Coronary Artery Stents in Heart Failure With Preserved Ejection Fraction (REPRIEVED)

April 27, 2026 updated by: King's College London

REvascularisation for Heart Failure With PReserved Ejection Fraction and Ischaemia: EValuation of Efficacy and Mechanistic Description

HFpEF (heart failure with preserved ejection fraction) is a condition in which the heart muscle becomes stiff and can't pump blood properly. People living with HFpEF also often have coronary artery disease, where the blood vessels that supply the heart are narrowed or blocked.

It is not yet know whether opening these arteries with stents improves symptoms or quality of life with HFpEF. REPRIEVED is a randomised clinical trial that aims to find out if heart stents can improve quality of life for people living with heart failure with preserved ejection fraction (HFpEF) and coronary artery disease.

Researchers will compare two groups of people; those who have a stent procedure to those who have a placebo procedure. The placebo procedure feels the same as a stent procedure but does not include a stent.

350 people with HFpEF and coronary artery disease will be asked to take part. Participants will be monitored over a period of 6 months to see if and how quality of life changes.

Before the procedure, participants will be asked to complete a short health questionnaire, have a blood test, undergo an electrocardiogram (heart tracing) and scans of their heart.

On the day of the procedure, the participant will come to the hospital for an angiogram and will be randomly allocated to have either treatment with a stent or the placebo procedure without a stent. Participants will not know whether they have received heart stents. This helps researchers know that any improvements in their quality of life are not just related to how they feel about the stenting treatment.

Participants will then be contacted by a member of the research team at 3 months and 6 months after their procedure.

At 3 months, participants will complete a short health questionnaire either by phone or during a hospital visit.

At 6 months, participants will attend the hospital to complete a short health questionnaire, have blood tests, a scan of the heart (echocardiogram) and an electrocardiogram (heart tracing) to measure any changes in the heart.

Participants will be told whether they received the stent procedure or the placebo procedure.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

350

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

1. A diagnosis of HFpEF, defined by the European Society of Cardiology (ESC) criteria, defined as:

  1. Symptoms of heart failure (New York Heart Association (NYHA) class II-IV) and
  2. Left ventricular ejection fraction ≥ 50% and
  3. NT-pro-BNP > 125 pg/ml in sinus rhythm or > 365 pg/ml in atrial fibrillation and
  4. One or more of the following objective signs of left ventricular diastolic dysfunction:

i. Invasively measured left ventricular end diastolic pressure ≥ 15 mmHg at rest or ≥ 25 mmHg on exercise (directly measured or estimated via pulmonary capillary wedge pressure) ii. Estimated pulmonary artery systolic pressure > 35mmHg or tricuspid regurgitation velocity > 2.8 m/s on echocardiography iii. Left atrial volume index > 34ml/m2 in patient in sinus rhythm or left atrial volume index > 40ml/m2 in atrial fibrillation iv. Relative left ventricular wall thickness > 0.42 v. Left ventricular mass index ≥ 95 g/m2 in females or ≥ 115 g/m2 in males vi. Mitral E/E' ratio > 9

Exclusion Criteria:

  1. Age <18 years
  2. People without capacity to provide informed consent
  3. PCI contraindicated or not feasible on coronary angiography or screening CTCA
  4. Contraindication to clopidogrel/dual antiplatelet therapy
  5. Recent acute myocardial infarction or coronary revascularisation (within 90 days)
  6. Enrolment in another interventional study which may affect study outcomes
  7. Severe chronic obstructive pulmonary disease (GOLD stage ≥3)
  8. Haemoglobin <=80 g/L
  9. Other cardiac diagnosis as a cause for HFpEF (hypertrophic cardiomyopathy, untreated severe left sided valvular disease, cardiac amyloidosis)

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: PCI
Procedure: Percutaneous coronary intervention
Participants will receive percutaneous coronary intervention (PCI) as per current standard of care. Angioplasty and stenting will be attempted to all significant coronary stenoses as determined by the CT-FFR or FFR measurements. Contemporary best practice including the use of intracoronary imaging is mandated. The default approach will be to implant drug eluting stents, but drug coated balloon angioplasty is permitted in selected cases in accordance with the current evidence base and guidelines. Operators will achieve as much revascularisation as can safely be delivered in a timeframe which maintains blinding; if incomplete revascularisation is necessary, operators will target treatment to the most haemodynamically significant lesions subtending the largest territories. Staged procedures are not permitted.
Placebo Comparator: Placebo PCI
Participants will undergo a placebo stent procedure that involves placement of a catheter but no actual stent. Participants randomised to the placebo procedure will receive matching placebo clopidogrel capsules, to be taken for up to 6 months after the procedure.
Other: Placebo procedure
Participant will undergo a placebo PCI procedure that involves placement of a thin tube to image the blood vessel but does not involve placement of an actual stent. Movements of the image intensifier, screen display and personnel will simulate a PCI procedure.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Quality of life measured using KCCQ-OSS
Time Frame: At 6 months
At 6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
All-cause death and hospitalisation for heart failure
Time Frame: At 6 months
At 6 months
Efficacy of blinding assessed using the blinding index
Time Frame: At discharge from the procedure
The blinding index is scaled to an interval of -1 to 1, 1 being complete lack of blinding, 0 being consistent with perfect blinding and -1 indicating opposite guessing which may be related to unblinding.
At discharge from the procedure
Individual components of the KCCQ (including total symptom score and clinical summary score)
Time Frame: At 6 months
At 6 months
Health status measured using New York Heart Association (NYHA) functional class
Time Frame: At 6 months
At 6 months
NT-pro-BNP measured using blood test/assay
Time Frame: At 6 months
At 6 months
Difference in left ventricular ejection fraction (LVEF)
Time Frame: At 6 months
At 6 months
Difference in diastolic function (mitral E/e')
Time Frame: At 6 months
At 6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

King's College London

Collaborators

Guy's and St Thomas' NHS Foundation Trust

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

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 (Actual)

March 23, 2026

Primary Completion (Estimated)

November 1, 2028

Study Completion (Estimated)

August 1, 2029

Study Registration Dates

First Submitted

March 18, 2026

First Submitted That Met QC Criteria

April 27, 2026

First Posted (Actual)

May 1, 2026

Study Record Updates

Last Update Posted (Actual)

May 1, 2026

Last Update Submitted That Met QC Criteria

April 27, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IRAS ID 330189
  • NIHR159715 (Other Grant/Funding Number: National Institute for Health and Care Research)
  • 12843546 (Registry Identifier: ISRCTN)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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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