FUnctional diagnoSIs of corONary Stenosis (FUSION)

NCT ID: NCT04356027

Last Updated: 2025-02-21

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

312 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-06-26

Study Completion Date

2021-10-15

Brief Summary

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The purpose of the FUSION study is to validate the diagnostic performance of Virtual Flow Reserve (VFR) by comparing it against a reference standard, fractional flow reserve (FFR).

Detailed Description

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This study is a single-arm, prospective, multi-center study collecting OCT pullback images of lesions pre-percutaneous coronary intervention (PCI) and (optional) post-PCI procedure, and the corresponding pressure tracings and physiology indices. Up to 30 centers in the US will enroll approximately 310 patients. The expected duration of enrollment is approximately 15 months. The total duration of the clinical investigation is expected to be approximately 27 months.

Conditions

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Coronary Artery Disease Coronary Stenosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Standard of Care: Angiography, OCT, FFR, and VFR

Patients will have Pre-OCT Angiography, OCT pullbacks, a FFR measurement and a VFR analysis

ICA (Invasive Coronary Angiography)

Intervention Type PROCEDURE

Patients will undergo a Pre-PCI Angiography

OCT

Intervention Type PROCEDURE

OCT pullback images will be collected pre-PCI and (optional) post-PCI procedure

FFR

Intervention Type PROCEDURE

FFR will be measured

VFR Analysis

Intervention Type OTHER

VFR will be calculated offline using the OCT pullback images

Interventions

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ICA (Invasive Coronary Angiography)

Patients will undergo a Pre-PCI Angiography

Intervention Type PROCEDURE

OCT

OCT pullback images will be collected pre-PCI and (optional) post-PCI procedure

Intervention Type PROCEDURE

FFR

FFR will be measured

Intervention Type PROCEDURE

VFR Analysis

VFR will be calculated offline using the OCT pullback images

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years
* Patient provides written informed consent
* Scheduled for clinically indicated coronary catheterization with the intent to perform physiologic assessment to guide physician clinical course (in lesions with visual % diameter stenosis 40-90%), if clinically indicated
* Subject is undergoing invasive FFR with Adenosine (high-dose intra-coronary (IC) \[200 μg for the left and or 100 μg for the right coronary artery\] or 140 μg/kg/min for intravenous (IV)) used as hyperemic stimulus
* Clinical presentation with or history of stable angina, unstable angina, or silent ischemia (defined as abnormal stress test or abnormal invasive physiology assessment) that has led to the procedure

Exclusion Criteria

* Prior history of myocardial infarction (MI) in the target vessel
* Presence of acute ST Elevation Myocardial Infarction (STEMI)
* Culprit vessel of Non-ST Elevation Myocardial Infarction (NSTEMI)
* TIMI flow \< Grade 3 at baseline or visible thrombus
* Prior history of coronary artery bypass grafting (CABG)
* Prior heart transplant
* Severe valvular heart disease or history of valve repair or replacement
* Prior history of PCI with stent in target vessel, or target vessel involves in-stent restenosis.
* Target coronary vessel is supplied by major collaterals or is supplying major collaterals to a CTO (chronic total occlusion)
* CTO in the target vessel
* Severe diffuse disease observed in target vessel defined as the presence of diffuse, serial gross luminal irregularities present in the majority of the coronary tree
* Presence of myocardial bridge (MB), regardless of vessel location
* Contraindication for FFR examination or administration of vasodilators
* Known LVEF ≤45%
* Target lesion involves Left Main coronary artery or ostial right coronary artery
* Known renal insufficiency (eGFR \< 30 ml/kg/m\^2 or serum creatinine ≥ 2.5 mg/dL) unless patient is on dialysis
* Heart Failure NYHA Class III or IV
* Subject is pregnant (For a female subject of childbearing potential, a pregnancy test must be performed within 14 days (≤14 days) prior to the index procedure per site standard test)
* Subject has or had active COVID-19 symptoms and/or a positive test result within the prior 2 months
* Participation in another clinical study of an investigational drug or device
* Presence of aneurysm in the target vessel


