NCT03820492 Comparison of Optical Coherence Tomography-derived Minimal Lumen Area, Invasive Fractional Flow Reserve and FFRCT
| NCT ID | NCT03820492 |
| Status | Recruiting |
| Phase | — |
| Sponsor | Insel Gruppe AG, University Hospital Bern |
| Condition | Coronary Stenosis |
| Study Type | INTERVENTIONAL |
| Enrollment | 104 participants |
| Start Date | 2019-05-28 |
| Primary Completion | 2026-12-31 |
Eligibility & Interventions
Eligibility Fast-Check
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What to Expect as a Participant
You will actively receive the study intervention — which may be a drug, biologic, device, or procedure.
This trial targets 104 participants in total. It began in 2019-05-28 with a primary completion date of 2026-12-31.
⚠ This information is for research awareness only. Always consult your physician before joining any clinical trial. Participation is voluntary and you may withdraw at any time.
Brief Summary
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.
Eligibility Criteria
Inclusion Criteria: * 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. Exclusion Criteria: * 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 \[e.g. diagonal branch, obtuse marginal branch\]) * Ostial LM disease. * Acute coronary syndrome (ACS) (non-ST-elevation ACS and ST-elevation MI). * LM In-stent restenosis. * Previous coronary stenting of the left coronary system. * Chronic total occlusion. * Previous coronary artery bypass graft. * Previous MI related to the left coronary artery. * Occurrence of ventricularization or hypotension during engagement of the LM ostial lesion. * The presence of hemodynamic instability. * Known renal insufficiency (serum creatinine \>1.5mg/dL or receiving dialysis). * Female of childbearing potential (age \<50 years and last menstruation within the last 12 months), who did not undergo tubal ligation, ovariectomy or hysterectomy. * Life expectancy less than 1 year. * Contraindication or known allergy against protocol-required medications including heparin, iodinated contrast, β-blocker, nitroglycerin, and adenosine. * Body mass index \>35kg/m2. * Complex congenital heart disease other than anomalous coronary origins alone. * Ventricular septal defect.
Contact & Investigator
Lorenz Raeber, Prof. MD PhD
PRINCIPAL INVESTIGATOR
Inselspital
Frequently Asked Questions
Who can join the NCT03820492 clinical trial?
This trial is open to participants of all sexes, aged 18 Years or older, studying Coronary Stenosis. Full inclusion and exclusion criteria are listed in the Eligibility Criteria section. Always confirm your eligibility with the research team before applying.
Is NCT03820492 currently recruiting?
Yes, NCT03820492 is actively recruiting participants. Contact the research team at lorenz.raeber@insel.ch for enrollment information.
Where is the NCT03820492 trial being conducted?
This trial is being conducted at Clermont-Ferrand, France, Paris, France, Saint-Denis, France, Giessen, Germany and 9 additional locations.
Who is sponsoring the NCT03820492 clinical trial?
NCT03820492 is sponsored by Insel Gruppe AG, University Hospital Bern. The principal investigator is Lorenz Raeber, Prof. MD PhD at Inselspital. The trial plans to enroll 104 participants.