Effect of Atorvastatin on Fractional Flow Reserve in Coronary Artery Disease

NCT ID: NCT01946815

Last Updated: 2023-04-12

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

PHASE3

Total Enrollment

119 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-09-30

Study Completion Date

2018-11-30

Brief Summary

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Natural course of intermediate coronary artery disease (CAD) is very important to predict the prognosis of the patient with such disease.

Several studies have well demonstrated the beneficial effect of lipid-lowering therapy on the progression of CAD with the modification of lipid profiles.

This effect can be also explained by intravascular ultrasound (IVUS) or optical coherence tomography. However, the effect of plaque modification on coronary physiology has been rarely evaluated.

This research is to evaluate the change of intermediate or nonculprit coronary lesion on lipid-lowering therapy via IVUS(optional) and FFR.

Detailed Description

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The patients who have intermediate CAD (30-80% diameter stenosis by visual estimation) with FFR≥0.80, or nonculprit coronary artery disease with FFR≥0.8 after culprit coronary artery disease intervention will be enrolled. FFR, IVUS(optional) and index of microcirculatory resistance (IMR) should be performed simultaneously. Atorvastatin 20mg is a starting dose, then up-titration will be done twice within each 4\~6weeks until LDL target goal (① LDL\<70mg/dl, or ② statin naive: \>50% reduction from baseline LDL, current statin user: \>30% reduction from baseline LDL). First titration will be atorvastatin 40mg, second will be atorvastatin 80mg. If patients have any adverse effect on atorvastatin, the dose of atorvastatin can be adjusted by investigator's decision. Official clinical follow-up except visit for statin dose titration will occur at 1, 12 months after index procedure. Follow-up coronary angiography, FFR,IMR,and IVUS(optional) will be performed 12 months after index procedure.

Conditions

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Coronary Artery Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Atorvastatin

Atorvastatin (Lipitor) will be prescribed with 20mg,40mg,or 80mg by the unit of 28 tablets upon the result of lipid profile. Besides Clinical and lab test, follow-up CAG, IVUS(optional) and FFR will be performed in 12 months.

Group Type EXPERIMENTAL

Atorvastatin

Intervention Type DRUG

Lipitor dose titration will be followed by the result of LDL lab test until it meets the target level of LDL. IVUS(optional) and FFR during follow up CAG in 12 months will be measured to evaluate the effect of lipitor.

Interventions

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Atorvastatin

Lipitor dose titration will be followed by the result of LDL lab test until it meets the target level of LDL. IVUS(optional) and FFR during follow up CAG in 12 months will be measured to evaluate the effect of lipitor.

Intervention Type DRUG

Other Intervention Names

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lipitor

Eligibility Criteria

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Inclusion Criteria

* patient \> 18 years of age and willing to participate
* patients who have stable intermediate CAD(30-80% diameter stenosis by visual estimation) on angiography with FFR≥0.8,or who have nonculprit CAD which is not planned revascularization
* Signed written Informed Consent

Exclusion Criteria

* Patients who are in cardiogenic shock
* Patients with LVEF\<35%
* Patients with left main disease, restenotic, bypass grafted lesions
* Patients with platelet count \< 100,000 cell/mm3
* Patients who have co-morbidity which reduces life expectancy to one year
* Patients who have a history of stroke or transient ischemic attack within 6 months
* Patients who are planned discontinuation of medication due to surgery
* Patients with known adverse reaction to HMG CO-A reductase therapy (statins)
* Patients with liver disease (elevation of AST or ALT more than 2 times)
* Patient with creatinine \> 2.0 mg/dL
* Pregnant women and women of childbearing potential who intend to have children during the duration of the trial
* Patients who consistently must take drugs affecting lipid levels in blood except the investigational product
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Seoul National University Hospital

OTHER

Sponsor Role collaborator

Ulsan University Hospital

OTHER

Sponsor Role collaborator

Inje University Ilsan Paik Hospital

OTHER

Sponsor Role collaborator

Keimyung University Dongsan Medical Center

OTHER

Sponsor Role lead

Responsible Party

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NAM, Chang-Wook

Associate Professor of Internal Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Chang-Wook Nam, Postdoctoral

Role: PRINCIPAL_INVESTIGATOR

Keimyung University Dongsan Medical Center

Locations

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Ulsan University Hospital

Ulsan, Gyeongsangbuk-do, South Korea

Site Status

Inje University Ilsan Paik Hospital

Ilsan, Kyeongki, South Korea

Site Status

Keimyung University Dongsan Medical center

Daegu, , South Korea

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Countries

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South Korea

References

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Lee CH, Hwang J, Kim IC, Cho YK, Park HS, Yoon HJ, Kim H, Han S, Hur SH, Kim KB, Kim JY, Chung JW, Lee JM, Doh JH, Shin ES, Koo BK, Nam CW. Effect of Atorvastatin on Serial Changes in Coronary Physiology and Plaque Parameters. JACC Asia. 2022 Nov 1;2(6):691-703. doi: 10.1016/j.jacasi.2022.07.010. eCollection 2022 Nov.

Reference Type DERIVED
PMID: 36444331 (View on PubMed)

Other Identifiers

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FORTE

Identifier Type: -

Identifier Source: org_study_id

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