Relationship Between OCT Coronary Plaque Morphology and Clinical Outcome

NCT ID: NCT02883088

Last Updated: 2017-12-21

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

UNKNOWN

Total Enrollment

1003 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-01-01

Study Completion Date

2019-12-01

Brief Summary

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The multicenter observational CLIMA registry has been conceived to explore correlation between OCT morphology of atherosclerotic plaques located in the left anterior descending artery with mid and long term clinical outcome.

Detailed Description

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Acute myocardial infarction (MI) is commonly caused by plaque ulceration and subsequent local thrombosis. Plaques that tend to rupture are typically characterized by a large superficial lipid pool, delimited by a thin fibrous cap and often exhibit local signs of inflammation. Such atherosclerotic lesions are commonly described as vulnerable plaques (1-4).

Identification of these plaque features with imaging modalities is potentially a valid approach to identify patients at increased risk of M (5). Optical coherence tomography is capable of visualizing superficial plaque components at a high resolution (in the range of 10-15 microns) and can depict all the features of plaque vulnerability or thrombogenicity (6,7).

The aim of the study is to relate presence of multiple OCT criteria of plaque vulnerability with following clinical events in a subset of coronary lesions. For this purpose all plaques in the proximal-mid portion of the left anterior descending artery will be evaluated with FD-OCT assessing the following criteria:

* minimum lumen area (MLA) \<3.5 mm2:
* fibrous cap minimum thickness \<75 µm:
* lipid arc extension \>180°;
* presence of macrophages;

Conditions

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Coronary Artery Disease

Keywords

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Optical coherence tomograhpy registry Coronary artery disease

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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LAD-group

Subjects over 18 years who are undergoing Frequency Domain - Optical Coherence Tomography (FD-OCT) evaluation of the native left anterior descending artery during clinically indicated coronary angiography regardless of the clinical syndrome (silent ischemia, effort angina or acute coronary syndrome).

Frequency Domain - Optical Coherence Tomography (FD-OCT)

Intervention Type PROCEDURE

FD-OCT assessment of the native proximal-mid left descending artery during clinically indicated coronary angiography

Interventions

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Frequency Domain - Optical Coherence Tomography (FD-OCT)

FD-OCT assessment of the native proximal-mid left descending artery during clinically indicated coronary angiography

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age \>18 years;
* Patients with clinical indication to coronary angiography undergoing OCT evaluation of the left anterior descending artery regardless of the clinical syndrome;
* Patients with at least 30 mm of naïve OCT-assessable proximal-mid left anterior descending artery;
* Patient has been informed of the nature of the study and agrees to its provisions and has provided written informed consent to the procedure;

Exclusion Criteria

* Female with childbearing potential or lactating;
* Acute or chronic renal dysfunction (defined as creatinine greater than 2.0 mg/dl);
* Advanced heart failure (NYHA III-IV)
* Previous Coronary artery by-pass surgery
* Previous stenting of proximal-mid left anterior descending artery with residual untreated segment \<30mm.
* Co-morbidities that could interfere with completion of study procedures, or life expectancy less than 1 year;
* Participating in another investigational drug or device trial that has not completed the primary endpoint or would interfere with the endpoints of this study;
* Heavily calcified vessel and/or lesion which cannot be successfully imaged by OCT
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centro per la Lotta Contro l'Infarto - Fondazione Onlus

OTHER

Sponsor Role collaborator

San Giovanni Addolorata Hospital

OTHER

Sponsor Role lead

Responsible Party

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Francesco Prati

Dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Francesco Prati, MD

Role: PRINCIPAL_INVESTIGATOR

San Giovanni Addolorata Hospital

Locations

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Policlinico Sant'Orsola-Malpighi

Bologna, , Italy

Site Status

Ospedale Brotzu

Cagliari, , Italy

Site Status

Presidio Ospedaliero Sant'Elia

Caltanissetta, , Italy

Site Status

University of Catania

Catania, , Italy

Site Status

GVM Care and Research, E. S. Health Science Foundation

Cotignola, , Italy

Site Status

Misericordia Hospital

Grosseto, , Italy

Site Status

Ospedale Civile Ferdinando Veneziale

Isernia, , Italy

Site Status

Policlinico G. Martino

Messina, , Italy

Site Status

Centro Cardiologico Monzino IRCCS

Milan, , Italy

Site Status

San Giovanni-Addolorata Hospital

Rome, , Italy

Site Status

Università Cattolica Del Sacro Cuore

Rome, , Italy

Site Status

Presidio Ospedaliero Umberto I°

Syracuse, , Italy

Site Status

Central Clinical Hospital of the Ministry of Interior

Warsaw, , Poland

Site Status

Hospital Universitario Clinico San Carlos

Madrid, , Spain

Site Status

Countries

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Italy Poland Spain

References

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Falk E, Shah PK, Fuster V. Coronary plaque disruption. Circulation. 1995 Aug 1;92(3):657-71. doi: 10.1161/01.cir.92.3.657. No abstract available.

Reference Type BACKGROUND
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De Caterina R. Endothelial dysfunctions: common denominators in vascular disease. Curr Opin Clin Nutr Metab Care. 2000 Nov;3(6):453-67. doi: 10.1097/00075197-200011000-00007.

