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.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Jingbo Hou, Ph.D.
- Telefonnummer: 13303609625
- E-Mail: jingbohou@163.com
Studieren Sie die Kontaktsicherung
- Name: Bo Yu, Ph.D.
- E-Mail: yubodr@163.com
Studienorte
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Beijing, China
- Noch keine Rekrutierung
- Fuwai Hospital, Chinese Academy of Medical Sciences
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Kontakt:
- Lei Song
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Beijing, China
- Noch keine Rekrutierung
- Beijing Luhe Hospital Affiliated to Capital Medical University
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Kontakt:
- Guangyao Zhai
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Cangzhou, China
- Noch keine Rekrutierung
- Cangzhou Central Hospital
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Kontakt:
- Jun Zhang
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Chengde, China
- Noch keine Rekrutierung
- Chengde Medical College Affiliated Hospital
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Kontakt:
- Ying Zhang
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Chengdu, China
- Noch keine Rekrutierung
- Sichuan Provincial People's Hospital
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Kontakt:
- Wenjie Tian
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Dalian, China
- Noch keine Rekrutierung
- The First Affiliated Hospital of Dalian Medical University
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Kontakt:
- Bo Zhang
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Dalian, China
- Noch keine Rekrutierung
- The Second Affiliated Hospital of Dalian Medical University
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Kontakt:
- Xin Zhao
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Dalian, China
- Noch keine Rekrutierung
- The Central Hospital Affiliated to Dalian University of Technology
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Kontakt:
- Xiaoqun Zheng
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Daqing, China
- Noch keine Rekrutierung
- Daqing Oilfield General Hospital
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Kontakt:
- Zhiqi Sun
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Harbin, China
- Noch keine Rekrutierung
- The Fourth Affiliated Hospital of Harbin Medical University
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Kontakt:
- Wei Yang
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Hunan, China
- Noch keine Rekrutierung
- The Third XIANGYA Hospital of Central South University
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Kontakt:
- Yu Cao
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Jiamusi, China
- Noch keine Rekrutierung
- Central Hospital of Jiamusi City
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Kontakt:
- Zhiyuan Weng
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Jiamusi, China
- Noch keine Rekrutierung
- The First Affiliated Hospital of Jiamusi University
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Kontakt:
- Guangyuan Yang
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Jilin City, China
- Noch keine Rekrutierung
- China-Japan Union Hospital of Jilin University
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Kontakt:
- Yuquan He
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Jilin City, China
- Noch keine Rekrutierung
- Jilin Central Hospital
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Kontakt:
- Yijun Shang
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Jilin City, China
- Noch keine Rekrutierung
- The First Hospital of Jilin University
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Kontakt:
- Qian Tong
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Jinan, China
- Noch keine Rekrutierung
- Shandong Provincial Hospital
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Kontakt:
- Haitao Yuan
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Jining, China
- Noch keine Rekrutierung
- The Affiliated Hospital of Jining Medical University
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Kontakt:
- Lijun Gan
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Lanzhou, China
- Noch keine Rekrutierung
- Lanzhou University First Hospital
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Kontakt:
- Ming Bai
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Linyi, China
- Noch keine Rekrutierung
- Linyi People's Hospital
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Kontakt:
- Yanjin Wei
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Mudanjiang, China
- Noch keine Rekrutierung
- Mudanjiang Cardiovascular Hospital
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Kontakt:
- Kai Liu
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Nanyang, China
- Noch keine Rekrutierung
- The First Affiliated Hospital of Nanyang Medical College
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Kontakt:
- Ou Zhang
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Qingdao, China
- Noch keine Rekrutierung
- The Affiliated Hospital of Qingdao University
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Kontakt:
- Zhexun Lian
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Qiqihar, China
- Noch keine Rekrutierung
- Qiqihar First Hospital
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Kontakt:
- Jinhui Zhang
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Qiqihar, China
- Noch keine Rekrutierung
- The Second Affiliated Hospital of Qiqihar Medical University
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Kontakt:
- Xiaojie Wu
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Qiqihar, China
- Noch keine Rekrutierung
- The Third Affiliated Hospital of Qiqihar Medical University
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Kontakt:
- Haifeng Shao
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Shenyang, China
- Noch keine Rekrutierung
- Shengjing Hospital of China Medical University
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Kontakt:
- Zhijun Sun
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Shenyang, China
- Noch keine Rekrutierung
- The Fourth Affiliated Hospital of China Medical University
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Kontakt:
- Yuanzhe Jin
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Shenyang, China
- Noch keine Rekrutierung
- Liaoning Provincial People's Hospital
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Kontakt:
- Bo Luan
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Shijia Zhuang, China
- Noch keine Rekrutierung
- The Second Hospital of Hebei Medical University
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Kontakt:
- Xinshun Gu
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Shijiazhuang, China
- Noch keine Rekrutierung
- Hebei Provincial People's Hospital
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Kontakt:
- Yi Dang
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Suihua, China
- Noch keine Rekrutierung
- Suihua First Hospital
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Kontakt:
- Qiuye Yang
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Taiyuan, China
- Noch keine Rekrutierung
- General Hospital of Taiyuan Iron and Steel (Group) Co.
