- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05857904
Clinical Outcomes of CT-FFR Versus QFR-guided Strategy for Decision-Making in Patients With Stable Chest Pain (CONFIDENT)
Clinical Outcomes of CoroNary CTA-Derived FFR Versus ICA-Derived QFR-guided Strategy for Decision-Making in Patients With Stable Chest Pain
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: chenguang Li, doctor
- Phone Number: 13816767665
- Email: li.chenguang@zs-hospital.sh.cn
Study Locations
-
-
Shagnhai
-
Shanghai, Shagnhai, China, 200032
- Zhongshan Hospital, Fudan University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥18 years
- with stable chest pain who underwent CCTA and have at least 1 lesion with a percent diameter stenosis (DS%) between 50% and 90% in a coronary artery with a ≥2.5 mm reference vessel diameter by visual assessment.These patients plan to undergo further non-invasive or invasive diagnosis and treatment.
- Able to undergo invasive coronary angiography (ICA)
- Capable of complying with the study procedures and fully understand the informed consent form approved by the ethics committee, and provide voluntary consent.
Exclusion Criteria:
General exclusion criteria:
- Patients with acute coronary syndrome requiring urgent revascularization.
- Patients with unstable angina, including those with first-onset chest pain within 48 hours, CCS III or higher first-onset angina, those whose angina has worsened to CCS III or IV within a short period of time, or those with rest angina lasting more than 20 minutes.
- Patients with iodine contrast agent allergy.
- Pregnant or lactating women.
- Patients with severe congestive heart failure (NYHA III-IV or LVEF <30%) or acute pulmonary edema.
- Patients with severe renal insufficiency (creatinine >150μmol/L or estimated - -glomerular filtration rate calculated by the Cockcroft-Gault formula <45ml/kg/1.73 m2).
- Patients with other comorbidities and an expected survival time of less than 1 year.
- Patients who, for any other reason, are considered by the investigators to be unsuitable for inclusion in the study or unable to complete the study and follow-up.
Coronary CTA and coronary angiography exclusion criteria:
- Patients with a body mass index >35 when undergoing coronary CT testing, resulting in poor CT image quality due to motion artifacts, severe calcification, or inadequate iodine contrast agent filling.
- Patients with a history of coronary artery bypass grafting (CABG).
- Target lesions related to acute myocardial infarction.
- Target lesions involving left main stem disease.
- Target lesions involving myocardial bridging.
- Target lesions involving in-stent restenosis.
- Low-quality angiography due to poor visualization of vascular boundaries or poor iodine contrast agent filling.
- Excessive overlap of the stenotic segment or severe tortuosity of the target vessel, making QFR calculation impossible.
Regen
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: CT-FFR guided group
Patients randomized to the experimental group (CT-FFR guided group) will undergo coronary artery three-dimensional reconstruction and CT-FFR calculation using the coronary CT angiography (CCTA) images and RuiXin-FFR software.
The researchers will interpret and analyze the clinical outcomes based on CT-FFR results.
If CT-FFR is >0.8, the patient will be treated with medical therapy alone.
If CT-FFR is ≤0.8, further examination with coronary angiography will be performed.
During the angiography examination, the operator will determine the treatment strategy (PCI, CABG, or medical therapy alone) based on the anatomical features of the lesion and the CT-FFR results.
|
CT -FFR(coronary computed tomography angiography drived fractional flow reserve derived) uses routine coronary computed tomography angiography (CTA) images and applies a specific algorithm to extract both anatomical and physiological information of the coronary arteries.
By combining these two pieces of information, a fluid dynamics model of the coronary arteries can be established, allowing the calculation of FFR at any location of the coronary arteries.
|
Active Comparator: QFR guided group
Patients randomized to the control group (QFR-guided group) will undergo invasive coronary angiography (ICA) in the catheterization lab, and QFR will be calculated using the ICA images.
The researchers will interpret and analyze the clinical outcomes based on QFR results.
