Cardiovasc Imaging Asia.
2020 Apr;4(2):45-50. 10.22468/cvia.2020.00031.
Study Design and Rationale of Cardiac Computed Tomography Angiography and MRI in Patients with Type 2 Diabetes for Detection of Unrecognized Myocardial Scar in Subclinical Coronary Atherosclerosis (ACCREDIT Study)
- Affiliations
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- 1Department of Radiology and Research Institution of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 2Department of Radiology, Wonju Severance Christian Hospital, Yonsei Wonju College of Medicine, Wonju, Korea
- 3Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- 4Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- 5Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
- 6Department of Radiology, Seoul National University Hospital, Seoul, Korea
- KMID: 2502250
- DOI: http://doi.org/10.22468/cvia.2020.00031
Abstract
Objective
Cardiac computed tomography angiography (CCTA) allows the detection of subclinical coronary artery disease (CAD) CAD and delayed-enhancement cardiac magnetic resonance imaging (DE-CMR) enables the diagnosis of occult myocardial scar (OMS). The main objectives of the Assessment with CCTA and MRI in Asymptomatic Patients with Type 2 Diabetes for Detection of Unrecognized Myocardial Scar in Subclinical Coronary Atherosclerosis (ACCREDIT) study are to prospectively investigate the prevalence of OMS on DE-CMR images in asymptomatic patients with type 2 DM and to assess its correlation with subclinical CAD detected by CCTA.
Materials and Methods
This prospective, open-label, non-randomized, fixed-sequence and multicenter study aims to enroll 340 patients with type 2 DM and at least two identified cardiac risk factors, but without chest pain or history of coronary disease. CMR and CCTA examinations will be performed. Patient follow-up will take place over a 5-year period in order to assess the occurrence of major adverse cardiac events (MACE) and cardiac emergent significant diseases (ESD). The prevalence of OMS will be calculated based on the DE-CMR examination. For each main coronary artery, the degree of stenosis, plaque characteristics and the coronary artery calcium score will be determined by CCTA. The prognostic value of OMS on DE-CMR images and subclinical atherosclerosis detected by CCTA for occurrence of MACE and cardiac ESD will be assessed.
Conclusion
The ACCREDIT study will determine the prevalence of OMS and assess the prognostic value of OMS on DE-CMR images and subclinical CAD detected by CCTA in asymptomatic patients with type 2 DM.
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