- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01567826
Reduction in YEllow Plaque by Aggressive Lipid LOWering Therapy (YELLOW)
Reduction in YEllow Plaque by Aggressive Lipid LOWering Therapy. (YELLOW Trial)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
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New York
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New York, New York, United States, 10029
- Icahn School of Medicine at Mount Sinai
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patient > 18 years of age and willing to participate
- Stable patients who will undergo cardiac catheterization and PCI (intent to stent)
- Patient is willing to go on a cholesterol lowering medication for the duration of the study and willing to change statin therapy to the randomized statin therapy regardless of previous statin therapy and dose (e.g. Atorvastatin 80 mg) Patients that are screened for this study and are receiving another Statin such as Pravachol will be required to be willing to change their therapy to Rosuvastatin as per is randomization. If patients are receiving another statin, such as pravachol, or any other agent, and are at appropriate Lipid levels, they will be permitted to continue this therapy (if randomized to the standard therapy arm). There are a virtually unlimited number of possible scenarios for potential combination of all Lipid lowering agents at the time of enrollment that patients may be taking.
- Signed written Informed Consent
- Women of childbearing potential must agree to be on an acceptable method of birth control/contraceptive such as barrier method (condoms/diaphragm); hormonal contraceptives (birth control pills, implants (Norplant) or injections (Depo-Provera)); Intrauterine Device; or abstinence (no sexual activity).
- Fluency in English and/or Spanish
Exclusion Criteria:
- Patients who have acute myocardial infarction (Q wave or non-Q wave with CK-MB > 5 times above the upper normal (31.5 ng/ml) within 72 hours)
- Patients who are in cardiogenic shock
- Patients with left main disease or restenotic lesions
- Patients with elevated CK-MB (> 6.5 ng/ml) or Tnl (> 0.5ng/L) at baseline
- Patients with platelet count < 100,000 cell/mm3
- Patients who have co-morbidity which reduces life expectancy to one year
- Patients who are currently participating in another investigational drug/device study
- Patients with known hypersensitivity to HMG CO-A reductase therapy (statins)
- Patients with liver disease
- Patient with creatinine > 2.0 mg/dL
- Pregnant women and women of childbearing potential who intend to have children during the duration of the trial
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: standard of care lipid therapy
standard-care lipid-lowering therapy: Zocor or Lipitor
|
Patients will be randomized in a 1:1 fashion to receive either A) Rosuvastatin (Crestor) 40mg daily, or B) standard-care lipid-lowering therapy. Zocor, Lipitor [any dose] and Crestor [less than 40mg]
Other Names:
|
Experimental: aggressive lipid therapy
aggressive lipid therapy: Crestor
|
Patients will be randomized in a 1:1 fashion to receive either A) Rosuvastatin (Crestor) 40mg daily, or B) standard-care lipid-lowering therapy.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Lipiscan - Lipid Core Burden Index (LCBI)
Time Frame: at baseline and at 6-8 weeks after intervention
|
The regression of yellow plaque content from the atherosclerotic lipid pool after statin therapy by utilizing NIR spectroscopy as compared from baseline to 6-8 weeks after intervention.
Spectroscopic information obtained from raw spectra was transformed into a probability of lipid core that was mapped to a red-to-yellow color scale, with the low probability of lipid shown as red and the high probability of lipid shown as yellow.
Analyses were performed offline using the Matlab-based software, as previously published.
Yellow pixels within the analyzed segment were divided by all viable pixels to generate the lipid-core burden index (LCBI).
The maximal value of LCBI for each nonculprit obstructive lesion was recorded and used for comparison.
|
at baseline and at 6-8 weeks after intervention
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LCBI4mm Max
Time Frame: at baseline and at 6-8 weeks after intervention
|
LCBI4mm max = change in lipid-core burden index at the 4-mm maximal segment.
Spectroscopic information obtained from raw spectra was transformed into a probability of lipid core that was mapped to a red-to-yellow color scale, with the low probability of lipid shown as red and the high probability of lipid shown as yellow.
Yellow pixels within the analyzed segment were divided by all viable pixels to generate the lipid-core burden index (LCBI).
