Comparison of Vessel-FFR Versus FFR in Intermediate Coronary Stenoses

NCT ID: NCT03497637

Last Updated: 2024-11-25

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

RECRUITING

Clinical Phase

NA

Total Enrollment

1054 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-10-23

Study Completion Date

2026-11-01

Brief Summary

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This is a prospective, randomized, controlled, multicenter, open-label study designed to assess whether vFFR is non-inferior to FFR in assessment of intermediate coronary stenosis in terms of the occurrence of MACE during 12 months after randomization.

Detailed Description

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Coronary angiography is insensitive to assess the physiologic significance of a coronary stenosis. Therefore, clinical guidelines support the use of pressure-derived fractional flow reserve (FFR) to assess the hemodynamic significance of coronary stenosis. Nevertheless, the penetration of FFR in clinical routine continues to be limited by its requirement for pharmacological vasodilation, prolonged procedure time and adverse systemic effects from adenosine.

Vessel-FFR (vFFR) is a novel method for evaluating the functional significance of coronary stenosis by calculation of the pressure drop in the vessel based on computation of two angiographic projections. The vFFR values at each point along the vessel are color-coded and superimposed on the 3D epicardial model and cut-off values of ≤0.80 identical to standard invasive FFR apply.

These developments may translate towards more physiology guided intervention bearing the potential to improve clinical outcomes in patients with stable CAD. The ability to derive FFR values from routinely performed coronary angiograms, without the practical drawbacks that limit invasive techniques, could have an important impact on daily clinical practice.

To date no randomized outcome-based clinical trial has compared an image-based FFR methodology with standard invasive FFR in terms of subsequent clinical outcomes.

Conditions

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Coronary Artery Disease Coronary Artery Stenoses

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Pd/Pa guided Therapy

use of resting distal coronary pressure to aortic pressure ratio (Pd/Pa) to assess the hemodynamic significance of coronary stenoses

Group Type ACTIVE_COMPARATOR

measurement of Pd/Pa

Intervention Type DIAGNOSTIC_TEST

use of resting distal coronary pressure to aortic pressure ratio (Pd/Pa) to assess the hemodynamic significance of coronary stenoses

FFR guided therapy

use of pressure-derived FFR to assess the hemodynamic significance of coronary stenoses

Group Type ACTIVE_COMPARATOR

measurement of FFR

Intervention Type DIAGNOSTIC_TEST

use of pressure-derived FFR to assess the hemodynamic significance of coronary stenoses

Interventions

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measurement of FFR

use of pressure-derived FFR to assess the hemodynamic significance of coronary stenoses

Intervention Type DIAGNOSTIC_TEST

measurement of Pd/Pa

use of resting distal coronary pressure to aortic pressure ratio (Pd/Pa) to assess the hemodynamic significance of coronary stenoses

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Age \>18 years
* Willing to participate and able to understand, read and sign the informed consent document before the planned procedure
* Eligible for coronary angiography and/or PCI
* Coronary artery disease in one or more native major epicardial vessels or their branches by coronary angiogram with visually assessed de novo coronary stenosis in which the physiological severity of the lesion is in question (typically 40-80% diameter stenosis).
* Stable angina or acute coronary syndrome (non-culprit vessels only and outside of primary intervention during acute STEMI or NSTE-ACS)
* Participation in another interventional study

Exclusion Criteria

* Previous CABG with patent grafts to the interrogated vessel
* Tandem stenoses separated by more than 10 mm that require separate pressure guide wire interrogation or PCI (not to be interrogated or treated as a single stenosis)
* Total coronary occlusions
* Hemodynamic instability (Killip class III-IV)
* Heavily calcified or tortuous vessels
* Terminal disease with life expectancy of less than 12 months
* STEMI within 48 hours of procedure
* Severe valvular heart disease
* ACS patients with difficulty in assessing which the culprit lesion is
* Significant contraindication to adenosine administration (e.g. Asthma bronchiale)
* Pregnancy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Heart Center Leipzig - University Hospital

OTHER

Sponsor Role collaborator

Helios Health Institute GmbH

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Holger Thiele, MD

Role: PRINCIPAL_INVESTIGATOR

Heart Center Leipzig - University Hospital

Locations

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Heart Center Dresden - University Clinic

Dresden, , Germany

Site Status RECRUITING

University Clinic Erlangen

Erlangen, , Germany

Site Status RECRUITING

Universitätsklinikum Essen

Essen, , Germany

Site Status RECRUITING

University Clinic Giessen and Marburg

Giessen, , Germany

Site Status RECRUITING

Herzzentrum Leipzig

Leipzig, , Germany

Site Status RECRUITING

University Clinic Leipzig

Leipzig, , Germany

Site Status RECRUITING

Klinikum der Stadt Ludwigshafen

Ludwigshafen, , Germany

Site Status RECRUITING

Lukaskrankenhaus Neuss

Neuss, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Holger Thiele, MD

Role: CONTACT

+49 341 865 1428

Facility Contacts

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Felix Woitek, Dr.

Role: primary

Luise Gaede, Dr.

Role: primary

Tienush Rassaf, Prof. Dr.

Role: primary

Holger Nef, Prof.

Role: primary

Holger Thiele, MD

Role: primary

Ulrich Laufs, Prof.

Role: primary

Uwe Zeymer, Prof.

Role: primary

Michael Haude, Prof.

Role: primary

Other Identifiers

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HRC045277

Identifier Type: -

Identifier Source: org_study_id

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