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Fractional Flow Reserve and Intravascular Ultrasound RelationShip STudy (FIRST)

27. februar 2015 oppdatert av: Volcano Corporation

Fractional Flow Reserve and Intravascular Ultrasound RelationShip STudy: The FIRST Study

This is a multi-center, prospective registry of patients with intermediate coronary lesions defined as a stenosis of 40-80% by angiography. Approximately 300 patients will be enrolled into the study at sites in the United States and Europe. There will be no follow up beyond hospital discharge in this study. A sub-group of 30 patients will undergo Adenosine MRI. The investigators hypothesize that Intravascular Ultrasound Radiofrequency (IVUS RF) anatomical criteria, such as minimal luminal area, plaque burden and virtual histology plaque type, can predict physiological ischemia by Fractional Flow Reserve (FFR).

Studieoversikt

Status

Fullført

Detaljert beskrivelse

Patients undergoing cardiac catheterization must meet clinical inclusion and exclusion criteria and sign an informed consent. At the time of catheterization the patients will be further analyzed for eligibility using angiographic inclusion and exclusion criteria. Patients who fulfilled the clinical and angiographic criteria will undergo further imaging evaluation using an IVUS RF catheter (Volcano Therapeutics) and FFR wire (Radi or Volcano). The decision for treatment of any lesion will be at the operator's discretion. For patients enrolled at Washington Hospital Center and do not undergo percutaneous coronary intervention, an assessment with non invasive perfusion adenosine MRI also be performed.

Studietype

Observasjonsmessig

Registrering (Faktiske)

350

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • District of Columbia
      • Washington, District of Columbia, Forente stater, 20010
        • Washingtoon Hospital Center

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 75 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

Patients required to have an intermediate coronary lesion (stenosis 40-80% by visual estimate) in one or more native, major epicardial coronary artery with reference diameter ≥2.5mm (visual estimate)

Beskrivelse

Inclusion Criteria:

  • Sign written informed consent to participate in the study.
  • Clinical indication for coronary angiography for stable or unstable angina

Specific Angiographic Inclusion Criteria:

  • Patients required to have an intermediate coronary lesion (stenosis 40-80% by visual estimate) in one or more native, major epicardial coronary artery with reference diameter ≥2.5mm (visual estimate)
  • The vessel(s) with the intermediate lesion must have no flow limiting lesions and must be available for imaging and must be considered safe for imaging evaluation.

Exclusion Criteria:

  • Patient has had a documented acute ST-segment elevation myocardial infarction within the past 24 hours
  • Decompensated heart failure or hypotension requiring intubation, inotropes, intravenous diuretics or intraaortic balloon counterpulsation.
  • Renal dysfunction (creatinine clearance < 60 mL/min/1.73m2)
  • Pregnancy or breast-feeding
  • Standard contra-indications to MRI for implanted ferro-magnetic devices - i.e.: pacemakers, defibrillator (AICD), and aneurysm clips
  • Body weight > 400lbs
  • Left ventricular hypertrophy >1.5cm by by echocardiogram
  • History of bronchospasm or asthma
  • ECG evidence of conduction defect, including 2nd or 3rd degree AVB
  • Patient has a known hypersensitivity, allergy or contraindication to gadolinium-based contrast agents.
  • Prior participation in this study or patient is currently enrolled in another investigational use device or drug study that has not reached its primary endpoint. If the patient is enrolled in another study that is not investigational, required visits for that trial must not interfere with the conduct of this trial.

Angiographic Exclusion Criteria:

  • Unprotected left main lesion location.
  • Ostial lesion
  • Angiographic evidence of severe calcification or marked tortuosity of the target vessel that would preclude safe imaging
  • Lesion is located within or distal to an arterial or saphenous vein graft.
  • Angiographic presence of thrombus in the lesion or vessel studied.
  • Lesion in a vessel with <2.5 mm reference diameter or with more than one lesion in the vessel

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intermediate coronary lesions

Diagnostic device: FFR

Diagnostic device: IVUS RF

At participating centers, FFR and IVUS are standard of care diagnostic procedures for patients with intermediate (40-80% angiographic stenosis by visual estimate). Both modalities were used regularly for such patients whether or not they are participants in this clinical study. In FIRST, the decision to perform percutaneous coronary intervention (PCI) was left to the discretion of the investigator, and was not dictated by the clinical protocol.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Correlation between (Minimum Luminal Area) MLA and FFR
Tidsramme: Day of Procedure
The correlation between MLA and FFR; and the threshold value for MLA corresponding to an FFR < 0.8.
Day of Procedure

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Correlation between FFR and IVUS and VH parameters
Tidsramme: Day of Procedure
Correlation between FFR and various IVUS measurements (MLA,area stenosis, lesion length, plaque burden) and VH parameters (plaque type and presence of a TCFA)
Day of Procedure
Association of FFR and Cut-off of MLA
Tidsramme: Day of Procedure
Assess the association between FFR <0.75 and 0.8 and determined cut-off of MLA with presence of a Thin Cap Fibro-Atheroma(TCFA) and/or plaque burden ≥70%
Day of Procedure
Identify risk score model
Tidsramme: 1 year
To identify a risk score model taking into account IVUS measurements (MLA, plaque burden, area stenosis, lesion length) and VH parameters (plaque type and presence of TCFA) associated with FFR < 0.8
1 year

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Hovedetterforsker: Ron Waksman, MD, MedStar Health Research Institute

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. september 2010

Primær fullføring (Faktiske)

1. juni 2012

Studiet fullført (Faktiske)

1. juni 2012

Datoer for studieregistrering

Først innsendt

28. juni 2010

Først innsendt som oppfylte QC-kriteriene

29. juni 2010

Først lagt ut (Anslag)

30. juni 2010

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

4. mars 2015

Siste oppdatering sendt inn som oppfylte QC-kriteriene

27. februar 2015

Sist bekreftet

1. januar 2015

Mer informasjon

Begreper knyttet til denne studien

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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