The maximal value of LCBI for each nonculprit obstructive lesion was recorded and used for comparison.
|
at baseline and at 6-8 weeks after intervention
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Change in LCBI4mm Max
Time Frame: at baseline and at 6-8 weeks after intervention
|
Change in LCBI4mm max at 6-8 weeks after intervention as compared to baseline.
LCBI4mm max = change in lipid-core burden index at the 4-mm maximal segment.
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at baseline and at 6-8 weeks after intervention
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Change in LCBI, Lesion
Time Frame: at baseline and at 6-8 weeks post intervention
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Change in LCBI at 6-8 weeks after intervention as compared to baseline
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at baseline and at 6-8 weeks post intervention
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Intravascular Ultrasound (IVUS) Parameters
Time Frame: at baseline and at 6-8 weeks after intervention
|
Change in atheroma volume and lumen CSA on IVUS as related to change in yellow plaque index as compared from baseline to 6-8 weeks after intervention. Data not analyzed. Data not available. |
at baseline and at 6-8 weeks after intervention
|
Fractional Flow Reserve (FFR) Value
Time Frame: at baseline and at 6-8 weeks after intervention
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Change in FFR as related to change in yellow plaque index as compared from baseline to 6-8 weeks after intervention.
Fractional flow reserve (FFR), defined as the ratio of maximum flow in the presence of a stenosis to normal maximum flow, is a lesion-specific index of stenosis severity that can be calculated by simultaneous measurement of mean arterial, distal coronary, and central venous pressure.
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at baseline and at 6-8 weeks after intervention
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Diameter Stenosis
Time Frame: Baseline and 6-8 weeks post intervention
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Percentage stenosis of vessel diameter in the analysis segment of nontarget lesions as measured by angiography that remained >70%, after successful PCI of the target lesion.
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Baseline and 6-8 weeks post intervention
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Post PCI Cardiac Enzymes
Time Frame: at 6-8 weeks after intervention
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Correlation of yellow plaque index with post procedure CK-MB, Troponin-I release.
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at 6-8 weeks after intervention
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Major Adverse Cardiac Events (MACE)
Time Frame: at 6-8 weeks after intervention
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MACE defined as a combined clinical endpoint of death, MI (Q wave or non Q-wave with CK-MB >3 times above the upper normal limit (48 U/L), urgent revascularization or stroke at 30 days and 1 year.
Details reported in adverse events section.
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at 6-8 weeks after intervention
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Blood Chemistry - HsCRP
Time Frame: at baseline and at 6-8 weeks after intervention
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Correlation of yellow plaque index with changes in levels of blood HsCRP as compared from baseline to 6-8 weeks after intervention
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at baseline and at 6-8 weeks after intervention
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Annapoorna Kini, MD, Icahn School of Medicine at Mount Sinai
Publications and helpful links
General Publications
- Kini AS, Baber U, Kovacic JC, Limaye A, Ali ZA, Sweeny J, Maehara A, Mehran R, Dangas G, Mintz GS, Fuster V, Narula J, Sharma SK, Moreno PR. Changes in plaque lipid content after short-term intensive versus standard statin therapy: the YELLOW trial (reduction in yellow plaque by aggressive lipid-lowering therapy). J Am Coll Cardiol. 2013 Jul 2;62(1):21-9. doi: 10.1016/j.jacc.2013.03.058. Epub 2013 May 1.
- Dohi T, Maehara A, Moreno PR, Baber U, Kovacic JC, Limaye AM, Ali ZA, Sweeny JM, Mehran R, Dangas GD, Xu K, Sharma SK, Mintz GS, Kini AS. The relationship among extent of lipid-rich plaque, lesion characteristics, and plaque progression/regression in patients with coronary artery disease: a serial near-infrared spectroscopy and intravascular ultrasound study. Eur Heart J Cardiovasc Imaging. 2015 Jan;16(1):81-7. doi: 10.1093/ehjci/jeu169. Epub 2014 Sep 4.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Arteriosclerosis
- Arterial Occlusive Diseases
- Coronary Artery Disease
- Myocardial Ischemia
- Coronary Disease
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antimetabolites
- Anticholesteremic Agents
- Hypolipidemic Agents
- Lipid Regulating Agents
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
- Atorvastatin
- Rosuvastatin Calcium
- Simvastatin
Other Study ID Numbers
- GCO 09-1294
- IF1292822
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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