Single vs. Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Intervention With DCB-only Strategy (KONG-FREEDOM-I) (KONG-FREEDOM-I)
An Investigator-initiated, Multicenter, Open-label, Randomized Controlled Non-inferiority Trial to Assess the Single vs. Dual Antiplatelet Therapy in the Chronic Coronary Syndrome (CCS) and Stable Acute Coronary Syndrome (S-ACS) Patients Undergoing Percutaneous Intervention With Drug-coated Balloons (DCB)-Only Strategy (KONG-FREEDOM-I)
調査の概要
状態
詳細な説明
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Yong Cao
- 電話番号:+86-0537-2905210
- メール:caoyong0419@163.com
研究場所
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Beijing Municipality
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Beijing、Beijing Municipality、中国
- まだ募集していません
- Beijing Luhe Hospital Capital Medical University
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コンタクト:
- Guangyao Zhai
- 電話番号:+86 18501308666
- メール:Drzhaiguangyao@163.com
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コンタクト:
- Wei He
- 電話番号:+86 13261694832
- メール:14916765@qq.com
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Hainan
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Haikou、Hainan、中国
- まだ募集していません
- The First Affiliated Hospital of Hainan Medical University
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Heilongjiang
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Harbin、Heilongjiang、中国
- まだ募集していません
- The 2nd Affiliated Hospital of Harbin Medical University
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コンタクト:
- Xiling Zhang
- 電話番号:+86 18003608232
- メール:xlzhangdr@163.com
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Jiangxi
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Nanchang、Jiangxi、中国
- まだ募集していません
- The Second Affiliated Hospital of Nanchang University
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Shandong
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Heze、Shandong、中国
- まだ募集していません
- Heze Municipal Hospital
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コンタクト:
- Ning Ma
- 電話番号:+86 19953030211
- メール:48725826@qq.com
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コンタクト:
- Yongqi Huang
- 電話番号:+86 13105119792
- メール:892722535@qq.com
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Jinan、Shandong、中国
- まだ募集していません
- Shandong Provincial Hospital
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コンタクト:
- Haitao Yuan
- 電話番号:+86 13688638072
- メール:doctoryuanht@126.com
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コンタクト:
- Xinran Cao
- 電話番号:+86 15098912873
- メール:caoxinran_1010@126.com
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Jinan、Shandong、中国
- まだ募集していません
- Shandong Provincial Third Hospital
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コンタクト:
- Guo Zhou
- 電話番号:+ 86 15853166471
- メール:zhouguo321@126.com
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コンタクト:
- Yanwei Wang
- 電話番号:+86 18663735013
- メール:827469067@qq.com
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Jining、Shandong、中国、272029
- 募集
- Affiliated Hospital of Jining Medical University
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コンタクト:
- Lijun Gan
- メール:13792336453@163.com
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Liaocheng、Shandong、中国
- まだ募集していません
- Liaocheng People's Hospital
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コンタクト:
- Mingting Liang
- 電話番号:+86 17862536696
- メール:Lmting007@163.com
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Qingdao、Shandong、中国
- まだ募集していません
- Qingdao Municipal Hospital
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コンタクト:
- Wei Xia
- 電話番号:+86 18669710958
- メール:18669710958@163.com
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コンタクト:
- Lei Zhang
- 電話番号:+86 17685506687
- メール:suwen-021@163.com
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Tai’an、Shandong、中国
- まだ募集していません
- Tai'an City Central Hospital
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Zaozhuang、Shandong、中国
- まだ募集していません
- Zaozhuang Municipal Hospital
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コンタクト:
- Jun Yang
- 電話番号:+86 18563231799
- メール:yang_js775@163.com
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コンタクト:
- Yaqing Yang
- 電話番号:+86 19863279581
- メール:601806846@qq.com
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Shanghai Municipality
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Shanghai、Shanghai Municipality、中国
- まだ募集していません
- Shanghai Fengxian District People's Hospital
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コンタクト:
- Jiangwei Ma
- 電話番号:+86 18616357007
- メール:Majiangwei2004@126.com
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コンタクト:
- Qiong Zhang
- 電話番号:+86 13918155548
- メール:qiongzyw@163.com
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Xinjiang
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Ürümqi、Xinjiang、中国
- まだ募集していません
- The First Affiliated Hospital of Xinjiang Medical University
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
Subjects who successfully underwent percutaneous coronary intervention (PCI) with drug-coated balloon (DCB) treatment without stent implantation are eligible for inclusion in this study if Male and female patients who meet the following criteria:
- Age ≥ 18 years.
- target lesion in vessels with diameter ≥2.0 and ≤4.5 mm (visual estimation).
- the total target vessels ≤2 and a total of target lesions ≤2.
- Total length of DCB used for target lesions <60 mm.
