Long-term Clinical Outcomes of intraVascular Ultrasound-guided vs Angiography-guided Primary pErcutaneous Intervention in Patients With Acute ST Segment Elevated Myocardial Infarction

NCT ID: NCT04063345

Last Updated: 2021-01-29

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

PHASE2/PHASE3

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-01

Study Completion Date

2023-10-01

Brief Summary

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To examine the impact of IVUS guidance on clinical outcomes in the patient with Acute ST Segment Elevated Myocardial Infarction.

Detailed Description

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Intravascular ultrasound (IVUS) has been increasingly used as a guide for percutaneous coronary intervention (PCI) during elective as well as emergent clinical scenario. Recent small number randomized studies, large scale registries as well as meta-analysis have consistently demonstrated advantages of IVUS-guidance over angiography-guide alone with respect to the lower incident of death, myocardial infarction and target vessel revascularization.

There are sparse data available on the clinical impact of IVUS-guided PCI in the setting of acute myocardial infarction (AMI) and its use remains a matter of controversy as shown by previous studies. This study is to examine the impact of IVUS guidance on clinical outcomes in the patient with Acute ST Segment Elevated Myocardial Infarction (STEMI).

Conditions

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ST Elevation Myocardial Infarction

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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IVUS-guided PCI

Percutaneous intervention under IVUS-guidance

Group Type EXPERIMENTAL

IVUS-guided PCI

Intervention Type PROCEDURE

Performing intravascular ultrasound before or/and after percutaneous intervention

Angiography-guided PCI

Percutaneous intervention under angiograhy-guidance only

Group Type ACTIVE_COMPARATOR

Angiography-guided PCI

Intervention Type PROCEDURE

Performing percutaneous intervention without intravascular ultrasound guidance

Interventions

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IVUS-guided PCI

Performing intravascular ultrasound before or/and after percutaneous intervention

Intervention Type PROCEDURE

Angiography-guided PCI

Performing percutaneous intervention without intravascular ultrasound guidance

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Age \> 18 years
2. Onset of STEMI \> 30 minutes, but \< 12 hours
3. ST segment elevation in at least 2 contiguous leads of≥ 1mm or newly developed LBBB on ECG
4. Willing and able to provide informed consent

1. Having at least one infarct-related coronary artery, of which (1) the Culprit lesion is suitable for stenting (2) the reference diameter of culprit vessel is ≥ 2.5 mm but ≤ 4 mm (3) the TIMI flow is ≤ 1 in culprit lesion segment prior to guide wire crossing
2. No excessive tortuosity and calcification in the culprit lesion segment that allowing stent implantation

Exclusion Criteria

1. Contraindicating to any concomitant study medications
2. Having cardiogenic shock with hemodynamic instability
3. A history of bleeding diathesis or known coagulopathy
4. A history of cerebrovascular accident (CVA) or transient ischemic attack (TIA) within the past 6 months; or a history of intracranial tumor, aneurysm or arteriovenous malformations; or a history of active peptic ulcer or active gastrointestinal (GI) bleeding within the past 2 months; or planned major procedure within 6 weeks; or known platelet count \< 100,000 /mm3 or Hb \< 10 g/dL
5. Planned surgery which may cause discontinuation of ADP-receptor antagonist
6. Other serious illness (e.g., cancer) that may reduce life expectancy to less than 1 year
7. Repeated MI within 7 days of hospitalization for acute MI

1. Bifurcated lesion unable to identify the culprit lesion
2. The culprit lesion is located in the left main artery
3. Diffusive lesions without distinguishable culprit lesion
4. Previous stent implantation in the culprit lesion segment or STEMI caused by stent thrombosis
5. Likely CABG procedure within 30 days
6. Renal failure requiring or during dialysis
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ningbo No. 1 Hospital

OTHER

Sponsor Role collaborator

First Affiliated Hospital of Wenzhou Medical University

OTHER

Sponsor Role collaborator

Second Affiliated Hospital of Wenzhou Medical University

OTHER

Sponsor Role collaborator

The First Affiliated Hospital of Xiamen University

OTHER

Sponsor Role collaborator

Shanghai Chest Hospital

OTHER

Sponsor Role collaborator

Taizhou Hospital

OTHER

Sponsor Role collaborator

Second Affiliated Hospital, School of Medicine, Zhejiang University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jian-an Wang, MD, PhD

Role: STUDY_CHAIR

Second Affiliated Hospital of Zhejiang University, School of Medicine

Locations

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Second affiliated Hospital Zhejiang University School of Medicine

Hangzhou, Zhejiang, China

Site Status

Countries

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China

Central Contacts

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Jun Jiang, MD, PhD

Role: CONTACT

+86-13588706891

Liang Dong, MD, PhD

Role: CONTACT

+86-13858188861

Facility Contacts

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Jun Jiang, MD, PhD

Role: primary

+86-13588706891

Other Identifiers

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SAHZJU CT015

Identifier Type: -

Identifier Source: org_study_id

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