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.
연구 개요
상태
상태
정황
정황
개입 / 치료
개입 / 치료
연구 유형
연구 유형
등록 (추정된)
등록
단계
단계
- 해당 없음
연락처 및 위치
연구 연락처
연구 연락처
- 이름: Jingbo Hou, Ph.D.
- 전화번호: 13303609625
- 이메일: jingbohou@163.com
연구 연락처 백업
- 이름: Bo Yu, Ph.D.
- 이메일: yubodr@163.com
연구 장소
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Beijing, 중국
- 아직 모집하지 않음
- Fuwai Hospital, Chinese Academy of Medical Sciences
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연락하다:
- Lei Song
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Beijing, 중국
- 아직 모집하지 않음
- Beijing Luhe Hospital Affiliated to Capital Medical University
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연락하다:
- Guangyao Zhai
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Cangzhou, 중국
- 아직 모집하지 않음
- Cangzhou Central Hospital
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연락하다:
- Jun Zhang
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Chengde, 중국
- 아직 모집하지 않음
- Chengde Medical College Affiliated Hospital
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연락하다:
- Ying Zhang
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Chengdu, 중국
- 아직 모집하지 않음
- Sichuan Provincial People's Hospital
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연락하다:
- Wenjie Tian
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Dalian, 중국
- 아직 모집하지 않음
- The First Affiliated Hospital of Dalian Medical University
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연락하다:
- Bo Zhang
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Dalian, 중국
- 아직 모집하지 않음
- The Second Affiliated Hospital of Dalian Medical University
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연락하다:
- Xin Zhao
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Dalian, 중국
- 아직 모집하지 않음
- The Central Hospital Affiliated to Dalian University of Technology
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연락하다:
- Xiaoqun Zheng
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Daqing, 중국
- 아직 모집하지 않음
- Daqing Oilfield General Hospital
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연락하다:
- Zhiqi Sun
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Harbin, 중국
- 아직 모집하지 않음
- The Fourth Affiliated Hospital of Harbin Medical University
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연락하다:
- Wei Yang
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Hunan, 중국
- 아직 모집하지 않음
- The Third XIANGYA Hospital of Central South University
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연락하다:
- Yu Cao
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Jiamusi, 중국
- 아직 모집하지 않음
- Central Hospital of Jiamusi City
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연락하다:
- Zhiyuan Weng
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Jiamusi, 중국
- 아직 모집하지 않음
- The First Affiliated Hospital of Jiamusi University
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연락하다:
- Guangyuan Yang
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Jilin City, 중국
- 아직 모집하지 않음
- China-Japan Union Hospital of Jilin University
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연락하다:
- Yuquan He
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Jilin City, 중국
- 아직 모집하지 않음
- Jilin Central Hospital
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연락하다:
- Yijun Shang
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Jilin City, 중국
- 아직 모집하지 않음
- The First Hospital of Jilin University
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연락하다:
- Qian Tong
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Jinan, 중국
- 아직 모집하지 않음
- Shandong Provincial Hospital
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연락하다:
- Haitao Yuan
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Jining, 중국
- 아직 모집하지 않음
- The Affiliated Hospital of Jining Medical University
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연락하다:
- Lijun Gan
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Lanzhou, 중국
- 아직 모집하지 않음
- Lanzhou University First Hospital
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연락하다:
- Ming Bai
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Linyi, 중국
- 아직 모집하지 않음
- Linyi People's Hospital
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연락하다:
- Yanjin Wei
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Mudanjiang, 중국
- 아직 모집하지 않음
- Mudanjiang Cardiovascular Hospital
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연락하다:
- Kai Liu
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Nanyang, 중국
- 아직 모집하지 않음
- The First Affiliated Hospital of Nanyang Medical College
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연락하다:
- Ou Zhang
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Qingdao, 중국
- 아직 모집하지 않음
- The Affiliated Hospital of Qingdao University
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연락하다:
- Zhexun Lian
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Qiqihar, 중국
- 아직 모집하지 않음
- Qiqihar First Hospital
-
연락하다:
- Jinhui Zhang
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Qiqihar, 중국
- 아직 모집하지 않음
- The Second Affiliated Hospital of Qiqihar Medical University
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연락하다:
- Xiaojie Wu
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Qiqihar, 중국
- 아직 모집하지 않음
- The Third Affiliated Hospital of Qiqihar Medical University
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연락하다:
- Haifeng Shao
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Shenyang, 중국
- 아직 모집하지 않음
- Shengjing Hospital of China Medical University
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연락하다:
- Zhijun Sun
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Shenyang, 중국
- 아직 모집하지 않음
- The Fourth Affiliated Hospital of China Medical University
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연락하다:
- Yuanzhe Jin
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Shenyang, 중국
- 아직 모집하지 않음
- Liaoning Provincial People's Hospital
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연락하다:
- Bo Luan
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Shijia Zhuang, 중국
- 아직 모집하지 않음
- The Second Hospital of Hebei Medical University
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연락하다:
- Xinshun Gu
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Shijiazhuang, 중국
- 아직 모집하지 않음
- Hebei Provincial People's Hospital
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연락하다:
- Yi Dang
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Suihua, 중국
- 아직 모집하지 않음
- Suihua First Hospital
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연락하다:
- Qiuye Yang
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Taiyuan, 중국
- 아직 모집하지 않음
- General Hospital of Taiyuan Iron and Steel (Group) Co.
