- ICH GCP
- Register voor klinische proeven in de VS.
- Klinische proef NCT07567625
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.
Studie Overzicht
Toestand
Conditie
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Jingbo Hou, Ph.D.
- Telefoonnummer: 13303609625
- E-mail: jingbohou@163.com
Studie Contact Back-up
- Naam: Bo Yu, Ph.D.
- E-mail: yubodr@163.com
Studie Locaties
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Beijing, China
- Nog niet aan het werven
- Fuwai Hospital, Chinese Academy of Medical Sciences
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Contact:
- Lei Song
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Beijing, China
- Nog niet aan het werven
- Beijing Luhe Hospital Affiliated to Capital Medical University
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Contact:
- Guangyao Zhai
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Cangzhou, China
- Nog niet aan het werven
- Cangzhou Central Hospital
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Contact:
- Jun Zhang
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Chengde, China
- Nog niet aan het werven
- Chengde Medical College Affiliated Hospital
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Contact:
- Ying Zhang
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Chengdu, China
- Nog niet aan het werven
- Sichuan Provincial People's Hospital
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Contact:
- Wenjie Tian
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Dalian, China
- Nog niet aan het werven
- The First Affiliated Hospital of Dalian Medical University
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Contact:
- Bo Zhang
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Dalian, China
- Nog niet aan het werven
- The Second Affiliated Hospital of Dalian Medical University
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Contact:
- Xin Zhao
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Dalian, China
- Nog niet aan het werven
- The Central Hospital Affiliated to Dalian University of Technology
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Contact:
- Xiaoqun Zheng
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Daqing, China
- Nog niet aan het werven
- Daqing Oilfield General Hospital
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Contact:
- Zhiqi Sun
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Harbin, China
- Nog niet aan het werven
- The Fourth Affiliated Hospital of Harbin Medical University
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Contact:
- Wei Yang
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Hunan, China
- Nog niet aan het werven
- The Third XIANGYA Hospital of Central South University
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Contact:
- Yu Cao
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Jiamusi, China
- Nog niet aan het werven
- Central Hospital of Jiamusi City
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Contact:
- Zhiyuan Weng
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Jiamusi, China
- Nog niet aan het werven
- The First Affiliated Hospital of Jiamusi University
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Contact:
- Guangyuan Yang
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Jilin City, China
- Nog niet aan het werven
- China-Japan Union Hospital of Jilin University
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Contact:
- Yuquan He
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Jilin City, China
- Nog niet aan het werven
- Jilin Central Hospital
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Contact:
- Yijun Shang
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Jilin City, China
- Nog niet aan het werven
- The First Hospital of Jilin University
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Contact:
- Qian Tong
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Jinan, China
- Nog niet aan het werven
- Shandong Provincial Hospital
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Contact:
- Haitao Yuan
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Jining, China
- Nog niet aan het werven
- The Affiliated Hospital of Jining Medical University
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Contact:
- Lijun Gan
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Lanzhou, China
- Nog niet aan het werven
- Lanzhou University First Hospital
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Contact:
- Ming Bai
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Linyi, China
- Nog niet aan het werven
- Linyi People's Hospital
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Contact:
- Yanjin Wei
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Mudanjiang, China
- Nog niet aan het werven
- Mudanjiang Cardiovascular Hospital
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Contact:
- Kai Liu
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Nanyang, China
- Nog niet aan het werven
- The First Affiliated Hospital of Nanyang Medical College
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Contact:
- Ou Zhang
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Qingdao, China
- Nog niet aan het werven
- The Affiliated Hospital of Qingdao University
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Contact:
- Zhexun Lian
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Qiqihar, China
- Nog niet aan het werven
- Qiqihar First Hospital
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Contact:
- Jinhui Zhang
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Qiqihar, China
- Nog niet aan het werven
- The Second Affiliated Hospital of Qiqihar Medical University
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Contact:
- Xiaojie Wu
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Qiqihar, China
- Nog niet aan het werven
- The Third Affiliated Hospital of Qiqihar Medical University
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Contact:
- Haifeng Shao
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Shenyang, China
- Nog niet aan het werven
- Shengjing Hospital of China Medical University
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Contact:
- Zhijun Sun
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Shenyang, China
- Nog niet aan het werven
- The Fourth Affiliated Hospital of China Medical University
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Contact:
- Yuanzhe Jin
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Shenyang, China
- Nog niet aan het werven
- Liaoning Provincial People's Hospital
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Contact:
- Bo Luan
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Shijia Zhuang, China
- Nog niet aan het werven
- The Second Hospital of Hebei Medical University
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Contact:
- Xinshun Gu
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Shijiazhuang, China
- Nog niet aan het werven
- Hebei Provincial People's Hospital
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Contact:
- Yi Dang
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Suihua, China
- Nog niet aan het werven
- Suihua First Hospital
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Contact:
- Qiuye Yang
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Taiyuan, China
- Nog niet aan het werven
- General Hospital of Taiyuan Iron and Steel (Group) Co.
