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Non-stenting Treatment Strategy for Acute Myocardial Infarction With Non-severe Stenosis(EROSION IV)

14. juli 2026 opdateret af: Yu Bo, Harbin Medical University

Non-stenting Treatment Strategy for Acute Myocardial Infarction With Non-severe Stenosis: a Prospective, Multicenter, Open-label, Non-inferiority, Randomised Controlled Trial(EROSION IV)

This study is a prospective, multicenter, open-label, non-inferiority, randomized controlled trial. A total of 2,000 patients with STEMI (<24 hours or 7-14 days) or NSTEMI will be recruited from at least 20 centers in China. Eligible patients must have residual DS < 70% at the culprit lesion assessed by QCA, with optional thrombus aspiration, and TIMI flow of grade 3. Patients will be randomly assigned in a 1:1 ratio to the experimental group or the control group. The planned enrollment period is 36 months, and all patients will be followed up for at least 12 months after randomization, with continued follow-up until the end of the study. The primary outcome is the first occurrence of TLF after randomization, defined as the composite of cardiovascular death, target vessel myocardial infarction, ischemia-driven target lesion revascularization. The study aims to verify whether guideline-recommended standard medical therapy is non-inferior to DES implantation combined with guideline-recommended standard medical therapy in AMI patients with non-severe coronary artery stenosis.

A total of 120 participants (60 in the experimental group and 60 in the control group) enrolled at the Second Affiliated Hospital of Harbin Medical University were included in the functional substudy. Using Abbott Pressure Wire™X pressure wire test functional indicators, and explore the incidence of coronary microvascular dysfunction (CMD) as assessed by the index of microcirculatory resistance (IMR) in two groups, and its impact on the rate of the composite endpoint of all-cause death and heart failure readmission occurring for the first time within 12 months.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

