NCT03174418

Brief Summary

Investigator-initiated, international, multicentre, observational study with two cohorts. The two study cohorts will be: Cohort A: to understand if the local blood flow patterns (associated with low WSS), as evaluated by computational fluid dynamic tools from combined angiographic and OCT invasive images, may better predict the clinical outcome of patients with bifurcated coronary lesions treated by PCI. Cohort B: to understand if the local blood flow patterns (associated with low WSS), as evaluated by computational fluid dynamic tools from combined angiographic and OCT invasive images, may better predict the clinical outcome of patients with sub-critical bifurcated lesions managed conservatively. Coronary angiography and OCT images will be combined to obtain a three-dimensional model of the diseased coronary vessels that will be used to calculate the local blood flow patterns and the time-averaged WSS at the bifurcated lesion level by using computational fluid dynamics software. Baseline (in patients both managed conservatively and treated by PCI) and post-PCI (in patients treated by PCI) images will be processed.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
300

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Sep 2017

Typical duration for all trials

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 30, 2017

Completed
3 days until next milestone

First Posted

Study publicly available on registry

June 2, 2017

Completed
3 months until next milestone

Study Start

First participant enrolled

September 1, 2017

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2018

Completed
2.5 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2021

Completed
Last Updated

June 2, 2017

Status Verified

May 1, 2017

Enrollment Period

1 year

First QC Date

May 30, 2017

Last Update Submit

May 30, 2017

Conditions

Keywords

Optical coherence tomographyPercutaneous coronary interventionsCoronary atherosclerosis in bifurcations

Outcome Measures

Primary Outcomes (1)

  • Target bifurcation failure (TBF)

    \- Target bifurcated lesion-related major adverse coronary event (MACE) defined as the composite of: * cardiac death * myocardial infarction (MI) not clearly related with another vessel * target vessel revascularization (TVR)

    1,6,12,18,24 and 36 months

Secondary Outcomes (2)

  • Target vessel failure

    1,6,12,18,24 and 36 months

  • Bifurcated lesion angiographic failure

    1,6,12,18,24 and 36 months

Study Arms (2)

Cohort A

Patients with bifurcated coronary lesions treated by percutaneous coronary interventions.

Procedure: Coronary angiography and optical coherence tomography

Cohort B

Patients with untreated bifurcated coronary lesions.

Procedure: Coronary angiography and optical coherence tomography

Interventions

Coronary angiography and OCT images will be combined to obtain a three-dimensional model of the diseased coronary vessels that will be used to calculate the local blood flow patterns and the arterial time-averaged wall shear stress at the bifurcated lesion level

Cohort ACohort B

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Patients with stable or unstable coronary artery disease due to atherosclerosis involving a major bifurcation site, who undergo diagnostic or interventional invasive percutaneous coronary procedures with the use of optical coherence tomography (OCT) based on operator's choice.

You may qualify if:

  • Patients with stable or unstable coronary artery disease;
  • TIMI 3 on both MV and SB;
  • MV visual diameter \> 2.5 mm;
  • SB visual diameter \> 2.0 mm;
  • Documentation of angiographically-critical (visually estimated percentage diameter stenosis ≥80% \<100%) coronary lesion treated by PCI and underwent post-PCI OCT assessment or angiographically-intermediate (visually estimated percentage diameter stenosis ranging between 30-80%) lesion in the MV considered suitable for conservative management (myocardial revascularization not planned).

You may not qualify if:

  • Age \< 18 years or impossibility to give informed consent.
  • Female sex with child-bearing potential.
  • Life expectancy of less than 12 months or factors making clinical follow-up difficult (no fixed address, etc.).
  • Ascertained or suspected contraindications to prolonged (up to 6 month) double antiplatelet therapy.
  • Known hypersensitivity to aspirin, heparin, contrast dye, sirolimus, everolimus, zotarolimus, cobalt, chromium, nickel, tungsten acrylic, and fluoro-polymers.
  • Poor cardiac function as defined by left ventricular global ejection fraction ≤ 30%.
  • Recent (\< 48 hours) ST-segment elevation myocardial infarction.
  • Severe myocardial hypertrophy (interventricular septum thickness \> 15 mm, ECG Sokolow's criteria fulfilled).
  • Severe valvular heart disease.
  • Significant platelet count alteration (\<100,000 cells/mm3 or \> 700,000 cells/mm3).
  • Gastrointestinal bleeding requiring surgery or blood transfusions within 4 previous weeks.
  • History of clotting pathology.
  • Advance renal failure with glomerular filtration rate \< 30 ml/min (Cockcroft-Gault equation)
  • Left main lesion.
  • Target bifurcation located on a distal coronary segment.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Policlinico A. Gemelli. Università Cattolica del Sacro Cuore

Roma, 00168, Italy

Location

MeSH Terms

Conditions

Coronary Artery Disease

Interventions

Tomography, Optical Coherence

Condition Hierarchy (Ancestors)

Coronary DiseaseMyocardial IschemiaHeart DiseasesCardiovascular DiseasesArteriosclerosisArterial Occlusive DiseasesVascular Diseases

Intervention Hierarchy (Ancestors)

Tomography, OpticalOptical ImagingDiagnostic ImagingDiagnostic Techniques and ProceduresDiagnosisTomographyInvestigative Techniques

Study Officials

  • Francesco Burzotta, MD

    Policlinico A. Gemelli. Università Cattolica del Sacro Cuore

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Francesco Burzotta, MD

CONTACT

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD, PhD

Study Record Dates

First Submitted

May 30, 2017

First Posted

June 2, 2017

Study Start

September 1, 2017

Primary Completion

September 1, 2018

Study Completion

March 1, 2021

Last Updated

June 2, 2017

Record last verified: 2017-05

Locations