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.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Jingbo Hou, Ph.D.
- Numero di telefono: 13303609625
- Email: jingbohou@163.com
Backup dei contatti dello studio
- Nome: Bo Yu, Ph.D.
- Email: yubodr@163.com
Luoghi di studio
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Beijing, Cina
- Non ancora reclutamento
- Fuwai Hospital, Chinese Academy of Medical Sciences
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Contatto:
- Lei Song
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Beijing, Cina
- Non ancora reclutamento
- Beijing Luhe Hospital Affiliated to Capital Medical University
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Contatto:
- Guangyao Zhai
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Cangzhou, Cina
- Non ancora reclutamento
- Cangzhou Central Hospital
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Contatto:
- Jun Zhang
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Chengde, Cina
- Non ancora reclutamento
- Chengde Medical College Affiliated Hospital
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Contatto:
- Ying Zhang
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Chengdu, Cina
- Non ancora reclutamento
- Sichuan Provincial People's Hospital
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Contatto:
- Wenjie Tian
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Dalian, Cina
- Non ancora reclutamento
- The First Affiliated Hospital of Dalian Medical University
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Contatto:
- Bo Zhang
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Dalian, Cina
- Non ancora reclutamento
- The Second Affiliated Hospital of Dalian Medical University
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Contatto:
- Xin Zhao
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Dalian, Cina
- Non ancora reclutamento
- The Central Hospital Affiliated to Dalian University of Technology
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Contatto:
- Xiaoqun Zheng
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Daqing, Cina
- Non ancora reclutamento
- Daqing Oilfield General Hospital
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Contatto:
- Zhiqi Sun
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Harbin, Cina
- Non ancora reclutamento
- The Fourth Affiliated Hospital of Harbin Medical University
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Contatto:
- Wei Yang
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Hunan, Cina
- Non ancora reclutamento
- The Third XIANGYA Hospital of Central South University
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Contatto:
- Yu Cao
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Jiamusi, Cina
- Non ancora reclutamento
- Central Hospital of Jiamusi City
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Contatto:
- Zhiyuan Weng
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Jiamusi, Cina
- Non ancora reclutamento
- The First Affiliated Hospital of Jiamusi University
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Contatto:
- Guangyuan Yang
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Jilin City, Cina
- Non ancora reclutamento
- China-Japan Union Hospital of Jilin University
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Contatto:
- Yuquan He
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Jilin City, Cina
- Non ancora reclutamento
- Jilin Central Hospital
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Contatto:
- Yijun Shang
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Jilin City, Cina
- Non ancora reclutamento
- The First Hospital of Jilin University
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Contatto:
- Qian Tong
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Jinan, Cina
- Non ancora reclutamento
- Shandong Provincial Hospital
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Contatto:
- Haitao Yuan
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Jining, Cina
- Non ancora reclutamento
- The Affiliated Hospital of Jining Medical University
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Contatto:
- Lijun Gan
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Lanzhou, Cina
- Non ancora reclutamento
- Lanzhou University First Hospital
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Contatto:
- Ming Bai
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Linyi, Cina
- Non ancora reclutamento
- Linyi People's Hospital
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Contatto:
- Yanjin Wei
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Mudanjiang, Cina
- Non ancora reclutamento
- Mudanjiang Cardiovascular Hospital
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Contatto:
- Kai Liu
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Nanyang, Cina
- Non ancora reclutamento
- The First Affiliated Hospital of Nanyang Medical College
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Contatto:
- Ou Zhang
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Qingdao, Cina
- Non ancora reclutamento
- The Affiliated Hospital of Qingdao University
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Contatto:
- Zhexun Lian
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Qiqihar, Cina
- Non ancora reclutamento
- Qiqihar First Hospital
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Contatto:
- Jinhui Zhang
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Qiqihar, Cina
- Non ancora reclutamento
- The Second Affiliated Hospital of Qiqihar Medical University
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Contatto:
- Xiaojie Wu
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Qiqihar, Cina
- Non ancora reclutamento
- The Third Affiliated Hospital of Qiqihar Medical University
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Contatto:
- Haifeng Shao
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Shenyang, Cina
- Non ancora reclutamento
- Shengjing Hospital of China Medical University
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Contatto:
- Zhijun Sun
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Shenyang, Cina
- Non ancora reclutamento
- The Fourth Affiliated Hospital of China Medical University
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Contatto:
- Yuanzhe Jin
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Shenyang, Cina
- Non ancora reclutamento
- Liaoning Provincial People's Hospital
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Contatto:
- Bo Luan
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Shijia Zhuang, Cina
- Non ancora reclutamento
- The Second Hospital of Hebei Medical University
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Contatto:
- Xinshun Gu
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Shijiazhuang, Cina
- Non ancora reclutamento
- Hebei Provincial People's Hospital
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Contatto:
- Yi Dang
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Suihua, Cina
- Non ancora reclutamento
- Suihua First Hospital
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Contatto:
- Qiuye Yang
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Taiyuan, Cina
- Non ancora reclutamento
- General Hospital of Taiyuan Iron and Steel (Group) Co.
