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Fractional Flow Reserve and Intravascular Ultrasound RelationShip STudy (FIRST)

27. februar 2015 opdateret af: Volcano Corporation

Fractional Flow Reserve and Intravascular Ultrasound RelationShip STudy: The FIRST Study

This is a multi-center, prospective registry of patients with intermediate coronary lesions defined as a stenosis of 40-80% by angiography. Approximately 300 patients will be enrolled into the study at sites in the United States and Europe. There will be no follow up beyond hospital discharge in this study. A sub-group of 30 patients will undergo Adenosine MRI. The investigators hypothesize that Intravascular Ultrasound Radiofrequency (IVUS RF) anatomical criteria, such as minimal luminal area, plaque burden and virtual histology plaque type, can predict physiological ischemia by Fractional Flow Reserve (FFR).

Studieoversigt

Status

Afsluttet

Betingelser

Detaljeret beskrivelse

Patients undergoing cardiac catheterization must meet clinical inclusion and exclusion criteria and sign an informed consent. At the time of catheterization the patients will be further analyzed for eligibility using angiographic inclusion and exclusion criteria. Patients who fulfilled the clinical and angiographic criteria will undergo further imaging evaluation using an IVUS RF catheter (Volcano Therapeutics) and FFR wire (Radi or Volcano). The decision for treatment of any lesion will be at the operator's discretion. For patients enrolled at Washington Hospital Center and do not undergo percutaneous coronary intervention, an assessment with non invasive perfusion adenosine MRI also be performed.

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

350

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • District of Columbia
      • Washington, District of Columbia, Forenede Stater, 20010
        • Washingtoon Hospital Center

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 75 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Patients required to have an intermediate coronary lesion (stenosis 40-80% by visual estimate) in one or more native, major epicardial coronary artery with reference diameter ≥2.5mm (visual estimate)

Beskrivelse

Inclusion Criteria:

  • Sign written informed consent to participate in the study.
  • Clinical indication for coronary angiography for stable or unstable angina

Specific Angiographic Inclusion Criteria:

  • Patients required to have an intermediate coronary lesion (stenosis 40-80% by visual estimate) in one or more native, major epicardial coronary artery with reference diameter ≥2.5mm (visual estimate)
  • The vessel(s) with the intermediate lesion must have no flow limiting lesions and must be available for imaging and must be considered safe for imaging evaluation.

Exclusion Criteria:

  • Patient has had a documented acute ST-segment elevation myocardial infarction within the past 24 hours
  • Decompensated heart failure or hypotension requiring intubation, inotropes, intravenous diuretics or intraaortic balloon counterpulsation.
  • Renal dysfunction (creatinine clearance < 60 mL/min/1.73m2)
  • Pregnancy or breast-feeding
  • Standard contra-indications to MRI for implanted ferro-magnetic devices - i.e.: pacemakers, defibrillator (AICD), and aneurysm clips
  • Body weight > 400lbs
  • Left ventricular hypertrophy >1.5cm by by echocardiogram
  • History of bronchospasm or asthma
  • ECG evidence of conduction defect, including 2nd or 3rd degree AVB
  • Patient has a known hypersensitivity, allergy or contraindication to gadolinium-based contrast agents.
  • Prior participation in this study or patient is currently enrolled in another investigational use device or drug study that has not reached its primary endpoint. If the patient is enrolled in another study that is not investigational, required visits for that trial must not interfere with the conduct of this trial.

Angiographic Exclusion Criteria:

  • Unprotected left main lesion location.
  • Ostial lesion
  • Angiographic evidence of severe calcification or marked tortuosity of the target vessel that would preclude safe imaging
  • Lesion is located within or distal to an arterial or saphenous vein graft.
  • Angiographic presence of thrombus in the lesion or vessel studied.
  • Lesion in a vessel with <2.5 mm reference diameter or with more than one lesion in the vessel

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intermediate coronary lesions

Diagnostic device: FFR

Diagnostic device: IVUS RF

At participating centers, FFR and IVUS are standard of care diagnostic procedures for patients with intermediate (40-80% angiographic stenosis by visual estimate). Both modalities were used regularly for such patients whether or not they are participants in this clinical study. In FIRST, the decision to perform percutaneous coronary intervention (PCI) was left to the discretion of the investigator, and was not dictated by the clinical protocol.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Correlation between (Minimum Luminal Area) MLA and FFR
Tidsramme: Day of Procedure
The correlation between MLA and FFR; and the threshold value for MLA corresponding to an FFR < 0.8.
Day of Procedure

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Correlation between FFR and IVUS and VH parameters
Tidsramme: Day of Procedure
Correlation between FFR and various IVUS measurements (MLA,area stenosis, lesion length, plaque burden) and VH parameters (plaque type and presence of a TCFA)
Day of Procedure
Association of FFR and Cut-off of MLA
Tidsramme: Day of Procedure
Assess the association between FFR <0.75 and 0.8 and determined cut-off of MLA with presence of a Thin Cap Fibro-Atheroma(TCFA) and/or plaque burden ≥70%
Day of Procedure
Identify risk score model
Tidsramme: 1 year
To identify a risk score model taking into account IVUS measurements (MLA, plaque burden, area stenosis, lesion length) and VH parameters (plaque type and presence of TCFA) associated with FFR < 0.8
1 year

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Ron Waksman, MD, Medstar Health Research Institute

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. september 2010

Primær færdiggørelse (Faktiske)

1. juni 2012

Studieafslutning (Faktiske)

1. juni 2012

Datoer for studieregistrering

Først indsendt

28. juni 2010

Først indsendt, der opfyldte QC-kriterier

29. juni 2010

Først opslået (Skøn)

30. juni 2010

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

4. marts 2015

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

27. februar 2015

Sidst verificeret

1. januar 2015

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • FIRST

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .