Optimal Strategy of Primary PCI for Left Main Coronary Artery Occlusion Induced AMI

NCT ID: NCT03282773

Last Updated: 2017-11-21

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

Clinical Phase

NA

Total Enrollment

480 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-01

Study Completion Date

2022-07-31

Brief Summary

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This study will compare clinical outcomes of immediate stent implantation with deferred stent implantation(4-10days after primary angiography) for patients presented with acute myocardial infarction due to left main coronary artery occlusion.

Detailed Description

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Primary percutaneous coronary intervention for patients presented with acute myocardial infarction caused by left main coronary artery occlusion is associated with significantly higher mortality and risks of major cardiac adverse events. Deferred stent implantation may improve prognosis of primary PCI through reducing distal embolization and no-reflow phenomenon. There is no randomized clinical trial focuses on the effect and outcome of deferred stent implantation on primary PCI for left main coronary artery occlusion in contrast with conventional strategy.

This prospective, multicenter, randomized trial is aimed to compare immediate stenting with deferred stenting for LM-AMI with 30 centers in China involved. We hope to determine whether deferred stenting is superior to conventional strategy for primary PCI of AMI caused by left main coronary artery occlusion in improving long-term clinical outcomes and cardiac function.

Conditions

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Acute Myocardial Infarction Percutaneous Coronary Intervention

Keywords

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acute myocardial infarction percutaneous coronary intervention deferred stent implantation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Deferred stent implantation

Drug-eluting stents are implanted 4-10 days after primary angiography and restoration of blood flow in left main coroanry artery in a secondary PCI

Group Type EXPERIMENTAL

Deferred stent implantation

Intervention Type DEVICE

Primary angiography and pretreatment including balloon dilatation and thrombus aspiration, second generation drug-eluting stents are implanted 4-10 days after restoration of blood flow in left main coronary artery in a secondary PCI.

Immediate stent implantation

Drug-eluting stents are implanted immediately after primary angiography and restoration of blood flow in left main coroanry artery

Group Type ACTIVE_COMPARATOR

Immediate stent implantation

Intervention Type DEVICE

Primary angiography and pretreatment including balloon dilatation and thrombus aspiration, second generation drug-eluting stents are implanted immediately after restoration of blood flow in left main coronary artery in a secondary PCI.

Interventions

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Deferred stent implantation

Primary angiography and pretreatment including balloon dilatation and thrombus aspiration, second generation drug-eluting stents are implanted 4-10 days after restoration of blood flow in left main coronary artery in a secondary PCI.

Intervention Type DEVICE

Immediate stent implantation

Primary angiography and pretreatment including balloon dilatation and thrombus aspiration, second generation drug-eluting stents are implanted immediately after restoration of blood flow in left main coronary artery in a secondary PCI.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of acute myocardial infarction occured within 12 hours
* Left main coronary artery occlusion confirmed by angiography
* Left main coronary artery occlusion (TIMI flow 0,1 or 2) confirmed by primary angiography, TIMI flow grade 3 achieved after pretreatment of thrombus aspiration or balloon dilatation

Exclusion Criteria

* Life expectancy less than 1 years
* Cardiogenic shock
* Chronic kidney disease, stage 4 by KDOQI(GFR\<30ml/min)
* Contraindications to aspirin or other anti-platelet drugs
* Allergy to contrast agent, rapamycin or paclitaxel
* Patients who are included in other ongoing trials
* Pregnant female
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai Zhongshan Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Junbo Ge, M.D.

Role: PRINCIPAL_INVESTIGATOR

Zhongshan Hospital,Shanghai

Locations

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Zhongshan Hospital

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Feng Zhang, M.D.

Role: CONTACT

Phone: 13917149007

Email: [email protected]

Yang Gao, M.D.

Role: CONTACT

Phone: 18801970322

Email: [email protected]

Facility Contacts

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Feng Zhang, M.D.

Role: primary

Yang Gao, M.D.

Role: backup

References

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Gao Y, Zhang F, Li C, Dai Y, Yang J, Qu Y, Qian J, Ge J; OPTIMAL trial investigators. Optimal strategy of primary percutaneous coronary intervention for acute myocardial infarction due to unprotected left main coronary artery occlusion (OPTIMAL): study protocol for a randomised controlled trial. Trials. 2019 Mar 8;20(1):162. doi: 10.1186/s13063-019-3211-0.

Reference Type DERIVED
PMID: 30850023 (View on PubMed)

Other Identifiers

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B2017-104

Identifier Type: -

Identifier Source: org_study_id