* Artifact in pre-PCI OCT for the target lesion or in the event of multiple target lesions, artifact in pre-PCI OCT for ALL target lesions
* Target lesion requires any preparation (including but not limited to balloon dilatation, atherectomy, etc.) prior to pre-PCI OCT and physiology measurement, or in case of multiple target lesions, ALL target lesions require-any preparation (including but not limited to balloon dilatation, atherectomy, etc.) prior to pre-PCI OCT and physiology measurement
* Severe vessel tortuosity or calcification in the target vessel such that it is unlikely that the OCT catheter can be delivered
* Target lesion not imaged by OCT or in the event of multiple target lesions, ALL target lesions not imaged by OCT
* Pressure drift of \> 0.03; i.e. Pd and Pa ratio value \< 0.97 or \> 1.03, unless physiology measurements are repeated after re-equalization
* Target lesion or significant CAD beyond 60mm from coronary ostium; i.e. not able to clearly image and capture all disease segment with OCT in 1 run
* Incorrectly done or unsuccessful catheter purge and/or contrast flush
* Presence of plaque rupture and/or intravascular hematoma in target vessel (visual % diameter stenosis ≥ 40%)
* Inability to receive intracoronary nitroglycerin prior to OCT or FFR
* Use of flush media other than radiographic contrast
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abbott Medical Devices

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Allen Jeremias, MD

Role: PRINCIPAL_INVESTIGATOR

St. Francis Hospital,Roslyn,NY, United States

Locations

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Heart Center Research, LLC.

Huntsville, Alabama, United States

Site Status

HonorHealth

Scottsdale, Arizona, United States

Site Status

Arkansas Heart Hospital

Little Rock, Arkansas, United States

Site Status

VA Palo Alto Medical Center

Palo Alto, California, United States

Site Status

UCLA Medical Center Santa Monica

Santa Monica, California, United States

Site Status

Holy Cross Hospital

Fort Lauderdale, Florida, United States

Site Status

The Cardiac & Vascular Institute Research Foundation, LLC

Gainesville, Florida, United States

Site Status

Tampa General Hospital

Tampa, Florida, United States

Site Status

Atlanta VA Medical Center

Decatur, Georgia, United States

Site Status

Loyola University Medical Center

Maywood, Illinois, United States

Site Status

Via Christi Regional Medical Center - St. Francis Campus

Wichita, Kansas, United States

Site Status

Cardiovascular Research Institute of Kansas

Wichita, Kansas, United States

Site Status

Brigham & Women's Hospital

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

Mercy Hospital

Coon Rapids, Minnesota, United States

Site Status

St. Patrick Hospital

Missoula, Montana, United States

Site Status

New York University Hospital

New York, New York, United States

Site Status

New York-Presbyterian/Columbia University Medical Center

New York, New York, United States

Site Status

St. Francis Hospital

Roslyn, New York, United States

Site Status

Montefiore Medical Center - Moses Division

The Bronx, New York, United States

Site Status

VA Medical Center Durham

Durham, North Carolina, United States

Site Status

Providence St. Vincent Medical Center

Portland, Oregon, United States

Site Status

Holy Spirit Hospital

Camp Hill, Pennsylvania, United States

Site Status

Greenville Health System

Greenville, South Carolina, United States

Site Status

Spartanburg Regional Medical Center

Spartanburg, South Carolina, United States

Site Status

Austin Heart

Austin, Texas, United States

Site Status

University of Texas Medical Branch (UTMB)

Galveston, Texas, United States

Site Status

Memorial Hermann Hospital

Houston, Texas, United States

Site Status

Countries

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United States

References

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Jeremias A, Maehara A, Matsumura M, Shlofmitz RA, Maksoud A, Akasaka T, Bezerra HG, Fearon WF, Samady H, Samuels B, Rapkin J, Gopinath A, Teraphongphom NT, Buccola J, Ali ZA. Optical Coherence Tomography-Based Functional Stenosis Assessment: FUSION-A Prospective Multicenter Trial. Circ Cardiovasc Interv. 2024 Apr;17(4):e013702. doi: 10.1161/CIRCINTERVENTIONS.123.013702. Epub 2024 Mar 25.

Reference Type DERIVED
PMID: 38525609 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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ABT-CIP-10331

Identifier Type: -

Identifier Source: org_study_id

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