Study Results
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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WITHDRAWN
NA
INTERVENTIONAL
2016-05-31
2021-12-31
Brief Summary
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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
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
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.
Chronic Total Occlusion Percutaneous Coronary Intervention
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.
Sham 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
Sham Procedure
Sham Procedure: Bilateral arterial access, without angiography or PCI being performed
Eligibility Criteria
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Inclusion Criteria
* 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
* 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
18 Years
ALL
No
Sponsors
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Minneapolis Heart Institute Foundation
OTHER
Responsible Party
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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.
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.
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.
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.
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.
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.
Other Identifiers
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16-009
Identifier Type: -
Identifier Source: org_study_id
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