Resting Full-cycle Flow Ratio (RFR) Versus Angiography to Guide Revascularization Strategy in Patients Undergoing Coronary Artery By-pass Grafting (CABG)

NCT ID: NCT04375306

Last Updated: 2024-02-01

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

500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-02-03

Study Completion Date

2027-06-30

Brief Summary

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Different trials have shown that fractional flow reserve (FFR) could successfully guide revascularization in patients undergoing percutaneous coronary intervention (PCI).

It is conceivable that a similar revascularization guidance could be useful also for surgical revascularization i.e. coronary by-pass graft (CABG). Experience learns that grafts placed on vessels with hemodynamically non-significant stenosis often occlude due to competitive antegrade flow.

Resting full-cycle Flow Ratio (RFR) is a measurement performed to evaluate the hemodynamic severity of coronary stenosis. Differently from FFR which is a measurement performed in maximal hyperemia, the RFR is a measurement that is performed in rest and therefore may predict better than FFR the baseline equilibriums that could lead to graft failure, while it has similar capacity to identify hemodynamically significant stenosis as FFR. It is unknown whether RFR guided CABG revascularization is superior as compared to angiography alone.

Detailed Description

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Conditions

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Coronary Artery Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

International prospective randomized multicenter superiority trial
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators
All patients will undergo RFR and FFR measurement before CABG. RFR and FFR values will be blinded to the patients in both arms. In the control arm (angiography guided CABG) the RFR values will be blinded to the cardiothoracic surgeon.

Study Groups

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angiography guided CABG

angiography guided CABG

Group Type ACTIVE_COMPARATOR

Angio guided CABG

Intervention Type PROCEDURE

All patients will undergo RFR and FFR measurement before CABG. RFR and FFR values will be blinded to the patients. In the control arm the RFR values will be blinded to the cardiothoracic surgeon.

RFR guided CABG

RFR guided CABG

Group Type EXPERIMENTAL

RFR guided CABG

Intervention Type PROCEDURE

All patients will undergo RFR and FFR measurement before CABG. RFR and FFR values will be blinded to the patients. In the experimental arm the decision to revascularize will be based on RFR.

Interventions

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RFR guided CABG

All patients will undergo RFR and FFR measurement before CABG. RFR and FFR values will be blinded to the patients. In the experimental arm the decision to revascularize will be based on RFR.

Intervention Type PROCEDURE

Angio guided CABG

All patients will undergo RFR and FFR measurement before CABG. RFR and FFR values will be blinded to the patients. In the control arm the RFR values will be blinded to the cardiothoracic surgeon.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* All patients between 18 or older undergoing CABG
* Patients willing and capable to provide written informed consent

Exclusion Criteria

* Previous CABG
* Concomitant severe valvular disease intervention
* Remaining (expected) coronary stenosis of \> 50% diameter stenosis distally to graft anastomosis
* Left ventricular ejection fraction \<30%
* Known transmural myocardial infarction
* Documented microvascular disease
* RFR/FFR measurement judged impossible
* Life expectancy \<2 years
* Participation in other investigational clinical trials
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Diagram B.V.

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Imelda ziekenhuis

Bonheiden, , Belgium

Site Status RECRUITING

AZ Sint-Jan Brugge

Bruges, , Belgium

Site Status ACTIVE_NOT_RECRUITING

Medical University of Silesia

Katowice, , Poland

Site Status RECRUITING

SUSCCH

Banská Bystrica, , Slovakia

Site Status RECRUITING

Countries

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Belgium Poland Slovakia

Central Contacts

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Prof. E. Kedhi, MD, PhD

Role: CONTACT

+31 384262999

S. Postma, PhD

Role: CONTACT

+31 384262999

Facility Contacts

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Dr. Dewilde, MD, PhD

Role: primary

Pawel Gasior, MD

Role: primary

Martin Hudec, MD, PhD

Role: primary

Other Identifiers

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9333

Identifier Type: -

Identifier Source: org_study_id

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