Performance of a New REsting Pressure Index During Invasive Angiography Compared To Adenosine Hyperemic FFR

NCT ID: NCT03237169

Last Updated: 2018-05-11

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

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-10-28

Study Completion Date

2018-09-30

Brief Summary

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To test the feasibility and diagnostic accuracy of a new automated pressure derived resting index (Pd/Pamin), using FFR as gold standard, in de novo coronary lesions in which invasive physiological evaluation is warranted.

Detailed Description

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Coronary lesions with a potential indication for percutaneous coronary intervention or warranting invasive physiological interrogation (in the opinion of the investigator) will undergo PressureWire™ assessment under 2 conditions: rest and adenosine hyperemia. The measurements at rest (standard Pd/Pa and Pd/Pamin) will be repeated to assess test/retest repeatability. Subsequent treatment decisions will be made by the operator according to the standard practice based on the adenosine FFR value together with all other clinical information.

Conditions

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Fractional Flow Reserve, Myocardial Coronary Artery Disease

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Prospective cohort

Prospective cohort of patients with stable or stabilized coronary artery disease and de novo coronary lesions, in whom functional evaluation is performed, according do standard clinical indications.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

1. Patients undergoing FFR assessment for standard clinical indications, according to individual operator decision.
2. Age ≥ 18 years.
3. Provided signed written informed consent for data collection the collection.
4. De novo coronary artery disease in target vessel.
5. Single or multiple vessel disease.
6. Patient eligible for elective or ad hoc PCI (or CABG), if revascularization is deemed indicated, in the setting of stable coronary artery disease or non-culprit lesions of non-ST elevation acute coronary syndromes (only in deferred procedures).
7. Stenosis deemed amenable for both evaluation with a pressure wire and for potential revascularization.

Exclusion Criteria

1. Subjects with restenosis in the target vessel.
2. Known severe renal insufficiency (examples being but not limited to eGFR \<30 ml/kg/min, serum creatinine ≥ 2.5 mg/dL or on dialysis).
3. Aorto-ostial lesion location within 3 mm of the aorta junction (both right and left).
4. Vessel(s) and lesion(s) not amenable for evaluation with a PressureWire™ and/or revascularization.
5. Tandem lesions
6. Moderate lesions in patients with multivessel disease in whom at least one lesion in another major epicardic vessel is severe (to minimize lesion interaction), unless the severe lesion is treated first (see above).
7. Left ventricular ejection fraction \<50%
8. Known severe left ventricular hypertrophy
9. Atrial fibrillation or any other significant arrhythmia (including an heart rate \<50/min on sinus rhythm)
10. Systolic blood pressure \<90 mmHg.
11. Any other medical condition that in the opinion of the investigator will interfere with patient safety or study results
12. Currently participating in another clinical study that interferes with study results.
13. Pregnant or nursing females
14. Planned or prior heart transplantation or listed for heart transplant.
15. Any condition that precludes the subject from undergoing PCI or any of the protocol mandated procedures, for example subjects with a prior history heparin induced thrombocytopenia, known intolerance to adenosine or with a contra-indication for dual anti-platelet therapy.
16. Patients with severe valvular disease
17. Patients with severe pulmonary disease
18. Culprit lesions in ACS patients are not to be included nor non-culprit lesions in patients with a recent STEMI undergoing staged procedures.
19. Patients with a CTO, regardless of the presence and the extent of angiographic collaterals from the target vessel.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abbott Medical Devices

INDUSTRY

Sponsor Role collaborator

Cardiovascular Research Foundation, New York

OTHER

Sponsor Role collaborator

Centro Hospitalar Lisboa Ocidental

OTHER_GOV

Sponsor Role lead

Responsible Party

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Luis Raposo

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Luis Raposo, MD

Role: PRINCIPAL_INVESTIGATOR

Centro Hospitalar de Lisboa Ocidental

Sergio Bravo Baptista, MD, PhD

Role: STUDY_CHAIR

Hospital Fernando da Fonseca

Locations

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St. Francis Hospital The Heart Center

New York, New York, United States

Site Status RECRUITING

Department of Cardiology, University Hospital

Lille, , France

Site Status RECRUITING

Institute of Cardiology, Catholic University of the Sacred Heart

Rome, , Italy

Site Status RECRUITING

Hospital Prof. Doutor Fernando da Fonseca

Amadora, , Portugal

Site Status RECRUITING

Centro Hospitalar de Lisboa Ocidental - Hospital de Santa Cruz

Carnaxide, , Portugal

Site Status RECRUITING

Centro Hospitalar de Lisboa Central (CHLC) - Hospital de Santa Marta

Lisbon, , Portugal

Site Status RECRUITING

Countries

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United States France Italy Portugal