2000

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

      • Beijing, Kina
        • Ikke rekrutterer endnu
        • Fuwai Hospital, Chinese Academy of Medical Sciences
        • Kontakt:
          • Lei Song
      • Beijing, Kina
        • Ikke rekrutterer endnu
        • Beijing Luhe Hospital Affiliated to Capital Medical University
        • Kontakt:
          • Guangyao Zhai
      • Cangzhou, Kina
        • Ikke rekrutterer endnu
        • Cangzhou Central Hospital
        • Kontakt:
          • Jun Zhang
      • Chengde, Kina
        • Ikke rekrutterer endnu
        • Chengde Medical College Affiliated Hospital
        • Kontakt:
          • Ying Zhang
      • Chengdu, Kina
        • Ikke rekrutterer endnu
        • Sichuan Provincial People's Hospital
        • Kontakt:
          • Wenjie Tian
      • Dalian, Kina
        • Ikke rekrutterer endnu
        • The First Affiliated Hospital of Dalian Medical University
        • Kontakt:
          • Bo Zhang
      • Dalian, Kina
        • Ikke rekrutterer endnu
        • The Second Affiliated Hospital of Dalian Medical University
        • Kontakt:
          • Xin Zhao
      • Dalian, Kina
        • Ikke rekrutterer endnu
        • The Central Hospital Affiliated to Dalian University of Technology
        • Kontakt:
          • Xiaoqun Zheng
      • Daqing, Kina
        • Ikke rekrutterer endnu
        • Daqing Oilfield General Hospital
        • Kontakt:
          • Zhiqi Sun
      • Harbin, Kina
        • Ikke rekrutterer endnu
        • The Fourth Affiliated Hospital of Harbin Medical University
        • Kontakt:
          • Wei Yang
      • Hunan, Kina
        • Ikke rekrutterer endnu
        • The Third XIANGYA Hospital of Central South University
        • Kontakt:
          • Yu Cao
      • Jiamusi, Kina
        • Ikke rekrutterer endnu
        • Central Hospital of Jiamusi City
        • Kontakt:
          • Zhiyuan Weng
      • Jiamusi, Kina
        • Ikke rekrutterer endnu
        • The First Affiliated Hospital of Jiamusi University
        • Kontakt:
          • Guangyuan Yang
      • Jilin City, Kina
        • Ikke rekrutterer endnu
        • China-Japan Union Hospital of Jilin University
        • Kontakt:
          • Yuquan He
      • Jilin City, Kina
        • Ikke rekrutterer endnu
        • Jilin Central Hospital
        • Kontakt:
          • Yijun Shang
      • Jilin City, Kina
        • Ikke rekrutterer endnu
        • The First Hospital of Jilin University
        • Kontakt:
          • Qian Tong
      • Jinan, Kina
        • Ikke rekrutterer endnu
        • Shandong Provincial Hospital
        • Kontakt:
          • Haitao Yuan
      • Jining, Kina
        • Ikke rekrutterer endnu
        • The Affiliated Hospital of Jining Medical University
        • Kontakt:
          • Lijun Gan
      • Lanzhou, Kina
        • Ikke rekrutterer endnu
        • Lanzhou University First Hospital
        • Kontakt:
          • Ming Bai
      • Linyi, Kina
        • Ikke rekrutterer endnu
        • Linyi People's Hospital
        • Kontakt:
          • Yanjin Wei
      • Mudanjiang, Kina
        • Ikke rekrutterer endnu
        • Mudanjiang Cardiovascular Hospital
        • Kontakt:
          • Kai Liu
      • Nanyang, Kina
        • Ikke rekrutterer endnu
        • The First Affiliated Hospital of Nanyang Medical College
        • Kontakt:
          • Ou Zhang
      • Qingdao, Kina
        • Ikke rekrutterer endnu
        • The Affiliated Hospital of Qingdao University
        • Kontakt:
          • Zhexun Lian
      • Qiqihar, Kina
        • Ikke rekrutterer endnu
        • Qiqihar First Hospital
        • Kontakt:
          • Jinhui Zhang
      • Qiqihar, Kina
        • Ikke rekrutterer endnu
        • The Second Affiliated Hospital of Qiqihar Medical University
        • Kontakt:
          • Xiaojie Wu
      • Qiqihar, Kina
        • Ikke rekrutterer endnu
        • The Third Affiliated Hospital of Qiqihar Medical University
        • Kontakt:
          • Haifeng Shao
      • Shenyang, Kina
        • Ikke rekrutterer endnu
        • Shengjing Hospital of China Medical University
        • Kontakt:
          • Zhijun Sun
      • Shenyang, Kina
        • Ikke rekrutterer endnu
        • The Fourth Affiliated Hospital of China Medical University
        • Kontakt:
          • Yuanzhe Jin
      • Shenyang, Kina
        • Ikke rekrutterer endnu
        • Liaoning Provincial People's Hospital
        • Kontakt:
          • Bo Luan
      • Shijia Zhuang, Kina
        • Ikke rekrutterer endnu
        • The Second Hospital of Hebei Medical University
        • Kontakt:
          • Xinshun Gu
      • Shijiazhuang, Kina
        • Ikke rekrutterer endnu
        • Hebei Provincial People's Hospital
        • Kontakt:
          • Yi Dang
      • Suihua, Kina
        • Ikke rekrutterer endnu
        • Suihua First Hospital
        • Kontakt:
          • Qiuye Yang
      • Taiyuan, Kina
        • Ikke rekrutterer endnu
        • General Hospital of Taiyuan Iron and Steel (Group) Co.
        • Kontakt:
          • Huifeng Wang
      • Taiyuan, Kina
        • Ikke rekrutterer endnu
        • Shanxi Provincial Cardiovascular Hospital
        • Kontakt:
          • Zhulin Zhang
      • Tianjin, Kina
        • Ikke rekrutterer endnu
        • Tianjin Chest Hospital
        • Kontakt:
          • Chunjie Li
      • Tianjin, Kina
        • Ikke rekrutterer endnu
        • Teda International Cardiovascular Hospital
        • Kontakt:
          • Wenhua Lin
      • Tianjin, Kina
        • Ikke rekrutterer endnu
        • General Hospital of Tianjin Medical University
        • Kontakt:
          • Qing Yang
      • Wenzhou, Kina
        • Ikke rekrutterer endnu
        • The Second Affiliated Hospital of Wenzhou Medical University
        • Kontakt:
          • Xueqiang Guan
      • Wuhan, Kina
        • Ikke rekrutterer endnu
        • Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
        • Kontakt:
          • Xiang Cheng
      • Wuhan, Kina
        • Ikke rekrutterer endnu
        • Wuhan Asia Heart Hospital
        • Kontakt:
          • Hua Yan
      • Xi'an, Kina
        • Ikke rekrutterer endnu
        • The First Affiliated Hospital of Xi'an Jiaotong University
        • Kontakt:
          • Zuyi Yuan
      • Xinjiang, Kina
        • Ikke rekrutterer endnu
        • The First Affiliated Hospital of Xinjiang Medical University
        • Kontakt:
          • Xiang Ma
      • Xinjiang, Kina
        • Ikke rekrutterer endnu
        • People's Hospital of Xinjiang Uygur Autonomous Region
        • Kontakt:
          • Yining Yang
      • Yantai, Kina
        • Ikke rekrutterer endnu
        • Yantai YuHuangDing Hospital
        • Kontakt:
          • Faxin Ren
      • Zhengzhou, Kina
        • Ikke rekrutterer endnu
        • The First Affiliated Hospital of Zhengzhou University
        • Kontakt:
          • Jinying Zhang
      • Zhengzhou, Kina
        • Ikke rekrutterer endnu
        • Fuwai Huazhong Cardiovascular Hospital
        • Kontakt:
          • Chuanyu Gao
      • Zunyi, Kina
        • Ikke rekrutterer endnu
        • Zunyi Medical University Affiliated Hospital
        • Kontakt:
          • Ranzun Zhao
    • Heilongjiang
      • Harbin, Heilongjiang, Kina, 150086
        • Rekruttering
        • The Second Affiliated Hospital of Harbin Medical University
        • Kontakt:

