Study of Lesion-Specific Invasive Haemodynamic Angina Thresholds (ORBITA-SOLAR)
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: Kayla Chiew, MBBS MRCP
- Phone Number: 020 7594 5735
- Email: kayla.chiew@imperial.ac.uk
Study Contact Backup
- Name: Rasha Al-Lamee, MBBS PhD MRCP
- Phone Number: 020 7594 5735
- Email: r.al-lamee13@imperial.ac.uk
Study Locations
-
-
-
Basildon, United Kingdom
- Recruiting
- Mid and South Essex NHS Foundation Trust
-
Contact:
- John Davies
- Email: john.davies32@nhs.net
-
Bournemouth, United Kingdom
- Not yet recruiting
- University Hospitals Dorset NHS Foundation Trust
-
Contact:
- Peter O'Kane
- Email: peter.o'kane@uhd.nhs.uk
-
London, United Kingdom
- Recruiting
- Imperial College Healthcare NHS Trust
-
Contact:
- Rasha Al-Lamee
- Phone Number: 02075945735
- Email: r.al-lamee13@imperial.ac.uk
-
London, United Kingdom
- Not yet recruiting
- Guy's and St Thomas' NHS Foundation Trust
-
Contact:
- Vasileios Panoulas
- Email: v.panoulas@imperial.ac.uk
-
London, United Kingdom
- Not yet recruiting
- Royal Free London NHS Foundation Trust
-
Contact:
- Niket Patel
- Email: niketpatel@nhs.net
-
London, United Kingdom
- Not yet recruiting
- St George's University Hospitals NHS Foundation Trust
-
Contact:
- Rupert Williams
- Email: rupertwilliams@nhs.net
-
London, United Kingdom
- Recruiting
- Chelsea and Westminster hospital NHS foundation Trust
-
Contact:
- Henry Seligman
- Email: h.seligman@nhs.net
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Eligibility for PCI due to angina or angina-equivalent symptoms on exertion
2 severe epicardial stenoses in a major coronary artery, defined as:
- ≥70% stenosis in a coronary artery with ≥2.5mm diameter, on invasive coronary angiography (ICA)
- Severe stenosis in a vessel with ≥2.5mm diameter, on CTCA
Evidence of ischaemia on an invasive or non-invasive test, including:
- Physiological test during invasive coronary angiography (ICA)
- Dobutamine stress echocardiography (DSE)
- Stress perfusion cardiac magnetic resonance (CMR)
- Myocardial perfusion scintigraphy (MPS)
- Fractional flow reserve computed-tomography (FFR-CT)
Exclusion Criteria:
- Age <18 years
- Acute coronary syndrome within 3 months
- Previous coronary artery bypass graft
- Significant left main stem disease
- Single lesion amenable to PCI
- Chronic total occlusion of the target artery
- Moderate to severe valve disease
- LVEF ≤40%, contraindication to PCI or drug-eluting stents
- PCI performed with drug-eluting balloons without stenting
- Contraindication to antiplatelet therapy
- Contraindication to adenosine
- Physical inability to exercise with an ergometer
- Femoral artery access
- Pregnancy
- Inability to consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Patients with stable coronary artery disease
|
Clinically indicated PCI for the management of stable angina
Following stenting, the order in which to perform the angina threshold assessment at the location of each stent will be randomised.
A non-compliant balloon with gradually be inflated over a pressure wire within the deployed stent to re-introduce stenosis.
Simultaneously, the participant will exercise on a supine ergometer.
At the point when angina is reproduced, the patient will rest and further balloon inflation will stop.
Physiological measurements using the pressure wire will be taken with the inflated balloon in situ.
This will represent the invasive physiological angina threshold.
The balloon will then be deflated and removed.
These steps will be repeated at the location of the second stent.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Intra-individual difference in FFR and NHPR angina thresholds
Time Frame: Intra-procedural
|
Difference in invasively measured physiological angina thresholds at the site of the 2 stents within each participant, stratified by vascular territory and lesion location along a vessel.
|
Intra-procedural
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Correlation of the angina threshold with other invasive physiological assessments
Time Frame: Intra-procedural
|
Including coronary artery disease pattern (focal, diffuse or mixed), presence of microvascular disease (IMR and CFR), extent of collateral flow (CFI), and pre- and post-PCI ischaemia (FFR and RFR)
|
Intra-procedural
|
|
Correlation of the angina threshold with anatomical characteristics assessed with computed tomography coronary angiography (CTCA)
Time Frame: 14 days
|
Including proportion of myocardial mass subtended (%), coronary artery territory (LAD, LCx, RCA), and lesion location along a vessel (proximal, mid, distal)
|
14 days
|
|
Correlation of the angina threshold with anatomical characteristics assessed with quantitative coronary angiography (QCA)
Time Frame: 14 days
|
Including lesion length (mm), minimum lumen diameter, (mm) percent diameter stenosis (%), and reference vessel diameter (mm)
|
14 days
|
|
Correlation of the angina threshold with anatomical characteristics assessed with intravascular imaging
Time Frame: Intra-procedural
|
Including lesion length (mm), pre-PCI minimum lumen area (mm2), post-PCI minimum stent area (mm2), reference vessel cross-sectional area (mm2), plaque characteristics (lipid, fibrotic, calcific)
|
Intra-procedural
|
|
Correlation of the angina threshold with features on a stress perfusion cardiac magnetic resonance imaging (CMR) scan
Time Frame: 14 days
|
Including myocardial perfusion reserve (MPR), number of segments of infarcted myocardium, and percentage mural infarct depth (%)
|
14 days
|
|
Correlation of the angina threshold with baseline symptoms, quality of life and pain perception
Time Frame: 14 days
|
Assessed with the ORBITA-app and validated questionnaires (SAQ, EQ5D5L)
|
14 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
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 (Actual)
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
- Pain
- Neurologic Manifestations
- Vascular Diseases
- Cardiovascular Diseases
- Heart Diseases
- Arteriosclerosis
- Arterial Occlusive Diseases
- Coronary Disease
- Myocardial Ischemia
- Chest Pain
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Coronary Artery Disease
- Angina Pectoris
- Angina, Stable
- Surgical Procedures, Operative
- Endovascular Procedures
- Vascular Surgical Procedures
- Cardiovascular Surgical Procedures
- Minimally Invasive Surgical Procedures
- Percutaneous Coronary Intervention
Other Study ID Numbers
Other Study ID Numbers
- 199514
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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