- The subject's indication for PCI is chronic coronary syndrome (CCS) and stable Acute Coronary Syndrome (S-ACS), include Silent Ischemia, stable angina (SA), unstable angina (UA), non-ST-segment elevation myocardial (NSTEMI), or ST-segment elevation acute myocardial infarction (STEMI) with onset >2 weeks.
- All lesions were successfully treated with a drug-eluting balloon during routine clinical practice, i.e., post-procedural angiographic visual diameter stenosis <30%.
- At the operator's discretion, no flow-limiting angiographic complications requiring extension of dual antiplatelet therapy (DAPT)have occurred.
- All PCI stages have been completed (if applicable), and no further PCI procedures are planned.
Inclusion criteria at the randomization visit within 24 hours post-index PCI:
At the time of the randomization visit (within 24 hours after successful drug-eluting balloon treatment during index PCI), the following criteria mustbe met:
The subject must have had an uneventful clinical course within 24 hours post-index PCI, i.e., no myocardial infarction,symptomatic restenosis, device-related thrombus formation, stroke, or any revascularization procedure (coronary or non-coronary)requiring extension of dual antiplatelet therapy.
Exclusion Criteria:
Patients will be ineligible if they meet any of the following criteria:
- Stent implantation within 6 months prior to index percutaneous coronary intervention (PCI).
- Treatment for in-stent thrombosis (IST) at the time of index PCI or within 6 months prior to it.
- Treatment with a bioabsorbable stent at any time prior to index PCI.
- Acute myocardial infarction with ST-segment elevation within the past two weeks.
- True bifurcation lesions requiring treatment with two stents (Medina 1,1,1/1,0,1/0,1,1) with a branch vessel diameter≥2.5 mm (visual estimation).
- Chronic total occlusion of the target lesion (≥3 months).
- Unprotected left main coronary artery.
- Thrombus present in the target lesion (imaging/visual).
- Total length of DCB used in the target lesion ≥60 mm.
- Active bleeding requiring medical intervention (BARC ≥2) at the time of randomization.
- Indications for long-term oral anticoagulation therapy.
- Life expectancy of less than 1 year.
- Known allergy or hypersensitivity to aspirin, clopidogrel, ticagrelor, or sirolimus.
- Currently participating in another trial and has not yet reached the primary endpoint.
- History of asthma induced by salicylates or substances with similar effects (particularly nonsteroidal anti-inflammatory drugs).
- Pregnant or breastfeeding women.
- Inability to understand and follow study-related instructions or to comply with the study protocol.
- Inability to provide written informed consent
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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アクティブコンパレータ:二重抗血小板療法
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抗血栓療法は、地域の好みおよび国際ガイドライン/ARC コンセンサスペーパーに従って、二重抗血小板療法 (DAPT) による標準治療に従います。
薬剤の種類と治療期間は、患者の臨床的特徴に応じて選択されます。
Fireliums rapamycin eluting coronary balloon dilatation catheter is a rapid exchange catheter, it has a patented microcrystalline coating process to ensure rapid drug delivery to the blood vessel wall and achieve a long-lasting sustained release effect, intended for coronary arteries percutaneous transluminal angioplasties.
Patients assigned to this arm will be treated with a Drug-Coated Balloon (DCB) after pre-dilatation, the angiography will be conducted as standard of care.
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実験的:単回抗血小板療法
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Fireliums rapamycin eluting coronary balloon dilatation catheter is a rapid exchange catheter, it has a patented microcrystalline coating process to ensure rapid drug delivery to the blood vessel wall and achieve a long-lasting sustained release effect, intended for coronary arteries percutaneous transluminal angioplasties.
Patients assigned to this arm will be treated with a Drug-Coated Balloon (DCB) after pre-dilatation, the angiography will be conducted as standard of care.
The antithrombotic regimen is single antiplatelet (P2Y12 inhibitor)therapy (SAPT).
The Investigator will decide whether to use ticagrelor first; if ticagrelor is not the first-line recommended drug, then clopidogrel will be considered.
The type of agent and treatment duration will be selected according to the clinical characteristics of the patient.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Rate of Net Adverse Clinical Events (NACE) at 12 months after randomization
時間枠:12 months after randomization
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Noninferiority of single antiplatelet therapy (SAPT) versus dual antiplatelet therapy (DAPT) in stable and unstable acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) with drug-coated balloons (DCB) without stent implantation assessed by the rate of Net Adverse Clinical Events (NACE).
NACE is defined as the composite of all-cause mortality, myocardial infarction, stroke, and bleeding events (defined as BARC grade 3 or 5) following successful PCI with DCB without stent implantation at 12 months after randomization.
