Resting Full-cycle Flow Ratio (RFR) Versus Angiography to Guide Revascularization Strategy in Patients Undergoing Coronary Artery By-pass Grafting (CABG) (RFR-CABG)
Resting Full-cycle Flow Ratio (RFR) Versus Angiography to Guide Revascularization Strategy in Patients Undergoing Coronary Artery By-pass Grafting (CABG): RFR-CABG Trial
Different trials have shown that fractional flow reserve (FFR) could successfully guide revascularization in patients undergoing percutaneous coronary intervention (PCI).
It is conceivable that a similar revascularization guidance could be useful also for surgical revascularization i.e. coronary by-pass graft (CABG). Experience learns that grafts placed on vessels with hemodynamically non-significant stenosis often occlude due to competitive antegrade flow.
Resting full-cycle Flow Ratio (RFR) is a measurement performed to evaluate the hemodynamic severity of coronary stenosis. Differently from FFR which is a measurement performed in maximal hyperemia, the RFR is a measurement that is performed in rest and therefore may predict better than FFR the baseline equilibriums that could lead to graft failure, while it has similar capacity to identify hemodynamically significant stenosis as FFR. It is unknown whether RFR guided CABG revascularization is superior as compared to angiography alone.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Prof. E. Kedhi, MD, PhD
- Phone Number: +31 384262999
- Email: ekedhi@me.com
Study Contact Backup
- Name: S. Postma, PhD
- Phone Number: +31 384262999
- Email: rfrcabg.trial@diagram-zwolle.nl
Study Locations
-
-
-
Bonheiden, Belgium
- Recruiting
- Imelda Ziekenhuis
-
Contact:
- Dr. Dewilde, MD, PhD
-
Brugge, Belgium
- Active, not recruiting
- AZ Sint-Jan Brugge
-
-
-
-
-
Katowice, Poland
- Recruiting
- Medical University of Silesia
-
Contact:
- Pawel Gasior, MD
-
-
-
-
-
Banská Bystrica, Slovakia
- Recruiting
- SUSCCH
-
Contact:
- Martin Hudec, MD, PhD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- All patients between 18 or older undergoing CABG
- Patients willing and capable to provide written informed consent
Exclusion Criteria:
- Previous CABG
- Concomitant severe valvular disease intervention
- Remaining (expected) coronary stenosis of > 50% diameter stenosis distally to graft anastomosis
- Left ventricular ejection fraction <30%
- Known transmural myocardial infarction
- Documented microvascular disease
- RFR/FFR measurement judged impossible
- Life expectancy <2 years
- Participation in other investigational clinical trials
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: angiography guided CABG
|
All patients will undergo RFR and FFR measurement before CABG.
RFR and FFR values will be blinded to the patients.
In the control arm the RFR values will be blinded to the cardiothoracic surgeon.
|
|
Experimental: RFR guided CABG
|
All patients will undergo RFR and FFR measurement before CABG.
RFR and FFR values will be blinded to the patients.
In the experimental arm the decision to revascularize will be based on RFR.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Number of participants who deceased, had a Myocardial Infarction (MI), Clinically-Driven Target Vessel Revascularization (CD-TVR), Stroke or Graft Dysfunction at 3 months post CABG
Time Frame: 3 months
|
3 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Cut-off value for the RFR that best predicts graft occlusion
Time Frame: Baseline
|
Baseline
|
|
Number of participants with graft dysfunction at 3 months post CABG
Time Frame: 3 months
|
3 months
|
|
Major adverse cardiac or cerebrovascular event (MACCE), a composite of Death, MI, CD-TVR and Stroke at 1 year
Time Frame: 1 year
|
1 year
|
|
Major adverse cardiac or cerebrovascular event (MACCE), a composite of Death, MI, CD-TVR and Stroke at 3 years
Time Frame: 3 years
|
3 years
|
|
CD-TVR at 3 months post CABG
Time Frame: 1 year
|
1 year
|
|
CD-TVR at 1 year post CABG
Time Frame: 1 year
|
1 year
|
|
CD-TVR at 3 years post CABG
Time Frame: 3 years
|
3 years
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 9333
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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