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Kontakt:
- Huifeng Wang
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Taiyuan, China
- Noch keine Rekrutierung
- Shanxi Provincial Cardiovascular Hospital
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Kontakt:
- Zhulin Zhang
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Tianjin, China
- Noch keine Rekrutierung
- Tianjin Chest Hospital
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Kontakt:
- Chunjie Li
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Tianjin, China
- Noch keine Rekrutierung
- Teda International Cardiovascular Hospital
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Kontakt:
- Wenhua Lin
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Tianjin, China
- Noch keine Rekrutierung
- General Hospital of Tianjin Medical University
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Kontakt:
- Qing Yang
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Wenzhou, China
- Noch keine Rekrutierung
- The Second Affiliated Hospital of Wenzhou Medical University
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Kontakt:
- Xueqiang Guan
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Wuhan, China
- Noch keine Rekrutierung
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
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Kontakt:
- Xiang Cheng
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Wuhan, China
- Noch keine Rekrutierung
- Wuhan Asia Heart Hospital
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Kontakt:
- Hua Yan
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Xi'an, China
- Noch keine Rekrutierung
- The First Affiliated Hospital of Xi'an Jiaotong University
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Kontakt:
- Zuyi Yuan
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Xinjiang, China
- Noch keine Rekrutierung
- The First Affiliated Hospital of Xinjiang Medical University
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Kontakt:
- Xiang Ma
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Xinjiang, China
- Noch keine Rekrutierung
- People's Hospital of Xinjiang Uygur Autonomous Region
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Kontakt:
- Yining Yang
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Yantai, China
- Noch keine Rekrutierung
- Yantai YuHuangDing Hospital
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Kontakt:
- Faxin Ren
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Zhengzhou, China
- Noch keine Rekrutierung
- The First Affiliated Hospital of Zhengzhou University
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Kontakt:
- Jinying Zhang
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Zhengzhou, China
- Noch keine Rekrutierung
- Fuwai Huazhong Cardiovascular Hospital
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Kontakt:
- Chuanyu Gao
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Zunyi, China
- Noch keine Rekrutierung
- Zunyi Medical University Affiliated Hospital
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Kontakt:
- Ranzun Zhao
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Heilongjiang
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Harbin, Heilongjiang, China, 150086
- Rekrutierung
- The Second Affiliated Hospital of Harbin Medical University
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Kontakt:
- Jingbo Hou, M.D.
- Telefonnummer: 8613303609625
- E-Mail: jingbohou@163.com
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
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.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
Experimental: 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
|
|
Aktiver 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.
|
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Target Lesion Failure(TLF)
Zeitfenster: 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.
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
All-cause death
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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.
|
|
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Rehospitalization for unstable angina pectoris
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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
Zeitfenster: 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
|
Andere Ergebnismessungen
Andere Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Definite or probable in-stent thrombosis
Zeitfenster: 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)
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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.
Zeitfenster: From randomization to the 12th month.
|
Exploratory endpoint:Functional sub research
|
From randomization to the 12th month.
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Bo Yu, Ph.D., The Second Affiliated Hospital of Harbin Medical University
- Hauptermittler: Jingbo Hou, Ph.D., The Second Affiliated Hospital of Harbin Medical University
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- KY2026-042
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Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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