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Contatto:
- Huifeng Wang
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Taiyuan, Cina
- Non ancora reclutamento
- Shanxi Provincial Cardiovascular Hospital
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Contatto:
- Zhulin Zhang
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Tianjin, Cina
- Non ancora reclutamento
- Tianjin Chest Hospital
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Contatto:
- Chunjie Li
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Tianjin, Cina
- Non ancora reclutamento
- Teda International Cardiovascular Hospital
-
Contatto:
- Wenhua Lin
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Tianjin, Cina
- Non ancora reclutamento
- General Hospital of Tianjin Medical University
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Contatto:
- Qing Yang
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Wenzhou, Cina
- Non ancora reclutamento
- The Second Affiliated Hospital of Wenzhou Medical University
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Contatto:
- Xueqiang Guan
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Wuhan, Cina
- Non ancora reclutamento
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
-
Contatto:
- Xiang Cheng
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Wuhan, Cina
- Non ancora reclutamento
- Wuhan Asia Heart Hospital
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Contatto:
- Hua Yan
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Xi'an, Cina
- Non ancora reclutamento
- The First Affiliated Hospital of Xi'an Jiaotong University
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Contatto:
- Zuyi Yuan
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Xinjiang, Cina
- Non ancora reclutamento
- The First Affiliated Hospital of Xinjiang Medical University
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Contatto:
- Xiang Ma
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Xinjiang, Cina
- Non ancora reclutamento
- People's Hospital of Xinjiang Uygur Autonomous Region
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Contatto:
- Yining Yang
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Yantai, Cina
- Non ancora reclutamento
- Yantai YuHuangDing Hospital
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Contatto:
- Faxin Ren
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Zhengzhou, Cina
- Non ancora reclutamento
- The First Affiliated Hospital of Zhengzhou University
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Contatto:
- Jinying Zhang
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Zhengzhou, Cina
- Non ancora reclutamento
- Fuwai Huazhong Cardiovascular Hospital
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Contatto:
- Chuanyu Gao
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Zunyi, Cina
- Non ancora reclutamento
- Zunyi Medical University Affiliated Hospital
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Contatto:
- Ranzun Zhao
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Heilongjiang
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Harbin, Heilongjiang, Cina, 150086
- Reclutamento
- The Second Affiliated Hospital of Harbin Medical University
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Contatto:
- Jingbo Hou, M.D.
- Numero di telefono: 8613303609625
- Email: jingbohou@163.com
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
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.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: 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
|
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Comparatore attivo: 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.
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DES implantation plus dual antiplatelet therapy, anticoagulation, thrombolysis, lipid-lowering, and other guideline recommended drugs related to myocardial infarction.
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Target Lesion Failure(TLF)
Lasso di tempo: 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.
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
All-cause death
Lasso di tempo: 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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Cardiovascular death
Lasso di tempo: 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)
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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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Target vessel revascularization
Lasso di tempo: 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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Target lesion revascularization
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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 heart failure
Lasso di tempo: 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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Major adverse cardiovascular and cerebrovascular events (MACCE)
Lasso di tempo: 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.
|
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Seattle Angina Questionnaire(SAQ)score
Lasso di tempo: 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
|
Altre misure di risultato
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Definite or probable in-stent thrombosis
Lasso di tempo: 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)
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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)
Lasso di tempo: 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.
Lasso di tempo: From randomization to the 12th month.
|
Exploratory endpoint:Functional sub research
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From randomization to the 12th month.
|
Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Investigatore principale: Bo Yu, Ph.D., The Second Affiliated Hospital of Harbin Medical University
- Investigatore principale: Jingbo Hou, Ph.D., The Second Affiliated Hospital of Harbin Medical University
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- KY2026-042
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