin Therapy on Coronary Atherosclerosis in Patients With Ac PMID 35368058
• Bar S, Knuuti J, Saraste A, Nurmohamed NS, Jukema RA, Klen R, Bax JJ, Knaapen P, Danad I, Maaniitty T. Outcomes with revascularization vs. medical therapy according to plaque burden from coronary computed tomography angiography. Eur Heart J Cardiovasc Imaging. 2026 Feb 27;27(3):554-566. doi: 10.1093/ehjci/jeaf372. PMID 41460775
• Bar S, Knuuti J, Saraste A, Klen R, Kero T, Nabeta T, Bax JJ, Danad I, Nurmohamed NS, Jukema RA, Knaapen P, Maaniitty T. Derivation and validation of an artificial intelligence-based plaque burden safety cut-off for long-term acute coronary syndrome from coronary computed tomography angiography. Eur Heart J Cardiovasc Imaging. 2025 Jun 30;26(7):1163-1173. doi: 10.1093/ehjci/jeaf121. PMID 40243706
• Sandoval Y, Leipsic JA, Collet C, Ali ZA, Azzalini L, Barbato E, Cavalcante JL, Costa RA, Garcia-Garcia HM, Jones DA, Khoo JK, Maran A, Nieman K, Pinilla-Echeverri N, Seto AH, Shlofmitz E, Brilakis ES. Coronary Computed Tomography Angiography to Guide Percutaneous Coronary Intervention: Expert Opinion from a SCAI/SCCT Roundtable. J Soc Cardiovasc Angiogr Interv. 2025 May 1;4(6):103664. doi: 10.101 PMID 40630246
• Williams MC, Kwiecinski J, Doris M, McElhinney P, D'Souza MS, Cadet S, Adamson PD, Moss AJ, Alam S, Hunter A, Shah ASV, Mills NL, Pawade T, Wang C, Weir McCall J, Bonnici-Mallia M, Murrills C, Roditi G, van Beek EJR, Shaw LJ, Nicol ED, Berman DS, Slomka PJ, Newby DE, Dweck MR, Dey D. Low-Attenuation Noncalcified Plaque on Coronary Computed Tomography Angiography Predicts Myocardial Infarction: Res PMID 32174130
• Nieman K, Garcia-Garcia HM, Hideo-Kajita A, Collet C, Dey D, Pugliese F, Weissman G, Tijssen JGP, Leipsic J, Opolski MP, Ferencik M, Lu MT, Williams MC, Bruining N, Blanco PJ, Maurovich-Horvat P, Achenbach S. Standards for quantitative assessments by coronary computed tomography angiography (CCTA): An expert consensus document of the society of cardiovascular computed tomography (SCCT). J Cardiova PMID 38849237

Identifiers

NCT: NCT07565805 · 2025-01507 · FF25040 · 84802808

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