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

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  1. Male or female patients aged ≥18 years and ≤75 years;
  2. Diagnosis of type 1 AMI, including STEMI (onset <24 hours or 7-14 days) or NSTEMI;
  3. After coronary angiography (CAG) ± thrombus aspiration, TIMI flow in the culprit vessel is restored to grade 3 and maintained for at least 5 minutes, with diameter stenosis (DS) <70% at the culprit lesion (QCA);
  4. Reference diameter of the culprit lesion >2.5 mm and ≤4.0 mm;
  5. Patients or a legally authorized representative must provide written Informed Consent prior to any study related procedure.

Exclusion Criteria:

1.Clinical exclusion criteria:

  1. Severe cardiac dysfunction (Killip/NYHA class ≥ 3) or LVEF < 30%;
  2. Cardiopulmonary resuscitation (CPR) performed at the onset of AMI;
  3. Persistent hemodynamic or cardiac electrical instability after TIMI flow restoration;
  4. Contraindication to antithrombotic drugs, or concurrent hemorrhagic diseases such as peptic ulcer or coagulation disorders;
  5. Contraindication to contrast;
  6. Severe renal dysfunction [defined as eGFR ≤30 ml/min/1.73m² or Scr ≥2.0 mg/dL] without regular dialysis (patients with chronic renal insufficiency on regular dialysis may be considered for enrollment);
  7. Active liver disease, defined as known infectious, neoplastic, or metabolic liver lesions, with ALT and AST >3× upper limit of normal (ULN);
  8. Previous history of CABG or PCI for the culprit lesion;
  9. Patients with other concurrent severe diseases and an expected life expectancy of <1 year;
  10. Pregnant or lactating women. Women of childbearing potential must use effective contraceptive measures during the study treatment period;
  11. Inability to comply with the study protocol or other conditions deemed unsuitable for study participation by the investigator.

2.Imaging exclusion criteria:

  1. Non-culprit lesion with DS ≥70% or planned revascularization;
  2. Left main coronary artery lesion with DS ≥50%;
  3. Culprit lesion is a true bifurcation lesion requiring a two-stent strategy;
  4. Long lesion (planned stent length >60 mm);
  5. Culprit lesion with dissection, false lumen, or other conditions necessitating stent implantation;
  6. Target lesion has undergone pre-treatment (such as balloon dilation, rotational atherectomy, etc.).

3.Functional sub study:

  1. Individuals who are allergic to adenosine triphosphate (ATP) or any component in its preparations;
  2. Second and third degree atrioventricular block, sick sinus syndrome (without artificial pacemaker protectors);
  3. Patients with bronchial asthma.