Central Contacts

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Luis Raposo, MD

Role: CONTACT

+351962933777

Facility Contacts

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Allen Jeremias, MD

Role: primary

516-390-9640

Eric VanBelle, MD

Role: primary

Antonio M Leone, MD

Role: primary

Sergio B Batista, MD

Role: primary

Luis Raposo, MD

Role: primary

Ruben Ramos, MD

Role: primary

References

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Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH; American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines; Society for Cardiovascular Angiography and Interventions. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol. 2011 Dec 6;58(24):e44-122. doi: 10.1016/j.jacc.2011.08.007. Epub 2011 Nov 7. No abstract available.

Reference Type BACKGROUND
PMID: 22070834 (View on PubMed)

Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS); European Association for Percutaneous Cardiovascular Interventions (EAPCI); Wijns W, Kolh P, Danchin N, Di Mario C, Falk V, Folliguet T, Garg S, Huber K, James S, Knuuti J, Lopez-Sendon J, Marco J, Menicanti L, Ostojic M, Piepoli MF, Pirlet C, Pomar JL, Reifart N, Ribichini FL, Schalij MJ, Sergeant P, Serruys PW, Silber S, Sousa Uva M, Taggart D. Guidelines on myocardial revascularization. Eur Heart J. 2010 Oct;31(20):2501-55. doi: 10.1093/eurheartj/ehq277. Epub 2010 Aug 29. No abstract available.

Reference Type BACKGROUND
PMID: 20802248 (View on PubMed)

Mamas MA, Horner S, Welch E, Ashworth A, Millington S, Fraser D, Fath-Ordoubadi F, Neyses L, El-Omar M. Resting Pd/Pa measured with intracoronary pressure wire strongly predicts fractional flow reserve. J Invasive Cardiol. 2010 Jun;22(6):260-5.

Reference Type BACKGROUND
PMID: 20516504 (View on PubMed)

Sen S, Escaned J, Malik IS, Mikhail GW, Foale RA, Mila R, Tarkin J, Petraco R, Broyd C, Jabbour R, Sethi A, Baker CS, Bellamy M, Al-Bustami M, Hackett D, Khan M, Lefroy D, Parker KH, Hughes AD, Francis DP, Di Mario C, Mayet J, Davies JE. Development and validation of a new adenosine-independent index of stenosis severity from coronary wave-intensity analysis: results of the ADVISE (ADenosine Vasodilator Independent Stenosis Evaluation) study. J Am Coll Cardiol. 2012 Apr 10;59(15):1392-402. doi: 10.1016/j.jacc.2011.11.003. Epub 2011 Dec 7.

Reference Type BACKGROUND
PMID: 22154731 (View on PubMed)

Ganz P, Abben R, Friedman PL, Garnic JD, Barry WH, Levin DC. Usefulness of transstenotic coronary pressure gradient measurements during diagnostic catheterization. Am J Cardiol. 1985 Apr 1;55(8):910-4. doi: 10.1016/0002-9149(85)90716-7.

Reference Type BACKGROUND
PMID: 3157307 (View on PubMed)

Gruntzig AR, Senning A, Siegenthaler WE. Nonoperative dilatation of coronary-artery stenosis: percutaneous transluminal coronary angioplasty. N Engl J Med. 1979 Jul 12;301(2):61-8. doi: 10.1056/NEJM197907123010201.

Reference Type BACKGROUND
PMID: 449946 (View on PubMed)

Berry C, van 't Veer M, Witt N, Kala P, Bocek O, Pyxaras SA, McClure JD, Fearon WF, Barbato E, Tonino PA, De Bruyne B, Pijls NH, Oldroyd KG. VERIFY (VERification of Instantaneous Wave-Free Ratio and Fractional Flow Reserve for the Assessment of Coronary Artery Stenosis Severity in EverydaY Practice): a multicenter study in consecutive patients. J Am Coll Cardiol. 2013 Apr 2;61(13):1421-7. doi: 10.1016/j.jacc.2012.09.065. Epub 2013 Feb 6.

Reference Type BACKGROUND
PMID: 23395076 (View on PubMed)

Ganz P, Harrington DP, Gaspar J, Barry WH. Phasic pressure gradients across coronary and renal artery stenoses in humans. Am Heart J. 1983 Dec;106(6):1399-406. doi: 10.1016/0002-8703(83)90052-2.

Reference Type BACKGROUND
PMID: 6650363 (View on PubMed)

Other Identifiers

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2017-02

Identifier Type: -

Identifier Source: org_study_id

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