Non-stenting Treatment Strategy for Acute Myocardial Infarction With Non-severe Stenosis(EROSION IV)
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
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Jingbo Hou, Ph.D.
- Telefonnummer: 13303609625
- E-mail: jingbohou@163.com
Undersøgelse Kontakt Backup
- Navn: Bo Yu, Ph.D.
- E-mail: yubodr@163.com
Studiesteder
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Beijing, Kina
- Ikke rekrutterer endnu
- Fuwai Hospital, Chinese Academy of Medical Sciences
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Kontakt:
- Lei Song
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Beijing, Kina
- Ikke rekrutterer endnu
- Beijing Luhe Hospital Affiliated to Capital Medical University
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Kontakt:
- Guangyao Zhai
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Cangzhou, Kina
- Ikke rekrutterer endnu
- Cangzhou Central Hospital
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Kontakt:
- Jun Zhang
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Chengde, Kina
- Ikke rekrutterer endnu
- Chengde Medical College Affiliated Hospital
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Kontakt:
- Ying Zhang
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Chengdu, Kina
- Ikke rekrutterer endnu
- Sichuan Provincial People's Hospital
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Kontakt:
- Wenjie Tian
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Dalian, Kina
- Ikke rekrutterer endnu
- The First Affiliated Hospital of Dalian Medical University
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Kontakt:
- Bo Zhang
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Dalian, Kina
- Ikke rekrutterer endnu
- The Second Affiliated Hospital of Dalian Medical University
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Kontakt:
- Xin Zhao
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Dalian, Kina
- Ikke rekrutterer endnu
- The Central Hospital Affiliated to Dalian University of Technology
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Kontakt:
- Xiaoqun Zheng
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Daqing, Kina
- Ikke rekrutterer endnu
- Daqing Oilfield General Hospital
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Kontakt:
- Zhiqi Sun
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Harbin, Kina
- Ikke rekrutterer endnu
- The Fourth Affiliated Hospital of Harbin Medical University
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Kontakt:
- Wei Yang
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Hunan, Kina
- Ikke rekrutterer endnu
- The Third XIANGYA Hospital of Central South University
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Kontakt:
- Yu Cao
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Jiamusi, Kina
- Ikke rekrutterer endnu
- Central Hospital of Jiamusi City
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Kontakt:
- Zhiyuan Weng
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Jiamusi, Kina
- Ikke rekrutterer endnu
- The First Affiliated Hospital of Jiamusi University
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Kontakt:
- Guangyuan Yang
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Jilin City, Kina
- Ikke rekrutterer endnu
- China-Japan Union Hospital of Jilin University
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Kontakt:
- Yuquan He
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Jilin City, Kina
- Ikke rekrutterer endnu
- Jilin Central Hospital
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Kontakt:
- Yijun Shang
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Jilin City, Kina
- Ikke rekrutterer endnu
- The First Hospital of Jilin University
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Kontakt:
- Qian Tong
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Jinan, Kina
- Ikke rekrutterer endnu
- Shandong Provincial Hospital
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Kontakt:
- Haitao Yuan
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Jining, Kina
- Ikke rekrutterer endnu
- The Affiliated Hospital of Jining Medical University
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Kontakt:
- Lijun Gan
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Lanzhou, Kina
- Ikke rekrutterer endnu
- Lanzhou University First Hospital
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Kontakt:
- Ming Bai
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Linyi, Kina
- Ikke rekrutterer endnu
- Linyi People's Hospital
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Kontakt:
- Yanjin Wei
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Mudanjiang, Kina
- Ikke rekrutterer endnu
- Mudanjiang Cardiovascular Hospital
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Kontakt:
- Kai Liu
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Nanyang, Kina
- Ikke rekrutterer endnu
- The First Affiliated Hospital of Nanyang Medical College
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Kontakt:
- Ou Zhang
-
Qingdao, Kina
- Ikke rekrutterer endnu
- The Affiliated Hospital of Qingdao University
-
Kontakt:
- Zhexun Lian
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Qiqihar, Kina
- Ikke rekrutterer endnu
- Qiqihar First Hospital
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Kontakt:
- Jinhui Zhang
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Qiqihar, Kina
- Ikke rekrutterer endnu
- The Second Affiliated Hospital of Qiqihar Medical University
-
Kontakt:
- Xiaojie Wu
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Qiqihar, Kina
- Ikke rekrutterer endnu
- The Third Affiliated Hospital of Qiqihar Medical University
-
Kontakt:
- Haifeng Shao
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Shenyang, Kina
- Ikke rekrutterer endnu
- Shengjing Hospital of China Medical University
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Kontakt:
- Zhijun Sun
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Shenyang, Kina
- Ikke rekrutterer endnu
- The Fourth Affiliated Hospital of China Medical University
-
Kontakt:
- Yuanzhe Jin
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Shenyang, Kina
- Ikke rekrutterer endnu
- Liaoning Provincial People's Hospital
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Kontakt:
- Bo Luan
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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
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Wuhan, Kina
- Ikke rekrutterer endnu
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
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Kontakt:
- Xiang Cheng
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Wuhan, Kina
- Ikke rekrutterer endnu
- Wuhan Asia Heart Hospital
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Kontakt:
- Hua Yan
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Xi'an, Kina
- Ikke rekrutterer endnu
- The First Affiliated Hospital of Xi'an Jiaotong University
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Kontakt:
- Zuyi Yuan
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Xinjiang, Kina
- Ikke rekrutterer endnu
- The First Affiliated Hospital of Xinjiang Medical University
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Kontakt:
- Xiang Ma
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Xinjiang, Kina
- Ikke rekrutterer endnu
- People's Hospital of Xinjiang Uygur Autonomous Region
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Kontakt:
- Yining Yang
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Yantai, Kina
- Ikke rekrutterer endnu
- Yantai YuHuangDing Hospital
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Kontakt:
- Faxin Ren
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Zhengzhou, Kina
- Ikke rekrutterer endnu
- The First Affiliated Hospital of Zhengzhou University
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Kontakt:
- Jinying Zhang
-
Zhengzhou, Kina
- Ikke rekrutterer endnu
- Fuwai Huazhong Cardiovascular Hospital
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Kontakt:
- Chuanyu Gao
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Zunyi, Kina
- Ikke rekrutterer endnu
- Zunyi Medical University Affiliated Hospital
-
Kontakt:
- Ranzun Zhao
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Heilongjiang
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Harbin, Heilongjiang, Kina, 150086
- Rekruttering
- The Second Affiliated Hospital of Harbin Medical University
-
Kontakt:
- Jingbo Hou, M.D.
- Telefonnummer: 8613303609625
- E-mail: jingbohou@163.com
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Male or female patients aged ≥18 years and ≤75 years;
- Diagnosis of type 1 AMI, including STEMI (onset <24 hours or 7-14 days) or NSTEMI;
- 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);
- Reference diameter of the culprit lesion >2.5 mm and ≤4.0 mm;
- Patients or a legally authorized representative must provide written Informed Consent prior to any study related procedure.
Exclusion Criteria:
1.Clinical exclusion criteria:
- Severe cardiac dysfunction (Killip/NYHA class ≥ 3) or LVEF < 30%;
- Cardiopulmonary resuscitation (CPR) performed at the onset of AMI;
- Persistent hemodynamic or cardiac electrical instability after TIMI flow restoration;
- Contraindication to antithrombotic drugs, or concurrent hemorrhagic diseases such as peptic ulcer or coagulation disorders;
- Contraindication to contrast;
- 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);
- Active liver disease, defined as known infectious, neoplastic, or metabolic liver lesions, with ALT and AST >3× upper limit of normal (ULN);
- Previous history of CABG or PCI for the culprit lesion;
- Patients with other concurrent severe diseases and an expected life expectancy of <1 year;
- Pregnant or lactating women. Women of childbearing potential must use effective contraceptive measures during the study treatment period;
- Inability to comply with the study protocol or other conditions deemed unsuitable for study participation by the investigator.
2.Imaging exclusion criteria:
- Non-culprit lesion with DS ≥70% or planned revascularization;
- Left main coronary artery lesion with DS ≥50%;
- Culprit lesion is a true bifurcation lesion requiring a two-stent strategy;
- Long lesion (planned stent length >60 mm);
- Culprit lesion with dissection, false lumen, or other conditions necessitating stent implantation;
- Target lesion has undergone pre-treatment (such as balloon dilation, rotational atherectomy, etc.).
3.Functional sub study:
- Individuals who are allergic to adenosine triphosphate (ATP) or any component in its preparations;
- Second and third degree atrioventricular block, sick sinus syndrome (without artificial pacemaker protectors);
- Patients with bronchial asthma.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / 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
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
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
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
Sponsor
Sponsor
Efterforskere
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
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
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Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- KY2026-042
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