A Multi-Centre, Randomised Trial Assessing the Value of Computed Tomography Coronary Angiography Prior to Invasive Coronary Angiography in Patients With Previous Coronary Artery Bypass Grafts in Reducing Cardiac Events

What this Trial Is About

This research aims to evaluate whether using coronary computed tomography angiography (CTCA) before invasive coronary angiography can reduce the risk of death, heart attack, stroke, and hospital admissions in patients who have had coronary artery bypass graft (CABG) surgery and now experience angina or myocardial infarction. The study compares CTCA-guided care to standard invasive angiography to see if CTCA improves patient outcomes, safety, and cost-effectiveness in a multi-centre, randomized trial involving 1,000 patients. Participants will be randomly assigned to either receive CTCA prior to invasive coronary angiography or undergo standard invasive angiography alone. In the CTCA group, angiography may be avoided if the CTCA findings support medical management. The study includes two groups: one undergoing invasive coronary angiogram only, and the other undergoing CTCA with or without invasive angiogram as needed. The trial will follow patients for up to 2.5 years to assess various health outcomes. Throughout the study, participants will have coronary imaging and regular follow-up assessments. They will complete questionnaires on quality of life and healthcare resource use at multiple time points. Researchers will collect clinical data from patient questionnaires, procedural records, and central registries to measure major adverse cardiovascular events (MACE), procedural safety, radiation exposure, hospital stay length, and cost-effectiveness. The median follow-up is 18 months, with a maximum of 2.5 years for outcome tracking.

CTCA Prior to Invasive Angiography in Post-Bypass Patients (BYPASS CTCA 2)