The SHINE-CTO Trial

NCT ID: NCT02784418

Last Updated: 2021-06-07

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

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2016-05-31

Study Completion Date

2021-12-31

Brief Summary

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Design: Single center, double-blind, sham-controlled trial that will randomize symptomatic patients with a coronary chronic total occlusion (CTO) to CTO percutaneous coronary intervention (PCI) or a sham procedure. All patients will receive optimal medical therapy.

Treatment:CTO PCI, as per standard clinical practice.

Control: Patients randomized to sham-procedure will undergo only bilateral arterial access, without angiography or PCI being performed.

Secondary Endpoints: (1) Greater improvement in SAQ-7 Summary scores during the entire duration of follow-up (6 months) using a repeated measures analysis (2) Greater improvement in individual components of patients' health status (3) Greater improvement in exercise capacity (4) Similar incidence of major adverse cardiac events (MACE), both peri-procedural and long-term

Detailed Description

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Conditions

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Coronary Artery Disease Chronic Total Occlusion of Coronary Artery Percutaneous Transluminal Coronary Angioplasty

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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PCI of CTO

Intervention: PCI of CTO (Chronic Total Occlusion Percutaneous Coronary Intervention) Chronic Total Occlusion Percutaneous Coronary Intervention (CTO PCI), as per standard clinical practice. Hospitalized overnight after the procedure, with post procedure monitoring practices as per standard of care for PCI. CTO PCI patients will receive blinded clopidogrel 75 mg daily for 6 months.

Group Type ACTIVE_COMPARATOR

Chronic Total Occlusion Percutaneous Coronary Intervention

Intervention Type PROCEDURE

Chronic Total Occlusion Percutaneous Coronary Intervention (CTO PCI), as per standard clinical practice

Sham Procedure

Intervention: Sham procedure Subjects will be blinded to randomization assignment using a combination of conscious sedation and sensory isolation (e.g., blindfold and noise isolation). Control subjects will only undergo a "Sham procedure", wherein they will undergo bilateral arterial access, without angiography or PCI being performed. Hospitalized overnight after the procedure, with post procedure monitoring practices as per standard of care for PCI. Sham group will receive blinded placebo clopidogrel for 6 months.

Group Type SHAM_COMPARATOR

Sham Procedure

Intervention Type PROCEDURE

Sham Procedure: Bilateral arterial access, without angiography or PCI being performed

Interventions

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Chronic Total Occlusion Percutaneous Coronary Intervention

Chronic Total Occlusion Percutaneous Coronary Intervention (CTO PCI), as per standard clinical practice

Intervention Type PROCEDURE

Sham Procedure

Sham Procedure: Bilateral arterial access, without angiography or PCI being performed

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age 18 years or greater
* Willing and able to give informed consent. The patients must be able to comply with study procedures and follow-up.
* Referred for clinically-indicated CTO PCI
* Optimal medical therapy (at least two anti-anginal medications at maximum tolerated doses, aspirin, and statin)

Exclusion Criteria

* Coexisting conditions that limit life expectancy to less than 6 months or that could affect a patient's compliance with the protocol
* Recent (\<7 days) acute myocardial infarction
* Patient has no symptoms related to the CTO
* Known allergy to aspirin or clopidogrel
* Increased risk of bleeding (need for warfarin, oral Xa inhibitor, or thrombin inhibitor administration, recent \[within 30 days\] major bleed, known bleeding diathesis or coagulation disorder)
* Positive pregnancy test or breast-feeding
* Chronic kidney disease, defined as serum creatinine \> 2.5 mg/dL
* Severe peripheral arterial disease limiting exercise capacity
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Minneapolis Heart Institute Foundation

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Emmanouil S Brilakis, MD, PhD

Role: STUDY_CHAIR

Minneapolis Heart Institute

References

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Brilakis ES, Grantham JA, Rinfret S, Wyman RM, Burke MN, Karmpaliotis D, Lembo N, Pershad A, Kandzari DE, Buller CE, DeMartini T, Lombardi WL, Thompson CA. A percutaneous treatment algorithm for crossing coronary chronic total occlusions. JACC Cardiovasc Interv. 2012 Apr;5(4):367-79. doi: 10.1016/j.jcin.2012.02.006.

Reference Type BACKGROUND
PMID: 22516392 (View on PubMed)

Kahn JK. Angiographic suitability for catheter revascularization of total coronary occlusions in patients from a community hospital setting. Am Heart J. 1993 Sep;126(3 Pt 1):561-4. doi: 10.1016/0002-8703(93)90404-w.

Reference Type BACKGROUND
PMID: 8362709 (View on PubMed)

Christofferson RD, Lehmann KG, Martin GV, Every N, Caldwell JH, Kapadia SR. Effect of chronic total coronary occlusion on treatment strategy. Am J Cardiol. 2005 May 1;95(9):1088-91. doi: 10.1016/j.amjcard.2004.12.065.

Reference Type BACKGROUND
PMID: 15842978 (View on PubMed)

Werner GS, Gitt AK, Zeymer U, Juenger C, Towae F, Wienbergen H, Senges J. Chronic total coronary occlusions in patients with stable angina pectoris: impact on therapy and outcome in present day clinical practice. Clin Res Cardiol. 2009 Jul;98(7):435-41. doi: 10.1007/s00392-009-0013-5. Epub 2009 Mar 18.

Reference Type BACKGROUND
PMID: 19294443 (View on PubMed)

Grantham JA, Jones PG, Cannon L, Spertus JA. Quantifying the early health status benefits of successful chronic total occlusion recanalization: Results from the FlowCardia's Approach to Chronic Total Occlusion Recanalization (FACTOR) Trial. Circ Cardiovasc Qual Outcomes. 2010 May;3(3):284-90. doi: 10.1161/CIRCOUTCOMES.108.825760. Epub 2010 Apr 13.

Reference Type BACKGROUND
PMID: 20388873 (View on PubMed)

Joyal D, Afilalo J, Rinfret S. Effectiveness of recanalization of chronic total occlusions: a systematic review and meta-analysis. Am Heart J. 2010 Jul;160(1):179-87. doi: 10.1016/j.ahj.2010.04.015.

Reference Type BACKGROUND
PMID: 20598990 (View on PubMed)

Other Identifiers

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16-009

Identifier Type: -

Identifier Source: org_study_id

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