Comparing angiography-guided physiology testing with usual care in stented coronary artery disease
Tests imaging-guided blood flow assessment versus usual care in adults with coronary artery disease.
Plain-language title generated from the registry record
Registry title: The PIONEER-IV Study is Comparing Clinical Outcomes Between Angiography-derived Physiology Guidance to Usual Care in an All-comers PCI Population With Unrestrictive Use of the HT Supreme Sirolimus-eluting Stent
Key facts
- Where
- Barcelona, Lugo, Valladolid, and Vigo, SpainSee the 4 sites
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults with coronary artery disease who need a stent placed in a heart artery (PCI). It compares two ways of guiding the procedure.
- Age
- 18 years or older
- Sex
- All sexes can join.
- Disease stage
- Chronic stable angina, acute coronary syndrome or silent ischemia, with one or more heart artery narrowings of 50% or more and a vessel diameter of at least 2.25 mm.
- Earlier treatment
- Earlier stent or other device treatment in the artery is allowed. No other prior treatment is asked for.
Main reasons for not taking part
- Pregnant or nursing women
- Known intolerance to cobalt chromium, sirolimus, aspirin, heparin, bivalirudin or P2Y12 inhibitors
- Planned major elective surgery needing a stop of dual antiplatelet therapy within 12 months
- Life expectancy of less than 3 years because of another medical condition
- Active pathological bleeding or a history of bleeding inside the skull
Read by machine on 9 November 2026.
Where in Spain
- Hospital Clínico de BarcelonaBarcelona, SpainTaking people
- Lucas Augusti HospitalLugo, SpainTaking people
- Hospital Clínico Universitario of ValladolidValladolid, SpainTaking people
- Hospital Álvaro Cunqueiro (Vigo)Vigo, SpainTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- National University of Ireland, Galway, Ireland
- Trial code
- NCT04923191
- Record updated
- 30 October 2023
- Original description
PIONEER-IV is a prospective, single-blind (patient), randomized, 1:1, controlled, multi-center study comparing clinical outcomes between angiography-derived physiology guidance to LRDP and usual care in an all-comers patient population (including patients with high bleeding risk, HBR) undergoing PCI with unrestrictive use of the HT Supreme sirolimus-eluting stent. Patients will be randomized to either angio-based physiology guidance angio-FFR (Quantitative Flow Ratio and coronary angiography-derived FFR, caFFR) or local routine diagnostic procedure (LRDP) and usual care. Patients will be treated with 1-year P2Y12 inhibitor monotherapy after 1-month of dual-antiplatelet therapy in approximately 2540 (2*1270) patients. All patients (both cohorts) must receive dual anti-platelet therapy, being aspirin (ASA) and ticagrelor for 1 month, followed by 11 months of ticagrelor only (i.e. monotherapy). At 1 year, ticagrelor monotherapy is replaced by aspirin monotherapy or left to the discretion of the operator.Read full original descriptionShow less
Non-inferiority of Angiography-derived Physiology Guidance Versus Usual Care in an All-comers PCI Population Treated With Unrestricted Use of the Healing-Targeted Supreme (HT Supreme) Drug-eluting Stent and P2Y12 Inhibitor Monotherapy After 1-month of Dual-antiplatelet Therapy
PIONEER-IV is a prospective, single-blind (patient), randomized, 1:1, controlled, multi-center study comparing clinical outcomes between angiography-derived physiology guidance to LRDP and usual care in an all-comers patient population (including patients with high bleeding risk, HBR) undergoing PCI with unrestrictive use of the HT Supreme sirolimus-eluting stent. Patients will be randomized to either angio-based physiology guidance angio-FFR (Quantitative Flow Ratio and coronary angiography-derived FFR, caFFR) or local routine diagnostic procedure (LRDP) and usual care. Patients will be treated with 1-year P2Y12 inhibitor monotherapy after 1-month of dual-antiplatelet therapy in approximately 2540 (2*1270) patients. All patients (both cohorts) must receive dual anti-platelet therapy, being aspirin (ASA) and ticagrelor for 1 month, followed by 11 months of ticagrelor only (i.e. monotherapy). At 1 year, ticagrelor monotherapy is replaced by aspirin monotherapy or left to the discretion of the operator.
Inclusion: Patient has chronic stable angina, acute coronary syndromes or silent ischemia; Presence of one or more coronary artery stenoses of ≥50% (by visual assessment) in a native coronary artery (with or without prior stent/other device treatment) or in a saphenous venous or arterial bypass conduit suitable for coronary stent implantation; The vessel should have a reference vessel diameter of at least 2.25 mm by visual assessment (no limitation on the number of treated lesions, vessels, or lesion length); Patient has been informed of the nature of the study and agrees to its provisions and has provided written informed consent as approved by the Ethical Committee and is willing to comply with all protocol-required (follow-up) evaluations.
Exclusion: Patient is a woman who is pregnant or nursing (a pregnancy test must be performed within 7 days prior to the index procedure in women of child-bearing potential according to local practice); Known intolerance to cobalt chromium, and medications such as sirolimus, aspirin, heparin, bivalirudin or P2Y12 inhibitors; Concurrent medical condition with a life expectancy of less than 3 years; Active pathological bleeding; History of intracranial haemorrhage; Planned major elective surgery requiring discontinuation of (dual)anti platelet therapy (DAPT) within 12 months of procedure; Currently participating in another trial and not yet at its primary endpoint.