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12 months after randomization
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Rate of Clinically Relevant Bleeding Events (Bleeding Academic Research Consortium [BARC] Scale, Grades 2-5; range 0-5, where higher grades indicate more severe bleeding and worse clinical outcome)
時間枠:1, 3, 6, 12 and 24 months after randomization
|
Incidence of clinically relevant bleeding events classified as BARC grades 2, 3, or 5 according to the Bleeding Academic Research Consortium (BARC) bleeding definition (scale range 0-5; higher scores indicate worse outcome) in the chronic coronary syndrome (CCS) and stable Acute Coronary Syndrome (S-ACS) patients treated with single antiplatelet therapy (SAPT) versus dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) with drug-coated balloon (DCB) without stent implantation.
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1, 3, 6, 12 and 24 months after randomization
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Patient-oriented composite endpoint (PoCE)
時間枠:1, 3, 6, 12 and 24 months after randomization
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Composite of all-cause death, all myocardial infarctions (MIs), or any repeat revascularization.
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1, 3, 6, 12 and 24 months after randomization
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Device-oriented Composite Endpoint (DoCE)
時間枠:1, 3, 6, 12 and 24 months after randomization
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Composite of cardiac death, target vessel myocardial infarction (TV-MI), and clinically driven target lesion revascularization (CI-TLR)
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1, 3, 6, 12 and 24 months after randomization
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協力者と研究者
スポンサー
出版物と役立つリンク
一般刊行物
- Wiviott SD, Braunwald E, McCabe CH, Montalescot G, Ruzyllo W, Gottlieb S, Neumann FJ, Ardissino D, De Servi S, Murphy SA, Riesmeyer J, Weerakkody G, Gibson CM, Antman EM; TRITON-TIMI 38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007 Nov 15;357(20):2001-15. doi: 10.1056/NEJMoa0706482. Epub 2007 Nov 4.
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- Rittger H, Brachmann J, Sinha AM, Waliszewski M, Ohlow M, Brugger A, Thiele H, Birkemeyer R, Kurowski V, Breithardt OA, Schmidt M, Zimmermann S, Lonke S, von Cranach M, Nguyen TV, Daniel WG, Wohrle J. A randomized, multicenter, single-blinded trial comparing paclitaxel-coated balloon angioplasty with plain balloon angioplasty in drug-eluting stent restenosis: the PEPCAD-DES study. J Am Coll Cardiol. 2012 Apr 10;59(15):1377-82. doi: 10.1016/j.jacc.2012.01.015. Epub 2012 Feb 29.
- Clever YP, Peters D, Calisse J, Bettink S, Berg MC, Sperling C, Stoever M, Cremers B, Kelsch B, Bohm M, Speck U, Scheller B. Novel Sirolimus-Coated Balloon Catheter: In Vivo Evaluation in a Porcine Coronary Model. Circ Cardiovasc Interv. 2016 Apr;9(4):e003543. doi: 10.1161/CIRCINTERVENTIONS.115.003543.
- Muramatsu T, Kozuma K, Tanabe K, Morino Y, Ako J, Nakamura S, Yamaji K, Kohsaka S, Amano T, Kobayashi Y, Ikari Y, Kadota K, Nakamura M; Task Force of the Japanese Association of Cardiovascular Intervention, Therapeutics (CVIT). Clinical expert consensus document on drug-coated balloon for coronary artery disease from the Japanese Association of Cardiovascular Intervention and Therapeutics. Cardiovasc Interv Ther. 2023 Apr;38(2):166-176. doi: 10.1007/s12928-023-00921-2. Epub 2023 Feb 27.
- Rasanen A, Karkkainen JM, Eranti A, Eranen J, Rissanen TT. Percutaneous coronary intervention with drug-coated balloon-only strategy combined with single antiplatelet treatment in patients at high bleeding risk: Single center experience of a novel concept. Catheter Cardiovasc Interv. 2023 Feb;101(3):569-578. doi: 10.1002/ccd.30558. Epub 2023 Jan 22.
- Her AY, Shin ES, Bang LH, Nuruddin AA, Tang Q, Hsieh IC, Hsu JC, Kiam OT, Qiu C, Qian J, Ahmad WAW, Ali RM. Drug-coated balloon treatment in coronary artery disease: Recommendations from an Asia-Pacific Consensus Group. Cardiol J. 2021;28(1):136-149. doi: 10.5603/CJ.a2019.0093. Epub 2019 Sep 30.
- Gao C, Zhu B, Ouyang F, Wen S, Xu Y, Jia W, Yang P, He Y, Zhong Y, Zhou Y, Guo Z, Shen G, Ma L, Xu L, Xue Y, Hu T, Wang Q, Liu Y, Zhang R, Liu J, Jiang Z, Xia J, Garg S, van Geuns RJ, Capodanno D, Onuma Y, Wang D, Serruys P, Tao L; REC-CAGEFREE II Investigators. Stepwise dual antiplatelet therapy de-escalation in patients after drug coated balloon angioplasty (REC-CAGEFREE II): multicentre, randomised, open label, assessor blind, non-inferiority trial. BMJ. 2025 Mar 31;388:e082945. doi: 10.1136/bmj-2024-082945.
