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

Summary

The goal of this clinical trial is to evaluate whether a coronary computed tomography angiography (CTCA)-guided strategy can reduce the risk of death, heart attack, stroke, and hospital admissions in patients experiencing angina or myocardial infarction following coronary artery bypass graft (CABG) surgery. The main questions it aims to answer are: * Can CTCA reduce major adverse cardiovascular events compared to standard invasive coronary angiography? * Is CTCA a cost-effective and safer alternative that improves patient quality of life? Researchers will compare outcomes between patients receiving CTCA prior to angiography and those undergoing standard angiography alone to determine if CTCA improves clinical outcomes and procedural safety. Participants will: * Be randomly assigned to either CTCA-guided care or standard angiography * Undergo coronary imaging and follow-up assessments * Complete questionnaires on quality of life and healthcare resource use

Eligibility

Inclusion Criteria:

* Aged ≥18
* Previous coronary artery bypass grafting (CABG)
* An indication for coronary angiography

  * Angina
  * Ischaemia on perfusion imaging
  * Acute coronary syndrome
* Patients are able and willing to give their written informed consent

Exclusion Criteria:

* Subjects presenting with ST segment myocardial infarction within window for primary PCI
* Patients considered unsuitable to participate by the research team (e.g. due to medical reasons, laboratory abnormalities, or subject's unwillingness to comply with all study related procedures)
* Life expectancy less than 1 year

Conditions2

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