Recovery of Left Ventricular Function in Chronic Total Occluded Coronary Arteries

NCT ID: NCT01924962

Last Updated: 2017-11-07

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

NA

Total Enrollment

205 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-05-28

Study Completion Date

2017-06-16

Brief Summary

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The study is a randomised comparison of recanalisation of chronic occluded coronary arteries with implantation of Sirolimus eluting stents and medical therapy. Myocardial function and scar-size are determinated by using magnetic resonance imaging. The study hypothesis is the superiority of medical therapy over revascularisation.

Detailed Description

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In the REVASC-study recovery of left ventricular function after recanalization of chronic total coronary occlusions (CTO) and implantation of sirolimus-eluting stents will be examined and compared to medical treatment. Extent of the scar, viable myocardium in the infarct zone and regional left ventricular function will be assessed by cardiac magnetic resonance. Patients with regional systolic left ventricular dysfunction of any degree in the supply territory of the CTO vessel will be randomized to either recanalization of the occluded coronary artery or to conservative therapy. It is of interest whether CTO patients will have an improvement in left ventricular function after late coronary reopening, regarding the high technical demands and costs of CTO recanalization.

Conditions

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Coronary Heart Disease

Keywords

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chronic occlusion of coronary artery left ventricular function revascularisation

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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medical therapy

patients are treated with medical therapy only, intervention (stent) of other than (chronic occluded) target-vessel is allowed.

Group Type NO_INTERVENTION

No interventions assigned to this group

revascularisation

revascularisation and stent-implantation of chronic occluded coronary artery

Group Type ACTIVE_COMPARATOR

revascularisation

Intervention Type DEVICE

revascularisation of chronic occluded coronary artery

Interventions

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revascularisation

revascularisation of chronic occluded coronary artery

Intervention Type DEVICE

Other Intervention Names

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Cypher-stent

Eligibility Criteria

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Inclusion Criteria

* chronic total occlusion with thrombolysis in myocardial infarction (TIMI) 0 flow (or distal capillary reflow) of a native coronary artery with an estimated reference vessel diameter of 2.5 to 4.0 mm
* chronic total occlusion has more than 4 weeks duration
* the target vessel has not previously been treated with percutaneous coronary intervention
* the target vessel must be feasible for stent implantation
* patient has stable or unstable angina pectoris or a positive functional study for ischemia
* patient must be 18 years of age or older
* female subjects of childbearing age must have a negative pregnancy test within 7 days before procedure
* patient has been informed of the nature of the study and agrees to its
* provisions ans has written informed consent as approved by the Ethics Committee
* patient complies with all required post-procedure follow-up

Exclusion Criteria

* a documented left ventricular function \< 30%
* patient has a acute myocardial infarction (\>3x normal creatine kinase (CK with presence of CK-MB) within 72 hours preceding the index procedure and CK has not returned to normal limits at the time of the procedure
* patients with known hypersensitivity or contraindication to aspirin, heparin, clopidogrel, stainless steel or contrast media that cannot be adequately been pre-medicated
* patient has a platelet count of \< 100000 cells/mm3 or \> 700000 cells/m3, a white blood cell count of \< 3000 cells/mm3 or documented or suspected liver disease
* patient has a history of bleeding diathesis or coagulopathy
* patient has suffered a cerebrovascular accident or transient ischemic attack within the past 6 months
* active peptic ulcer or upper gastrointestinal bleeding within the prior 6 months
* patients has a co-morbidity (i.e. cancer or congestive heart failure) that may cause the patient to be non-compliant with the protocol, or is associated with limited life-expectancy (less than 2 years)
* the target vessel contains intraluminal thrombus
* the target vessel or lesson shows angiographic evidence of severe calcification
* patient has contraindications to magnetic resonance imaging
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Heart Center Freiburg - Bad Krozingen

OTHER

Sponsor Role lead

Responsible Party

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Dr. Heinz Joachim Buettner

head of cath-lab department

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Heinz Joachim Buettner, MD

Role: PRINCIPAL_INVESTIGATOR

Universitaets-Herzzentrum Freiburg-Bad Krozingen, Clinics for Cardiology and Angiology II, D-79189 Bad Krozingen, Germany

Locations

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Universitäts Herzzentrum Freiburg Bad Krozingen

Bad Krozingen, Baden-Wurttemberg, Germany

Site Status

Countries

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Germany

Other Identifiers

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BK 1-2011

Identifier Type: -

Identifier Source: org_study_id