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연락하다:
- Huifeng Wang
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Taiyuan, 중국
- 아직 모집하지 않음
- Shanxi Provincial Cardiovascular Hospital
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연락하다:
- Zhulin Zhang
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Tianjin, 중국
- 아직 모집하지 않음
- Tianjin Chest Hospital
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연락하다:
- Chunjie Li
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Tianjin, 중국
- 아직 모집하지 않음
- Teda International Cardiovascular Hospital
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연락하다:
- Wenhua Lin
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Tianjin, 중국
- 아직 모집하지 않음
- General Hospital of Tianjin Medical University
-
연락하다:
- Qing Yang
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Wenzhou, 중국
- 아직 모집하지 않음
- The Second Affiliated Hospital of Wenzhou Medical University
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연락하다:
- Xueqiang Guan
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Wuhan, 중국
- 아직 모집하지 않음
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
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연락하다:
- Xiang Cheng
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Wuhan, 중국
- 아직 모집하지 않음
- Wuhan Asia Heart Hospital
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연락하다:
- Hua Yan
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Xi'an, 중국
- 아직 모집하지 않음
- The First Affiliated Hospital of Xi'an Jiaotong University
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연락하다:
- Zuyi Yuan
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Xinjiang, 중국
- 아직 모집하지 않음
- The First Affiliated Hospital of Xinjiang Medical University
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연락하다:
- Xiang Ma
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Xinjiang, 중국
- 아직 모집하지 않음
- People's Hospital of Xinjiang Uygur Autonomous Region
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연락하다:
- Yining Yang
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Yantai, 중국
- 아직 모집하지 않음
- Yantai YuHuangDing Hospital
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연락하다:
- Faxin Ren
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Zhengzhou, 중국
- 아직 모집하지 않음
- The First Affiliated Hospital of Zhengzhou University
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연락하다:
- Jinying Zhang
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Zhengzhou, 중국
- 아직 모집하지 않음
- Fuwai Huazhong Cardiovascular Hospital
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연락하다:
- Chuanyu Gao
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Zunyi, 중국
- 아직 모집하지 않음
- Zunyi Medical University Affiliated Hospital
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연락하다:
- Ranzun Zhao
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Heilongjiang
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Harbin, Heilongjiang, 중국, 150086
- 모병
- The Second Affiliated Hospital of Harbin Medical University
-
연락하다:
- Jingbo Hou, M.D.
- 전화번호: 8613303609625
- 이메일: jingbohou@163.com
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-
참여기준
자격 기준
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
설명
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.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
팔의 수
무기와 개입
참가자 그룹 / 팔참가자 그룹 / 팔 |
개입 / 치료개입 / 치료 |
|---|---|
|
실험적: 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
|
|
활성 비교기: 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.
|
연구는 무엇을 측정합니까?
주요 결과 측정
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Target Lesion Failure(TLF)
기간: 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.
|
2차 결과 측정
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
All-cause death
기간: 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
기간: 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)
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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)
기간: 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
기간: 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
|
기타 결과 측정
기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Definite or probable in-stent thrombosis
기간: 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)
기간: 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
기간: 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
기간: 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)
기간: 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.
기간: From randomization to the 12th month.
|
Exploratory endpoint:Functional sub research
|
From randomization to the 12th month.
|
공동 작업자 및 조사자
수사관
수사관
- 수석 연구원: Bo Yu, Ph.D., The Second Affiliated Hospital of Harbin Medical University
- 수석 연구원: Jingbo Hou, Ph.D., The Second Affiliated Hospital of Harbin Medical University
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
연구 시작
기본 완료 (추정된)
기본 완료
연구 완료 (추정된)
연구 완료
연구 등록 날짜
최초 제출
최초 제출
QC 기준을 충족하는 최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
처음 게시됨
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
마지막 업데이트 게시됨
QC 기준을 충족하는 마지막 업데이트 제출
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
기타 연구 ID 번호
기타 연구 ID 번호
- KY2026-042
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .