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NCT03820492Recruiting

Comparison of Optical Coherence Tomography-derived Minimal Lumen Area, Invasive Fractional Flow Reserve and FFRCT

Multimodality Assessment of Intermediate Left Main Stenosis: Comparison of Optical Coherence Tomography-derived Minimal Lumen Area, Invasive Fractional Flow Reserve and FFRCT

Source: ClinicalTrials.gov · Last updated 9 Feb 2023 · Not updated for over 12 months - ask the site whether it is still open

Brief summary (registry, in English)

Significant left main (LM) stenosis is associated with a poor prognosis, therefore, adequate judgement of the prognostic significance of LM stenosis is essential to improve patients' prognosis. Recently, fractional flow reserve (FFR) has become widespread practice and carries a Class Ia recommendation to assess functional significance of intermediate coronary stenosis in patients with stable angina. Intravascular ultrasound (IVUS)-derived minimum lumen area (MLA) represents an accurate measure to determine LM significance as shown in multiple studies, while optical coherence tomography (OCT) ,which is a novel intracoronary imaging method with a greater spatial resolution (15μm vs. 100μm), faster image acquisition and facilitated image interpretation, OCT derived-MLA has never been validated against FFR and accordingly, it is not mentioned in the current guidelines for myocardial revascularization. Coronary computed tomography angiography (CTA) has emerged as a noninvasive alternative of coronary angiography with its excellent negative predictive value, while the positive predictive value of CTA is limited. Computational fluid dynamics is an emerging method that enables prediction of blood flow in coronary arteries and calculation of FFR from computed tomography (FFRCT) noninvasively. Noninvasive and accurate assessment of functional significance would bring a great benefit for patients with LM stenosis, however, there are no data to evaluate the diagnostic accuracy of FFRCT for LM stenosis in comparison with FFR and minimal lumen area derived by OCT. This study will investigate the optimal OCT-derived MLA cut-off point and the diagnostic performance of FFRCT for intermediate LM stenosis compared with FFR ≤0.8 as a reference standard.

Status (registry)
Recruiting
Study type
Interventional
Enrollment
104 (estimated)
First submitted
17 Jan 2019
Start date
28 May 2019
Primary completion date
31 Dec 2026
Lead sponsor
Insel Gruppe AG, University Hospital Bern
NCT number
NCT03820492

What you commit to

  • Study type: Interventional
  • Planned participants: 104
  • From 28 May 2019 to the primary completion date, 31 Dec 2026
  • 13 sites in 4 countries
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Prior treatment

  • Previous coronary stenting of the left coronary system.
  • Previous coronary artery bypass graft.
  • Previous MI related to the left coronary artery.

Other illness

  • Ostial LM disease.
  • Acute coronary syndrome (ACS) (non-ST-elevation ACS and ST-elevation MI).
  • Contraindication or known allergy against protocol-required medications including heparin, iodinated contrast, β-blocker, nitroglycerin, and adenosine.
  • Complex congenital heart disease other than anomalous coronary origins alone.

Lab values

  • Known renal insufficiency (serum creatinine \>1.5mg/dL or receiving dialysis).

Age

  • Female of childbearing potential (age \<50 years and last menstruation within the last 12 months), who did not undergo tubal ligation, ovariectomy or hysterectomy.

Other

  • Significant distal lesions (\>50% angiographic DS on visual estimation within the left anterior descending artery \[LAD\] or left circumflex artery \[LCX\], except for ostium of LAD or LCX or diseased side branch \[e.g. diagonal branch, obtuse marginal branch\])
  • LM In-stent restenosis.
  • Chronic total occlusion.
  • Occurrence of ventricularization or hypotension during engagement of the LM ostial lesion.
  • The presence of hemodynamic instability.
  • Life expectancy less than 1 year.
  • Body mass index \>35kg/m2.
  • Ventricular septal defect.

Who the study is looking for

  • Unprotected LM lesion \[midshaft, and distal bifurcation (Medina 1,1,1 or 1,1,0 or 1,0,1 or 1,0,0)\] of 30% to 80% angiographic diameter stenosis (DS) on visual estimation or equivocal disease by angiography.
  • Age ≥18 years.
  • Ability to give preliminary oral consent witnessed by an independent physician or sign written informed consent prior to any study-specific procedures.

Age in the registry: 18 years to - · Sex: All · Does not accept healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (13)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
Inselspital
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BernSwitzerlandRecruiting
CHUV
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LausanneSwitzerlandRecruiting
Friedrich Alexander Universität (FAU) , Medizinische Klinik 2 , Kardiologie und Angiologie
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ErlangenGermanyRecruiting
Universitätsklinikum Giessen Justus-Liebig Universität
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GiessenGermanyRecruiting
Centre Hospitalier Universitaire de Clermont-Ferrand
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Clermont-FerrandFranceRecruiting
Institute Mutualiste Montsouris
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ParisFranceRecruiting
Centre Cardiologique du Nord
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Saint-DenisFranceRecruiting
Ageo Central General Hospital
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AgeoJapanRecruiting
Gifu Heart Center
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GifuJapanRecruiting
Department of Cardiovascular Medicine Shinshu University School of Medicine
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NaganoJapanRecruiting
Kansai Medical University,
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OsakaJapanRecruiting
Medical Corporation Ouyuukai Tokorozawa Heart Center
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SaitamaJapanRecruiting
Sapporo Higashi Tokushukai Hospital
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SapporoJapanRecruiting

This page is information, not medical advice. Discuss any trial with your doctor.