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Guideline-recommended standard medical therapy alone
Dual antiplatelet therapy, anticoagulation, thrombolysis, lipid-lowering, and other guideline recommended drugs related to myocardial infarction.
Dual antiplatelet therapy, anticoagulation, thrombolysis, lipid-lowering, and other guideline recommended drugs related to myocardial infarction
Aktiv komparator: DES implantation plus guideline-recommended standard medical therapy
DES implantation plus dual antiplatelet therapy, anticoagulation, thrombolysis, lipid-lowering, and other guideline recommended drugs related to myocardial infarction.
DES implantation plus dual antiplatelet therapy, anticoagulation, thrombolysis, lipid-lowering, and other guideline recommended drugs related to myocardial infarction.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Target Lesion Failure(TLF)
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
TLF is defined as a composite endpoint consisting of cardiovascular death, target vessel myocardial infarction and ischemia-driven target lesion revascularization.
From randomization to the end of the study, median follow-up duration is 30 months.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
All-cause death
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
From randomization to the end of the study, median follow-up duration is 30 months.
Cardiovascular death
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
From randomization to the end of the study, median follow-up duration is 30 months.
Myocardial infarction (MI)
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
From randomization to the end of the study, median follow-up duration is 30 months.
Target vessel myocardial infarction
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
From randomization to the end of the study, median follow-up duration is 30 months.
Coronary Revascularization
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
From randomization to the end of the study, median follow-up duration is 30 months.
Target vessel revascularization
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
From randomization to the end of the study, median follow-up duration is 30 months.
Target lesion revascularization
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
From randomization to the end of the study, median follow-up duration is 30 months.
Ischemia-driven target lesion revascularization
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
From randomization to the end of the study, median follow-up duration is 30 months.
Stroke
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
From randomization to the end of the study, median follow-up duration is 30 months.
Rehospitalization for unstable angina pectoris
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
From randomization to the end of the study, median follow-up duration is 30 months.
Rehospitalization for heart failure
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
From randomization to the end of the study, median follow-up duration is 30 months.
Major adverse cardiovascular and cerebrovascular events (MACCE)
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
MACCE: defined as a composite endpoint consisting of all-cause death, myocardial infarction, stroke, and repeat revascularization.
From randomization to the end of the study, median follow-up duration is 30 months.
Seattle Angina Questionnaire(SAQ)score
Tidsramme: From 24 hours after surgery to discharge and the 12th month after discharge
From 24 hours after surgery to discharge and the 12th month after discharge

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Definite or probable in-stent thrombosis
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
Safety endpoint
From randomization to the end of the study, median follow-up duration is 30 months.
Contrast-induced acute kidney injury(CI-AKI)
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
Safety endpoint
From randomization to the end of the study, median follow-up duration is 30 months.
Procedure-related myocardial infarction
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
Safety endpoint
From randomization to the end of the study, median follow-up duration is 30 months.
Bleeding Academic Research Consortium(BARC)type 3 and type 5 bleeding
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
Safety endpoint
From randomization to the end of the study, median follow-up duration is 30 months.
Microcirculation resistance index(IMR)to assess the incidence of coronary microvascular dysfunction (CMD)
Tidsramme: From randomization to the end of the study, median follow-up duration is 30 months.
Exploratory endpoint:Functional sub research
From randomization to the end of the study, median follow-up duration is 30 months.
The first occurrence of all-cause death and readmission due to heart failure within 12 months.
Tidsramme: From randomization to the 12th month.
Exploratory endpoint:Functional sub research
From randomization to the 12th month.

Samarbejdspartnere og efterforskere

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

Sponsor

Efterforskere

  • Ledende efterforsker: Bo Yu, Ph.D., The Second Affiliated Hospital of Harbin Medical University
  • Ledende efterforsker: Jingbo Hou, Ph.D., The Second Affiliated Hospital of Harbin Medical University

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 (Faktiske)

13. juli 2026

Primær færdiggørelse (Anslået)

1. april 2029

Studieafslutning (Anslået)

1. december 2030

Datoer for studieregistrering

Først indsendt

21. april 2026

Først indsendt, der opfyldte QC-kriterier

30. april 2026

Først opslået (Faktiske)

5. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

16. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

14. juli 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • KY2026-042

Plan for individuelle deltagerdata (IPD)

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INGEN

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