If QFR is ≤0.8 and the lesion is suitable for intervention, the patient will undergo percutaneous coronary intervention (PCI) treatment.
If QFR is >0.8, the patient will be recommended for medical treatment alone.
|
Quantitative flow ratio (QFR) is a new method for evaluating the functional significance of coronary artery stenosis based on angiography.
It can be used for real-time detection of hemodynamic abnormalities in the coronary arteries in the catheterization lab.
Unlike traditional methods that require the use of pressure wires and vasodilators such as adenosine, the QFR examination process only requires routine coronary angiography.
By reconstructing the three-dimensional structure of the blood vessels and analyzing the hemodynamics, the QFR can evaluate the fractional flow reserve (FFR) without the need for pressure wires and vasodilators.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
1-year MACE
Time Frame: 1-year
|
Major Adverse Coronary Event (MACE) rates, defined as:
|
1-year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
MACE
Time Frame: 1-month, 6-month, 2-years, 3-years
|
Major Adverse Coronary Event (MACE) rates, defined as:
|
1-month, 6-month, 2-years, 3-years
|
All cause death
Time Frame: 1-month, 6-month, 1-year, 2-years, 3-years
|
All cause death defined as: Cardiovascular death, non-cardiovascular death, death of unknown cause |
1-month, 6-month, 1-year, 2-years, 3-years
|
Non-fatal myocardial infarction (MI)
Time Frame: 1-month, 6-month, 1-year, 2-years, 3-years
|
myocardial infarction (MI) defined as: Spontaneous myocardial infarction , perioperative myocardial infarction
|
1-month, 6-month, 1-year, 2-years, 3-years
|
repeat myocardial
Time Frame: 1-month, 6-month, 1-year, 2-years, 3-years
|
Repeat myocardial defined as:Planned revascularization,Unplanned revascularization
|
1-month, 6-month, 1-year, 2-years, 3-years
|
non-lethal stroke
Time Frame: 1-month, 6-month, 1-year, 2-years, 3-years
|
The American Heart Association/American Stroke Association (AHA/ASA) defines stroke as including the following types:CNS infarction,Ischemic stroke,Silent CNS infarction,Intracerebral hemorrhage,Subarachnoid hemorrhage,Cerebral venous thrombosis
|
1-month, 6-month, 1-year, 2-years, 3-years
|
The definite and probable stent thrombosis (defined by ARC-2 criteria)
Time Frame: 1-month, 6-month, 1-year, 2-years, 3-years
|
The definite and probable stent thrombosis (defined by ARC-2 criteria) including acute, subacute, late, and very late stent thrombosis within a specific time frame.
|
1-month, 6-month, 1-year, 2-years, 3-years
|
Proportion of non-obstructive CAD detected by ICA examination
Time Frame: 1-month, 6-month, 1-year, 2-years, 3-years
|
Proportion of non-obstructive CAD detected by ICA examination
|
1-month, 6-month, 1-year, 2-years, 3-years
|
Health Economics Evaluation Endpoints
Time Frame: 1-month, 6-month, 1-year, 2-years, 3-years
|
Cost-effectiveness analysis, cost-utility analysis. The information collected by the cost indicators is as follows:
|
1-month, 6-month, 1-year, 2-years, 3-years
|
Quality of life (QOL)
Time Frame: 1-month, 6-month, 1-year, 2-years, 3-years
|
Quality of life (QOL) will be assessed using the EQ-5D-VAS questionnaire.
Angina status will be assessed using the Seattle Angina Questionnaire.
|
1-month, 6-month, 1-year, 2-years, 3-years
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Cumulative radiation exposure
Time Frame: 1-month, 6-month, 1-year, 2-years, 3-years
|
Cumulative radiation exposure within1-month, 6-month, 1-year, 2-years and 3-years of study entry included all cardiovascular tests and invasive procedures, including CTA, myocardial perfusion imaging, and ICA.
|
1-month, 6-month, 1-year, 2-years, 3-years
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Junbo Ge, Doctor, Fudan University
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- RX-RD-FFR-FA-001
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
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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