Early Effects of Intensive Lipid Lowering Treatment With Ezetimibe/ Simvastatin (Vytorin®) Assessed by Virtual Histology-Intravascular Ultrasound (VH-IVUS) and Optical Coherence Tomography (OCT) on Plaque Characteristics in Patients With Acute Coronary Syndrome

NCT ID: NCT01857843

Last Updated: 2014-02-05

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

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-11-30

Study Completion Date

2014-01-31

Brief Summary

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Objective: To evaluate the early effects of intensive lipid lowering treatments with ezetimibe/simvastatin (Vytorin®) for each component of coronary plaques.

Study Design

* Prospective, randomized, single-center study of each 80 subjects enrolled
* Subjects with acute coronary syndrome who meet all inclusion and exclusion criteria will be enrolled.
* Eligible subjects will be randomized 1:1 to A) Ezetimibe/Simvastatin (n=80) vs. B) Pravastatin (n=80), and each group of patients will be randomized further in a ratio of 1:1 to a) ZES (n=40) vs. b) EES (n=40), according to the type of stent used.
* All subjects will undergo VH-IVUS at initial procedure.
* Follow-up VH-IVUS will be performed at 3 months after index procedure. OCT at initial procedure and 3-months will be performed in available cases.

Detailed Description

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Conditions

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Acute Coronary Syndrome

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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ZES group

Group Type EXPERIMENTAL

Zotalolimus Eluting Stent

Intervention Type DEVICE

Permuted block randomization into 4 groups according to the type of drug and stent will be carried out in a ratio of 1:1:1:1(i.e.,Vytorin-ZES, Vytorin-EES, mevalotin-ZES, or mevalotin-EES) for balanced randomization.

Patients with native coronary arteries who fulfill all enrollment criteria for OCT study will be randomized to receive either ZES (Endeavor®-Sprint or Resolute-integrity) or EES (Xience®) in a ratio of 1:1.

EES group

Group Type ACTIVE_COMPARATOR

Everolimus eluting stent

Intervention Type DEVICE

Permuted block randomization into 4 groups according to the type of drug and stent will be carried out in a ratio of 1:1:1:1(i.e.,Vytorin-ZES, Vytorin-EES, mevalotin-ZES, or mevalotin-EES) for balanced randomization.

Patients with native coronary arteries who fulfill all enrollment criteria for OCT study will be randomized to receive either ZES (Endeavor®-Sprint or resolute-integrity) or EES (Xience®) in a ratio of 1:1.

Vytorin group

Group Type EXPERIMENTAL

Ezetimibe 10mg & Simvastatin 40mg

Intervention Type DRUG

Permuted block randomization into 4 groups according to the type of drug and stent will be carried out in a ratio of 1:1:1:1(i.e.,Vytorin-ZES, Vytorin-EES, mevalotin-ZES, or mevalotin-EES) for balanced randomization.

Patients will be randomized in a ratio of 1:1 according to the two different types of lipid lowering treatment.

1. Ezetimibe 10mg/Simvastatin 40mg (Vytorin®, MSD)
2. Pravastatin 20mg (mevalotin®, BMS)

Mevalotin group

Group Type ACTIVE_COMPARATOR

Pravastatin 20mg

Intervention Type DRUG

Permuted block randomization into 4 groups according to the type of drug and stent will be carried out in a ratio of 1:1:1:1(i.e.,Vytorin-ZES, Vytorin-EES, mevalotin-ZES, or mevalotin-EES) for balanced randomization.

Patients will be randomized in a ratio of 1:1 according to the two different types of lipid lowering treatment.

1. Ezetimibe 10mg/Simvastatin 40mg (Vytorin®, MSD)
2. Pravastatin 20mg (mevalotin®, BMS)

Interventions

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Zotalolimus Eluting Stent

Permuted block randomization into 4 groups according to the type of drug and stent will be carried out in a ratio of 1:1:1:1(i.e.,Vytorin-ZES, Vytorin-EES, mevalotin-ZES, or mevalotin-EES) for balanced randomization.

Patients with native coronary arteries who fulfill all enrollment criteria for OCT study will be randomized to receive either ZES (Endeavor®-Sprint or Resolute-integrity) or EES (Xience®) in a ratio of 1:1.

Intervention Type DEVICE

Everolimus eluting stent

Permuted block randomization into 4 groups according to the type of drug and stent will be carried out in a ratio of 1:1:1:1(i.e.,Vytorin-ZES, Vytorin-EES, mevalotin-ZES, or mevalotin-EES) for balanced randomization.

Patients with native coronary arteries who fulfill all enrollment criteria for OCT study will be randomized to receive either ZES (Endeavor®-Sprint or resolute-integrity) or EES (Xience®) in a ratio of 1:1.

Intervention Type DEVICE

Ezetimibe 10mg & Simvastatin 40mg

Permuted block randomization into 4 groups according to the type of drug and stent will be carried out in a ratio of 1:1:1:1(i.e.,Vytorin-ZES, Vytorin-EES, mevalotin-ZES, or mevalotin-EES) for balanced randomization.

Patients will be randomized in a ratio of 1:1 according to the two different types of lipid lowering treatment.

1. Ezetimibe 10mg/Simvastatin 40mg (Vytorin®, MSD)
2. Pravastatin 20mg (mevalotin®, BMS)

Intervention Type DRUG

Pravastatin 20mg

Permuted block randomization into 4 groups according to the type of drug and stent will be carried out in a ratio of 1:1:1:1(i.e.,Vytorin-ZES, Vytorin-EES, mevalotin-ZES, or mevalotin-EES) for balanced randomization.

Patients will be randomized in a ratio of 1:1 according to the two different types of lipid lowering treatment.

1. Ezetimibe 10mg/Simvastatin 40mg (Vytorin®, MSD)
2. Pravastatin 20mg (mevalotin®, BMS)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Acute coronary syndrome including unstable angina, acute non-ST elevation myocardial infarction and acute ST elevation myocardial infarction
2. Age of 20 years or older
3. Patients with signed informed consent


1. De novo lesion without significant plaque (angiographic lumen diameter stenosis \< 50%)
2. Reference vessel diameter ?\> 3.0 mm by operator assessment
3. Segment length of 10-20 mm
4. Distance from the PCI site \> 5.0mm (either proximal or distal)
5. Available for serial high quality IVUS studies of the entire segment.

Exclusion Criteria

1. Failed PCI
2. Recommended coronary artery bypass grafting (CABG)
3. Cardiogenic Shock
4. Administration of lipid lowering agents before enrollment
5. Significant hepatic dysfunction (3 times normal reference values)
6. Significant renal dysfunction (Serum creatinine \> 2.0 mg/dl)
7. Significant leukopenia, thrombocytopenia, anemia, or known bleeding diathesis
8. Pregnant women or women with potential childbearing
9. Saphenous vein graft
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yonsei University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Severance Hospital

Seoul, Seoul, South Korea

Site Status

Countries

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South Korea

Other Identifiers

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1-2009-0032

Identifier Type: -

Identifier Source: org_study_id

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