Multislice Computed Tomography Assessment of PCSK9 Inhibition on Coronary Perfusion

NCT ID: NCT03851263

Last Updated: 2019-12-06

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

WITHDRAWN

Clinical Phase

PHASE4

Study Classification

INTERVENTIONAL

Study Start Date

2019-08-30

Study Completion Date

2023-02-24

Brief Summary

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The MARKOV study is an investigator-sponsored single arm, prospective study to assess the effect of evolocumab on the improvement in coronary flow (FFRCT) after 18 and 36 months of treatment in patients with coronary atherosclerosis.

Detailed Description

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The MARKOV study is an investigator-initiated, open-label, single arm, international, multicenter, prospective study to assess the effect of evolocumab on the improvement in coronary flow (FFRCT) after 18 and 36 months of treatment in patients with coronary atherosclerosis. The study will be conducted in 5 sites in 3 different countries in Europe. Patients will receive evolocumab for approximately 3 year. The expected duration of the entire study from First Subject First Visit to Last Subject Last Follow-up is 46 months (3 year and 10 months).

Conditions

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Coronary Artery Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Evolocumab

All subjects are treated with evolocumab 140mg every 2 weeks (q2w) starting on day 1 and ending on day 1071 (week 153).

Group Type EXPERIMENTAL

Evolocumab

Intervention Type BIOLOGICAL

Subcutaneous injection, using a pre-filled auto-injector pen. Each pen contains 1.0 ml fluid (containing 140 mg evolocumab) which is injected in the abdomen, thigh or outer area of upper arm every 2 weeks (q2w).

Interventions

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Evolocumab

Subcutaneous injection, using a pre-filled auto-injector pen. Each pen contains 1.0 ml fluid (containing 140 mg evolocumab) which is injected in the abdomen, thigh or outer area of upper arm every 2 weeks (q2w).

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

1. At least 2 coronary vessels suitable for CCTA; vessels fulfilling all requirements below: a. patent main branch b. no previous stent placement
2. At least two of the evaluable vessels with subclinical coronary artery disease as defined non-invasively by CCTA with encroachment of the vessel and either: a. Lesion with visual diameter stenosis (DS) \< 50% or, b. Lesion with visual DS ≥ 50% and FFRCT \> 0.80;
3. No planned coronary revascularization (during the course of the study) at the time of enrollment;
4. Most recent, taken within 30 days prior to informed consent form (ICF) signature, fasting LDL-C ≥ 80 mg/dL (≥ 2.07 mmol/L) and on stable statin therapy for at least 30 days at the time of blood sampling, or statin-intolerant or for whom a statin is contraindicated.
5. Subject signed informed consent form

Exclusion Criteria

1. History of coronary artery bypass surgery, heart transplantation, surgical or percutaneous valve repair and/or replacement
2. New York Heart Association (NYHA) class III or IV heart failure
3. Last known left ventricular ejection fraction \<30%
4. Active liver disease or hepatic dysfunction, either known or defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \> 3 times the upper limit of normal (ULN)
5. Severe renal dysfunction, defined as an estimated glomerular filtration rate (eGFR) \<30 mL/min/1.73 m2
6. Active malignancy except for adequately treated non-melanoma skin cancer or other non-invasive or in situ neoplasm (e.g. successfully treated cervical cancer in situ or non-active prostate cancer) Imaging CCTA-related
7. Absence of baseline CCTA obtained in the context of standard clinical care
8. Baseline CCTA not meeting Core Lab quality standards
9. Any contraindication for repeat CCTA such as known anaphylactic allergy to iodinated contrast

Concomitant and study medication
11. LDL or plasma apheresis within 12 months of screening
12. Subject \< 18 years of age
13. Legally incompetent to provide written informed consent;
14. Known pregnancy or breast-feeding at time of screening
15. Female subject of childbearing potential, i.e. who are not surgically sterile or post-menopausal (defined as no menses for 2 years without an alternative cause)
16. Male subject with female partner of childbearing potential who is not using highly effective birth control
17. Currently participating in another trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Amgen

INDUSTRY

Sponsor Role collaborator

GE Healthcare

INDUSTRY

Sponsor Role collaborator

HeartFlow, Inc.

INDUSTRY

Sponsor Role collaborator

ECRI bv

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Patrick W Serruys, Prof. dr.

Role: STUDY_CHAIR

NHLI Imperial College, London

Other Identifiers

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ECRI-11

Identifier Type: -

Identifier Source: org_study_id