Drug-Eluting Stent Implantation Versus Optimal Medical Treatment in Patients With Chronic Total Occlusion (DECISION-CTO)

NCT ID: NCT01078051

Last Updated: 2019-08-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE4

Total Enrollment

840 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-03-22

Study Completion Date

2019-07-22

Brief Summary

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The purpose of this study is to compare the safety and effectiveness of drug-eluting stent implantation compared to optimal medical treatment in patients with chronic total occlusion.

Detailed Description

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Prospective, two arms, randomized multi-center trial in Asian-pacific region. Following angiography, patients with chronic total occlusion (more than 3 months) have documented myocardial ischemia or symptoms of angina, and eligible for stenting without any exclusion criteria will be randomized 1:1 to: a) drug-eluting stent vs. b) optimal medical treatment. All patients will be followed for at least 3 year.

The subjects with chronic total occlusion but failed to random for any reason, they will be enrolled in registry group.

The random design was closed at the date of 22 July 2019 however already randomized subjects and subjects from registry design continue 10 years follow-up on IRIS-CTO registry.

Conditions

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Coronary Artery Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Optimal medical therapy

optimal medical therapy

Group Type ACTIVE_COMPARATOR

optimal medical therapy

Intervention Type DRUG

optimal medical therapy

drug-eluting stent

Cypher, xience, Endeavor, Taxus

Group Type ACTIVE_COMPARATOR

Cypher, xience, Endeavor, Taxus

Intervention Type PROCEDURE

all species of drug-eluting stent implantation

Interventions

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Cypher, xience, Endeavor, Taxus

all species of drug-eluting stent implantation

Intervention Type PROCEDURE

optimal medical therapy

optimal medical therapy

Intervention Type DRUG

Other Intervention Names

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percutaneous coronary intervention intensive medical therapy

Eligibility Criteria

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Inclusion Criteria

Clinical

1. Patients with angina or silent ischemia and documented ischemia
2. Patients who are eligible for intracoronary stenting
3. Age \> 18 years

Angiographic

1. De novo lesion CTO
2. Reference vessel size 2.5 mm by visual estimation
3. At least one CTO lesions located in proximal or mid epicardial coronary artery. (If the patient has two CTO lesions, one CTO lesion should be located in proximal or mid epicardial coronary artery)

CTO definition: TIMI flow 0 and estimated duration over 3 months The duration of the occlusion was determined by the interval from the last episode of acute coronary syndrome, or In patients without a history of acute coronary syndrome, from the first episode of effort angina consistent with the location of the occlusion

1. Angiographically defined total occlusion over 3 months
2. If no definite symptom with total occlusion, two experienced operators decide CTO in consideration of angiographical morphology (degree of calcification, bridging collaterals, non-tapered stump, angiographic filling from collaterals)

Exclusion Criteria

1. History of bleeding diathesis or coagulopathy
2. Pregnant state
3. Three vessel CTO
4. Known hypersensitivity or contra-indication to contrast agent and heparin
5. ST-elevation acute myocardial infarction requiring primary stenting
6. Characteristics of lesion 1) Left main disease 2) In-stent restenosis 3) Graft vessels 4) Distal epicardial coronary artery CTO lesions
7. Hematological disease
8. Hepatic dysfunction, liver enzyme (ALT and AST) elevation 3 times normal
9. Renal dysfunction, creatinine more than 2.0
10. Contraindication to aspirin, clopidogrel or other commercial antiplatelet agent
11. Left ventricular ejection fraction
12. Patients who are actively participating in another drug or device investigational study, which have not completed the primary endpoint follow-up period.
13. Non-cardiac co-morbid conditions are present with limited life expectancy or that may result in protocol non-compliance (per site investigator's medical judgment).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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CardioVascular Research Foundation, Korea

OTHER

Sponsor Role collaborator

Seung-Jung Park

OTHER

Sponsor Role lead

Responsible Party

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Seung-Jung Park

MD,PhD, Chairman,Heart Institute, Asan Medical Center,University of Ulsan,College of Medicine

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Seung-Jung Park, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine

Locations

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Ruby Hall Clinic

Pune, , India

Site Status

Medistra Hospital

Jakarta, , Indonesia

Site Status

Sam Anyang Hospital

Anyang, , South Korea

Site Status

Soonchunhyang University Hospital, Buchen

Bucheon-si, , South Korea

Site Status

Soonchunhyang University Hospital, Cheonan

Cheonan, , South Korea

Site Status

Chungbuk National University Hospital

Cheongju-si, , South Korea

Site Status

Kangwon National University Hospital

Chuncheon, , South Korea

Site Status

Keimyung University Dongsan Medical Center

Daegu, , South Korea

Site Status

Chungnam National University Hospital

Daejeon, , South Korea

Site Status

The Catholic University of Korea, Daejeon ST.Mary's Hospital

Daejeon, , South Korea

Site Status

GangNeung Asan Hospital

Gangneung, , South Korea

Site Status

Chonbuk National University Hospital

Jeonju, , South Korea

Site Status

Chonnam National University Hospital

Kwangju, , South Korea

Site Status

Dong-A University Medical Center

Pusan, , South Korea

Site Status

Pusan National University Yangsan Hospital

Pusan, , South Korea

Site Status

Asan Medical Center

Seoul, , South Korea

Site Status

Hallym University Medical Center, Hangang Sacred Heart Hospital

Seoul, , South Korea

Site Status

Kangbuk Samsung Hospital

Seoul, , South Korea

Site Status

Korea University Guro Hospital

Seoul, , South Korea

Site Status

The Catholic University of Korea, Kangnam ST.Mary's Hospital

Seoul, , South Korea

Site Status

Bundang CHA Hospital

Sŏngnam, , South Korea

Site Status

Ulsan University Hospital

Ulsan, , South Korea

Site Status

Wonju Christian Hospital

Wŏnju, , South Korea

Site Status

National Taiwan University hospital

Taipei, , Taiwan

Site Status

Shin Kong Hospital

Taipei, , Taiwan

Site Status

King chulalongkorn Memorial Hospital

Bangkok, , Thailand

Site Status

Countries

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India Indonesia South Korea Taiwan Thailand

References

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Lee SW, Lee PH, Ahn JM, Park DW, Yun SC, Han S, Kang H, Kang SJ, Kim YH, Lee CW, Park SW, Hur SH, Rha SW, Her SH, Choi SW, Lee BK, Lee NH, Lee JY, Cheong SS, Kim MH, Ahn YK, Lim SW, Lee SG, Hiremath S, Santoso T, Udayachalerm W, Cheng JJ, Cohen DJ, Muramatsu T, Tsuchikane E, Asakura Y, Park SJ. Randomized Trial Evaluating Percutaneous Coronary Intervention for the Treatment of Chronic Total Occlusion. Circulation. 2019 Apr 2;139(14):1674-1683. doi: 10.1161/CIRCULATIONAHA.118.031313.

Reference Type DERIVED
PMID: 30813758 (View on PubMed)

Azzalini L, Vo M, Dens J, Agostoni P. Myths to Debunk to Improve Management, Referral, and Outcomes in Patients With Chronic Total Occlusion of an Epicardial Coronary Artery. Am J Cardiol. 2015 Dec 1;116(11):1774-80. doi: 10.1016/j.amjcard.2015.08.050. Epub 2015 Sep 11.

Reference Type DERIVED
PMID: 26434510 (View on PubMed)

Other Identifiers

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2009-0647

Identifier Type: -

Identifier Source: org_study_id

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