Study Comparing Best Medical Therapy Alone Versus Best Medical Therapy Plus Coronary CT and FFRct in Patients Over 50 After Carotid Artery Revascularization

What this Trial Is About

Researchers are investigating whether adding selective coronary revascularization based on coronary CT angiography CTA and fractional flow reserve derived from CT FFRct to best medical therapy BMT can reduce heart-related problems and improve survival in patients with carotid artery stenosis CAS who have no known coronary artery disease CAD. This study focuses on patients who have had successful carotid artery revascularization and compares outcomes between those treated with BMT alone and those receiving BMT plus selective coronary revascularization guided by FFRct assessment. Participants are randomly assigned within 14 days after carotid revascularization to either BMT alone or BMT plus coronary CTA and FFRct analysis. Those in the CTA-FFRct group undergo a coronary CT scan to assess the significance of coronary artery lesions. Results from this analysis help doctors decide if coronary revascularization percutaneous coronary intervention or bypass surgery is needed and is recommended within 3 months of randomization. The study includes clinical follow-up visits at 6 months, 1 year, and 2 years, with additional long-term follow-up planned up to 5 years. During the study, participants will have assessments including coronary CT scans, FFRct analysis, and clinical evaluations to monitor heart-related events and survival. An independent committee reviews all outcome events without knowing patient group assignments. The main outcome measured is major adverse cardiac events over 2 years. Participants receive post-operative best medical therapy, and their health is closely monitored throughout the follow-up period to evaluate the impact of adding coronary imaging and possible revascularization.

Selective Coronary Revascularization in Carotid Artery Disease Patients After Carotid Revascularization (SCORECAD Trial)