- Jeger RV, Farah A, Ohlow MA, Mangner N, Mobius-Winkler S, Weilenmann D, Wohrle J, Stachel G, Markovic S, Leibundgut G, Rickenbacher P, Osswald S, Cattaneo M, Gilgen N, Kaiser C, Scheller B; BASKET-SMALL 2 Investigators. Long-term efficacy and safety of drug-coated balloons versus drug-eluting stents for small coronary artery disease (BASKET-SMALL 2): 3-year follow-up of a randomised, non-inferiority trial. Lancet. 2020 Nov 7;396(10261):1504-1510. doi: 10.1016/S0140-6736(20)32173-5. Epub 2020 Oct 19.
- Corballis NH, Wickramarachchi U, Vassiliou VS, Eccleshall SC. Duration of dual antiplatelet therapy in elective drug-coated balloon angioplasty. Catheter Cardiovasc Interv. 2020 Nov;96(5):1016-1020. doi: 10.1002/ccd.28632. Epub 2019 Dec 4.
- Musumeci G, Albani S. Drug-coated balloon angioplasty and 1 month DAPT strategy: Insights from the real world. Catheter Cardiovasc Interv. 2020 Nov;96(5):1021-1022. doi: 10.1002/ccd.29339. No abstract available.
- Cortese B, Testa L, Di Palma G, Heang TM, Bossi I, Nuruddin AA, Ielasi A, Tespili M, Perez IS, Milazzo D, Benincasa S, Latib A, Cacucci M, Caiazzo G, Seresini G, Tomai F, Ocaranza R, Torres A, Perotto A, Bedogni F, Colombo A. Clinical performance of a novel sirolimus-coated balloon in coronary artery disease: EASTBOURNE registry. J Cardiovasc Med (Hagerstown). 2021 Feb 1;22(2):94-100. doi: 10.2459/JCM.0000000000001070.
- Mohiaddin H, Wong TDFK, Burke-Gaffney A, Bogle RG. Drug-Coated Balloon-Only Percutaneous Coronary Intervention for the Treatment of De Novo Coronary Artery Disease: A Systematic Review. Cardiol Ther. 2018 Dec;7(2):127-149. doi: 10.1007/s40119-018-0121-2. Epub 2018 Oct 27.
- Her AY, Shin ES. Drug-Coated Balloon Treatment for De Novo Coronary Lesions: Current Status and Future Perspectives. Korean Circ J. 2024 Sep;54(9):519-533. doi: 10.4070/kcj.2024.0148. Epub 2024 Jun 3.
- Poerner TC, Duderstadt C, Goebel B, Kretzschmar D, Figulla HR, Otto S. Fractional flow reserve-guided coronary angioplasty using paclitaxel-coated balloons without stent implantation: feasibility, safety and 6-month results by angiography and optical coherence tomography. Clin Res Cardiol. 2017 Jan;106(1):18-27. doi: 10.1007/s00392-016-1019-4. Epub 2016 Jul 5.
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- Valgimigli M, Garcia-Garcia HM, Vrijens B, Vranckx P, McFadden EP, Costa F, Pieper K, Vock DM, Zhang M, Van Es GA, Tricoci P, Baber U, Steg G, Montalescot G, Angiolillo DJ, Serruys PW, Farb A, Windecker S, Kastrati A, Colombo A, Feres F, Juni P, Stone GW, Bhatt DL, Mehran R, Tijssen JGP. Standardized classification and framework for reporting, interpreting, and analysing medication non-adherence in cardiovascular clinical trials: a consensus report from the Non-adherence Academic Research Consortium (NARC). Eur Heart J. 2019 Jul 1;40(25):2070-2085. doi: 10.1093/eurheartj/ehy377.
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- Rao SV, O'Grady K, Pieper KS, Granger CB, Newby LK, Van de Werf F, Mahaffey KW, Califf RM, Harrington RA. Impact of bleeding severity on clinical outcomes among patients with acute coronary syndromes. Am J Cardiol. 2005 Nov 1;96(9):1200-6. doi: 10.1016/j.amjcard.2005.06.056. Epub 2005 Sep 12.
- Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD; Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018 Nov 13;138(20):e618-e651. doi: 10.1161/CIR.0000000000000617. No abstract available.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- JYFY-CV-001
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
IPD 共有時間枠
IPD 共有アクセス基準
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- CSR
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米国で製造され、米国から輸出された製品。
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