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Predicting Plaque Growth Using Blood Flow Stress Markers: A Proof-of-Concept Study

Sponsor: Queen Mary University of London • ClinicalTrials.gov ID: NCT07864051

Registry updated: 2026-10-07

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Description

Coronary artery disease occurs when fatty deposits (plaques) build up inside the arteries that supply blood to the heart. Some plaques remain stable, while others continue to grow or become more likely to rupture, which can lead to a heart attack. Identifying plaques that are at higher risk of progression could help doctors provide earlier and more personalized treatment. The purpose of this study is to determine whether combining information about blood flow within the coronary arteries with information about a person's biological response to blood flow can improve prediction of plaque growth. Participants undergoing treatment for coronary artery disease will have a specialized heart scan to assess blood flow patterns around plaques in their coronary arteries. Researchers will also collect blood samples to study cells that line blood vessels and investigate how these cells respond to blood flow forces. The study will follow participants over time to determine whether plaques are more likely to progress in individuals who show a stronger biological response to abnormal blood flow. The findings may help researchers develop new ways to identify patients at higher risk of future heart problems and support the development of more personalized approaches to prevention and treatment of coronary artery disease.

Interventions

PCCTA scan (Procedure)
During the scans, the patient will be cardiac monitored using ECG synchronisation. PCCTA scan acquisition and parameters will follow Barts Health's standard operating procedures and institutional protocols.
Endothelial cell isolation from peripheral blood sample (Other)
A 50mL blood sample will be collected from consenting patients. The blood will be processed to isolate peripheral mononuclear cells. These cells will be cultured to support the growth of endothelial colony forming cells (ECFCs).

Eligibility criteria

Inclusion Criteria: 1. Age ≥40 2. Stable angina, defined as typical symptoms with evidence of reversible ischemia in non-invasive test and/or documented obstructive coronary artery disease on coronary angiography (\>70% stenosis of at least one major epicardial coronary artery or positive fractional flow reserve study) 3. Patient that is willing and can provide written informed consent. Exclusion Criteria: 1. Acute coronary syndrome within \<3 months 2. Estimated glomerular filtration rate (eGFR) \<60ml/min/1.73m² 3. Previous coronary artery bypass surgery 4. Decompensated heart failure, or left ventricular ejection fraction ≤30% 5. Patient allergic to contrast or cannot receive treatment with aspirin, heparin, or thienopyridines 6. Anticipated life expectancy \<2 years 7. Flow limiting coronary artery disease in the proximal segments of all the 3 epicardial coronaries 8. History of heart transplantation 9. Patient that requires surgical revascularization 10. Extensive coronary artery disease (i.e., multiple chronic total occlusions) or tortuous coronary anatomy that does not allow assessment of the coronary arteries with intravascular imaging 11. Pregnant women will be excluded. All women of childbearing potential will undergo a pregnancy risk assessment and a urine pregnancy test prior to the 12-month PCCTA scan, in line with standard clinical practice for all PCCTA scans.

Conditions

Coronary Artery Disease (CAD)

Locations

Queen Marys University London — London, United Kingdom

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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