Reference Type BACKGROUND
PMID: 11085831 (View on PubMed)

Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, Badimon JJ, Stefanadis C, Moreno P, Pasterkamp G, Fayad Z, Stone PH, Waxman S, Raggi P, Madjid M, Zarrabi A, Burke A, Yuan C, Fitzgerald PJ, Siscovick DS, de Korte CL, Aikawa M, Juhani Airaksinen KE, Assmann G, Becker CR, Chesebro JH, Farb A, Galis ZS, Jackson C, Jang IK, Koenig W, Lodder RA, March K, Demirovic J, Navab M, Priori SG, Rekhter MD, Bahr R, Grundy SM, Mehran R, Colombo A, Boerwinkle E, Ballantyne C, Insull W Jr, Schwartz RS, Vogel R, Serruys PW, Hansson GK, Faxon DP, Kaul S, Drexler H, Greenland P, Muller JE, Virmani R, Ridker PM, Zipes DP, Shah PK, Willerson JT. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I. Circulation. 2003 Oct 7;108(14):1664-72. doi: 10.1161/01.CIR.0000087480.94275.97.

Reference Type BACKGROUND
PMID: 14530185 (View on PubMed)

Narula J, Nakano M, Virmani R, Kolodgie FD, Petersen R, Newcomb R, Malik S, Fuster V, Finn AV. Histopathologic characteristics of atherosclerotic coronary disease and implications of the findings for the invasive and noninvasive detection of vulnerable plaques. J Am Coll Cardiol. 2013 Mar 12;61(10):1041-51. doi: 10.1016/j.jacc.2012.10.054.

Reference Type BACKGROUND
PMID: 23473409 (View on PubMed)

Jang IK, Bouma BE, Kang DH, Park SJ, Park SW, Seung KB, Choi KB, Shishkov M, Schlendorf K, Pomerantsev E, Houser SL, Aretz HT, Tearney GJ. Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography: comparison with intravascular ultrasound. J Am Coll Cardiol. 2002 Feb 20;39(4):604-9. doi: 10.1016/s0735-1097(01)01799-5.

Reference Type BACKGROUND
PMID: 11849858 (View on PubMed)

Jang IK, Tearney GJ, MacNeill B, Takano M, Moselewski F, Iftima N, Shishkov M, Houser S, Aretz HT, Halpern EF, Bouma BE. In vivo characterization of coronary atherosclerotic plaque by use of optical coherence tomography. Circulation. 2005 Mar 29;111(12):1551-5. doi: 10.1161/01.CIR.0000159354.43778.69. Epub 2005 Mar 21.

Reference Type BACKGROUND
PMID: 15781733 (View on PubMed)

Kawasaki M, Bouma BE, Bressner J, Houser SL, Nadkarni SK, MacNeill BD, Jang IK, Fujiwara H, Tearney GJ. Diagnostic accuracy of optical coherence tomography and integrated backscatter intravascular ultrasound images for tissue characterization of human coronary plaques. J Am Coll Cardiol. 2006 Jul 4;48(1):81-8. doi: 10.1016/j.jacc.2006.02.062. Epub 2006 Jun 9.

Reference Type BACKGROUND
PMID: 16814652 (View on PubMed)

Biccire FG, Fabbiocchi F, Gatto L, La Manna A, Ozaki Y, Romagnoli E, Marco V, Boi A, Fineschi M, Piedimonte G, Cerrato E, Musto C, Taglieri N, Di Giorgio A, Vizzari G, Ruscica G, Canova PA, Vergallo R, Burzotta F, Limbruno U, Albertucci M, Raber L, Crea F, Alfonso F, Arbustini E, Stone GW, Prati F. Long-Term Prognostic Impact of OCT-Derived High-Risk Plaque Features: Extended Follow-Up of the CLIMA Study. JACC Cardiovasc Interv. 2025 Jun 9;18(11):1361-1372. doi: 10.1016/j.jcin.2025.04.044.

Reference Type DERIVED
PMID: 40500004 (View on PubMed)

Budassi S, Biccire FG, Gatto L, Scorza M, Marco V, Porta Y, Sammartini E, Paoletti G, Debelak C, Di Pietro R, Circhetta S, Albertucci M, Burzotta F, Ozaki Y, Canova PA, Piedimonte G, Alfonso F, Arbustini E, Prati F. Independent role of atherosclerotic plaque composition and extension in predicting the risk of cardiac events: a CLIMA substudy. Int J Cardiovasc Imaging. 2024 Dec;40(12):2535-2543. doi: 10.1007/s10554-024-03260-2. Epub 2024 Oct 21.

Reference Type DERIVED
PMID: 39432135 (View on PubMed)

Biccire FG, Debelak C, Varricchione G, Budassi S, Gatto L, Romagnoli E, Di Pietro R, Sammartini E, Marco V, Paoletti G, Burzotta F, Ozaki Y, Pastori D, Alfonso F, Arbustini E, Prati F. Sex-specific features of optical coherence tomography detected plaque vulnerability related to clinical outcomes: insights from the CLIMA study. Int J Cardiovasc Imaging. 2023 Apr;39(4):873-881. doi: 10.1007/s10554-022-02775-w. Epub 2022 Dec 19.

Reference Type DERIVED
PMID: 36534217 (View on PubMed)

Other Identifiers

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CLI-01-2013

Identifier Type: -

Identifier Source: org_study_id