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Contact:
- Huifeng Wang
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Taiyuan, China
- Nog niet aan het werven
- Shanxi Provincial Cardiovascular Hospital
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Contact:
- Zhulin Zhang
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Tianjin, China
- Nog niet aan het werven
- Tianjin Chest Hospital
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Contact:
- Chunjie Li
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Tianjin, China
- Nog niet aan het werven
- Teda International Cardiovascular Hospital
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Contact:
- Wenhua Lin
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Tianjin, China
- Nog niet aan het werven
- General Hospital of Tianjin Medical University
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Contact:
- Qing Yang
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Wenzhou, China
- Nog niet aan het werven
- The Second Affiliated Hospital of Wenzhou Medical University
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Contact:
- Xueqiang Guan
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Wuhan, China
- Nog niet aan het werven
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
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Contact:
- Xiang Cheng
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Wuhan, China
- Nog niet aan het werven
- Wuhan Asia Heart Hospital
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Contact:
- Hua Yan
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Xi'an, China
- Nog niet aan het werven
- The First Affiliated Hospital of Xi'an Jiaotong University
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Contact:
- Zuyi Yuan
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Xinjiang, China
- Nog niet aan het werven
- The First Affiliated Hospital of Xinjiang Medical University
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Contact:
- Xiang Ma
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Xinjiang, China
- Nog niet aan het werven
- People's Hospital of Xinjiang Uygur Autonomous Region
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Contact:
- Yining Yang
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Yantai, China
- Nog niet aan het werven
- Yantai YuHuangDing Hospital
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Contact:
- Faxin Ren
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Zhengzhou, China
- Nog niet aan het werven
- The First Affiliated Hospital of Zhengzhou University
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Contact:
- Jinying Zhang
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Zhengzhou, China
- Nog niet aan het werven
- Fuwai Huazhong Cardiovascular Hospital
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Contact:
- Chuanyu Gao
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Zunyi, China
- Nog niet aan het werven
- Zunyi Medical University Affiliated Hospital
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Contact:
- Ranzun Zhao
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Heilongjiang
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Harbin, Heilongjiang, China, 150086
- Werving
- The Second Affiliated Hospital of Harbin Medical University
-
Contact:
- Jingbo Hou, M.D.
- Telefoonnummer: 8613303609625
- E-mail: jingbohou@163.com
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
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.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: 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
|
|
Actieve vergelijker: 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.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Target Lesion Failure(TLF)
Tijdsspanne: 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.
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
All-cause death
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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 uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Definite or probable in-stent thrombosis
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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.
Tijdsspanne: From randomization to the 12th month.
|
Exploratory endpoint:Functional sub research
|
From randomization to the 12th month.
|
Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Bo Yu, Ph.D., The Second Affiliated Hospital of Harbin Medical University
- Hoofdonderzoeker: Jingbo Hou, Ph.D., The Second Affiliated Hospital of Harbin Medical University
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- KY2026-042
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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