CAPRA-EVO: a Randomized Serial PCCT Trial of Early Evolocumab After ACS (CAPRA-EVO)
A Single-center, Randomized Controlled Comparison of Effect of Evolocumab Versus Standard Lipid Lowering Therapy on Plaque Progression in Patients With Acute Coronary Syndrome by Serial PCCT(CAPRA-EVO Trial)
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Xiaoyu Wang
- Telefonnummer: 86+18384252874
- E-mail: wxy2cd@yeah.net
Studiesteder
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Sichuan
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Chengdu, Sichuan, Kina
- Rekruttering
- West China Hospital of Sichuan University
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-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
Eligible patients must meet the following criteria:
- Age between 40 and 75 years.
- Diagnosis of ACS, including ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI) or unstable angina (UA).
- Successful PCI treatment, with post-procedural TIMI grade 3 flow and residual stenosis <30% and atherosclerotic plaque presence in non-culprit coronary vessels (not attributed to this target event).
- Suboptimal LDL-C control: Patients must have received any statin treatment for at least 4 weeks, with an LDL-C level ≥1.8 mmol/L; or Statin-naive patients must have an LDL-C level ≥3.2 mmol/L.
- Agreement to complete baseline CCTA and laboratory tests within 7 days of enrollment and signed informed consent.
- Commitment to complete 52 weeks of follow-up.
Exclusion Criteria:
- History of coronary artery bypass grafting (CABG).
- History of valve surgery.
- History of PCI treatment before the index ACS event
- Complex bifurcation lesions (Medina 1,1,1).
- Use of PCSK9 inhibitors (e.g., evolocumab, alirocumab) or potent CYP3A4 inhibitors (e.g., itraconazole) within the last 12 months.
- Known intolerance to statins, evolocumab, or other investigational drugs related to the study.
- Hepatic or renal insufficiency (eGFR <60 mL/min/1.73m² or ALT/AST >3 times the upper limit of normal).
- Active autoimmune diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus).
- Uncontrolled heart failure (NYHA class III-IV) or malignant arrhythmias.
- Known allergy or hypersensitivity to iodinated contrast media
- Hyperthyroidism or active thyroid disease
- Pregnancy or breastfeeding (or plans for pregnancy within the next year).
- Life expectancy of less than 1 year (e.g., due to advanced malignancy).
- Participation in another interventional clinical trial within the past 3 months.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Tredobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Experimental: Evolocumab Plus Standard Lipid-Lowering Therapy
Participants randomized to this arm will receive early evolocumab in addition to standard-of-care lipid-lowering therapy after successful percutaneous coronary intervention for acute coronary syndrome.
Participants will undergo serial photon-counting coronary computed tomography angiography at baseline and 52 weeks to evaluate changes in non-culprit coronary plaque burden, stenosis severity, and high-risk plaque features.
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Evolocumab will be administered early after randomization in participants assigned to the experimental arm, in addition to standard-of-care lipid-lowering therapy.
The treatment is intended to achieve intensive low-density lipoprotein cholesterol reduction and to evaluate its effect on coronary plaque progression or stabilization over 52 weeks.
All participants will undergo photon-counting coronary computed tomography angiography at baseline and at 52 weeks.
Imaging will be used to assess changes in total atherosclerotic volume, stenosis severity, and high-risk plaque features in non-culprit coronary vessels.
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Aktiv komparator: Active Comparator: Standard Lipid-Lowering Therapy
Participants randomized to this arm will receive guideline-directed standard-of-care lipid-lowering therapy after successful percutaneous coronary intervention for acute coronary syndrome.
Participants will undergo serial photon-counting coronary computed tomography angiography at baseline and 52 weeks to evaluate changes in non-culprit coronary plaque burden, stenosis severity, and high-risk plaque features.
|
All participants will undergo photon-counting coronary computed tomography angiography at baseline and at 52 weeks.
Imaging will be used to assess changes in total atherosclerotic volume, stenosis severity, and high-risk plaque features in non-culprit coronary vessels.
Participants will receive guideline-directed standard lipid-lowering therapy according to contemporary clinical practice and investigator judgment.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Total atherosclerotic volume and stenosis severity
Tidsramme: From enrollment to the end of treatment at 52 weeks
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a. Total atherosclerotic volume (TAV) at the whole-non-culprit-vessel level: Change from baseline CTA (week 0) to endpoint CTA(week 52).
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From enrollment to the end of treatment at 52 weeks
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b. Stenosis severity at the target lesion level (defined as luminal stenosis ≥50%, particularly in left main coronary artery [LMCA] or proximal left anterior descending artery [LAD] OR presence of ≥2 high-risk plaque features)
Tidsramme: From enrollment to the end of treatment at 52 weeks
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From enrollment to the end of treatment at 52 weeks
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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HRP change
Tidsramme: From enrollment to the end of treatment at 52 weeks
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Change in high-risk plaque (HRP) features from baseline CTA (week 0) to endpoint CTA (week 52).
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From enrollment to the end of treatment at 52 weeks
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Studieleder: Yong He, West China Hospital
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
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
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- WestChinaH-CVD-010
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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