- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05611190
CT-FFR-guided Strategy for In-stent Restenosis
November 8, 2022 updated by: Yan'an Affiliated Hospital of Kunming Medical University
Coronary CT Angiography-Derived Fractional Flow Reserve-guided Optimize Treatment Strategy for In-stent Restenosis
This study will be a prospective, randomized clinical trial to compare standard practice guided by usual care testing to CT-FFR-guided management in patients with in-stent restenosis.
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Detailed Description
This trial will randomize 294 patients with in-stent restenosis to receive either CT-FFR or routine clinical assessment.
In all subjects, the investigators will review all diagnostic test results and determine a treatment strategy.
The primary end point will be 12-month Major Adverse Coronary Event (MACE) rates, defined as all cause death, non-fatal myocardial infarction (MI), ischemia-driven target vessel revascularization (TVR).
Secondary end points will include total medical costs, and quality of life (QOL), medical radiation exposure, etc.
We will test noninferiority of current FFR-guided strategy compared with standard care strategy.
Study Type
Interventional
Enrollment (Anticipated)
294
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Qiang Xue
- Phone Number: 13987199913
- Email: Xueqiang3513@126.com
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- (1) >18 years old;
- (2) ability to provide informed consent;
- (3) previous PCI who underwent CCTA and have at least 1 lesion with a percent diameter in-stent stenosis between 30% and 90% in a coronary artery with a ≥2.25 mm reference vessel diameter by visual assessment;
- (4) accepted further clinically indicated coronary testing, coronary arteriography, or FFR, or IVUS, or PCI, etc.
Exclusion Criteria:
- (1) Prior coronary artery bypass surgery (CABG), heart valve surgery, cardiac pacemaker, or implanted cardiac defibrillator;
- (2) Target vascular stents were evaluated for implantation within one month;
- (3) unstable clinical conditions including acute chest pain, cardiogenic shock, congestive heart failure (NYHA grade III or IV), unstable blood pressure (systolic blood pressure < 90mmHg) or acute pulmonary edema;
- (4) Acute myocardial infarction occurred within 7 days before enrollment, and left ventricular ejection fraction ≤40%;
- (5) Other severe cases are not suitable for clinical trials including complex congenital heart disease, sick sinus syndrome, long QT syndrome, severe arrhythmia, tachycardia, severe asthma, severe or very severe chronic obstructive pulmonary disease (COPD) and severe chronic renal damage;
- (6) Contraindication to beta blockers, nitroglycerin, adenosine, or allergy to iodine contrast agents;
- (7) Pregnancy or pregnancy status unknown;
- (8) Life expectancy <1 years;
- (9)Repeated enrollment;
- (10) Any other factors that other researchers consider not suitable for inclusion or completion of this study.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Usual Care
Participants randomized to usual care will be evaluated according to institutional standard practice.
The investigators will review clinical data and results of the diagnostic tests to recommend a treatment strategy, according to the institution's standard practice.
|
Participants randomized to usual care will be evaluated according to institutional standard practice.
|
Experimental: CT-FFR
Participants randomized to a CT-FFR strategy will be assigned to non-invasive CT-FFR evaluation.
The investigators will review the results CT-FFR, and will recommend a further ICA test if CT-FFR≤0.8.
The investigators will review the results of all available diagnostic tests, including CT-FFR and ICA, and will recommend a treatment strategy accordingly.
|
CT-FFR is a type of non-invasive procedure to provide a 3D model of coronary arteries as a way to evaluate the hemodynamic significance of coronary artery lesions.
CT-FFR calculates FFR from subject-specific CCTA data using computational fluid dynamics technology.
CT-FFR value ≤0.80 is considered hemodynamically significant.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
12-month MACE
Time Frame: 12 months
|
12-month Major Adverse Coronary Event (MACE) rates, defined as:
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
MACE
Time Frame: 3-month, 6-month, 24-month, 36-month
|
MACE defined as:
|
3-month, 6-month, 24-month, 36-month
|
Rates of Target lesion failure (TLF)
Time Frame: 3-month, 6-month, 24-month, 36-month
|
Composite of clinically driven TLR, MI or cardiac death related to the target vessel.
|
3-month, 6-month, 24-month, 36-month
|
Total costs
Time Frame: 6-month, 12-month
|
Total costs will be calculated from the use of all cardiac-related invasive and non-invasive tests, revascularization procedures, hospital admissions and outpatient attendances due to a cardiovascular cause, and cardiac medications.
|
6-month, 12-month
|
Quality of life (QOL) will be assessed using the EQ-5D-VAS questionnaire
Time Frame: 6-month, 12-month
|
Quality of life (QOL), will be assessed using the EQ-5D-VAS questionnaire
|
6-month, 12-month
|
Seattle Angina Questionnaire
Time Frame: 6-month, 12-month
|
angina status, will be assessed using the Seattle Angina Questionnaire
|
6-month, 12-month
|
Cumulative radiation exposure
Time Frame: 6-month, 12-month
|
Cumulative radiation exposure within 6-month and 12-month of study entry included all cardiovascular tests and invasive procedures, including CTA, myocardial perfusion imaging, and ICA.
|
6-month, 12-month
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Qiang Xue, Yan'an Affiliated Hospital of Kunming Medical University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Anticipated)
December 12, 2022
Primary Completion (Anticipated)
December 11, 2024
Study Completion (Anticipated)
December 11, 2025
Study Registration Dates
First Submitted
November 3, 2022
First Submitted That Met QC Criteria
November 8, 2022
First Posted (Actual)
November 9, 2022
Study Record Updates
Last Update Posted (Actual)
November 9, 2022
Last Update Submitted That Met QC Criteria
November 8, 2022
Last Verified
November 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- In-stent Restenosis
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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