The Flash FFR Ⅱ Study

NCT ID: NCT04575207

Last Updated: 2023-03-21

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

2132 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-12

Study Completion Date

2025-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The overall purpose of Flash FFR Ⅱ is to investigate whether coronary angiography-derived fractional flow reserve (caFFR), compared with fractional flow reserve (FFR) measured by a pressure wire, has non-inferior clinical effect and cost benefit in guiding the percutaneous coronary intervention (PCI) for patients with moderate coronary artery stenosis in terms of long-term clinical prognosis.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Flash FFR Ⅱ is a prospective, multicenter, blinded, randomized, non-inferiority trial. Eligible patients with moderate coronary artery stenosis will be included in the study and randomly assigned to either caFFR-guided group or FFR-guided group. Participant caFFR or FFR will be used to guide percutaneous coronary intervention (PCI) strategy.

The rate of major cardiovascular adverse events (MACE) and the cost data will be collected during the long-term follow-up (2 years). MACE is defined as a composite of all-cause death, myocardial infarction (MI), unplanned revascularization. Clinical outcomes and cost-effectiveness will be compared between the two groups.

A subgroup analysis is pre-set and included in the protocol, including age, sex, body mass index, diabetes mellitus, smoking status, mean aortic pressure (resting state), acute coronary syndrome, left ventricular ejection fraction, lesion site, lesion stenosis severity, target vessel reference diameter, small vessel lesion, blood flow velocity, PCI mode, and so on.

The trial is equipped with a core laboratory. Some interesting sub-studies will be carried out, such as a comparison of laboratory and operator analysis results.

If the trial results show non-inferiority, it should be noted that caFFR can bring new benefits to both operators and patients as a new index of physiological assessment of coronary artery stenosis severity with the advantages of lower cost, less risk, faster time, and less use of resources.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Coronary Artery Disease Coronary Stenosis Myocardial Ischaemia Coronary Circulation Stable Angina Pectoris Unstable Angina Pectoris Asymptomatic Ischemia Acute Myocardial Infarction Percutaneous Coronary Intervention

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

SINGLE

Outcome Assessors
In the Flash FFR II study, clinical outcome assessors (including the follow-up research personnel, clinical events committee (CEC), data and safety monitoring board (DSMB), and core laboratory) will be blinded to randomization arm. The data safety monitoring board (DSMB) may request unblinding of grouping information due to patient safety reasons. All the study site personnel will receive training for the blinding requirements before the trial initiating to prevent disclosure of random assignment to the follow-up personnel in any unplanned way.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

caFFR-guided

Participants who are randomly assigned to caFFR-guided group will receive the detection of Coronary Angiography-Derived Fractional Flow Reserve (caFFR) Measurement System. The online caFFR value is used to guide the PCI strategy. If caFFR ≤ 0.80, PCI treatment will be performed in lesions and optimal medicine treatment will be performed when caFFR \> 0.80.

Group Type EXPERIMENTAL

caFFR

Intervention Type DIAGNOSTIC_TEST

caFFR is a new index of physiological assessment of coronary artery stenosis severity, based on angiographic images. Through two-dimensional analysis and three-dimensional reconstruction of two coronary angiography image series with an angle-off \> 30 degrees, combined with fluid mechanics, TIMI frame counting method, and optimized CFD algorithm, the pressure drop from coronary ostium to every point in the vessel can be obtained, and then the caFFR value of each point in the vessel can be computed. The cutoff value in this trial is caFFR ≤ 0.80 for myocardial ischemia.

FFR-guided

Participants who are randomly assigned to FFR-guided group will receive the detection of pressure wire. The FFR value is used to guide the PCI strategy. If FFR ≤ 0.80, PCI treatment will be performed in lesions and optimal medicine treatment will be performed when FFR \> 0.80.

Group Type ACTIVE_COMPARATOR

FFR

Intervention Type DIAGNOSTIC_TEST

FFR is a widely used, pressure-based functional assessment index of coronary stenoses obtained with an intracoronary pressure wire fitted with pressure sensors. The pressure wire passes through the stenosis and directly measures the pressure distal to the stenosis. FFR value can be obtained by combining the pressure at the coronary ostium and the distal pressure to the stenosis. The cutoff value in this trial is FFR ≤ 0.80 for myocardial ischemia.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

caFFR

caFFR is a new index of physiological assessment of coronary artery stenosis severity, based on angiographic images. Through two-dimensional analysis and three-dimensional reconstruction of two coronary angiography image series with an angle-off \> 30 degrees, combined with fluid mechanics, TIMI frame counting method, and optimized CFD algorithm, the pressure drop from coronary ostium to every point in the vessel can be obtained, and then the caFFR value of each point in the vessel can be computed. The cutoff value in this trial is caFFR ≤ 0.80 for myocardial ischemia.

Intervention Type DIAGNOSTIC_TEST

FFR

FFR is a widely used, pressure-based functional assessment index of coronary stenoses obtained with an intracoronary pressure wire fitted with pressure sensors. The pressure wire passes through the stenosis and directly measures the pressure distal to the stenosis. FFR value can be obtained by combining the pressure at the coronary ostium and the distal pressure to the stenosis. The cutoff value in this trial is FFR ≤ 0.80 for myocardial ischemia.

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Coronary Angiography-Derived Fractional Flow Reserve Fractional Flow Reserve

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Age above 18 years old, no limit on the gender;
2. Angiography is considered necessary and feasible by investigator, and PCI will be performed if necessary;
3. Suspected coronary heart disease, stable angina pectoris, unstable angina pectoris, non-culprit vascular assessment in participants with acute non-ST-segment elevation myocardial infarction, and non-culprit vascular assessment in patients with previous ST-segment elevation acute myocardial infarction;
4. Participants voluntarily participate in this clinical trial and sign informed consent form.

The presence of at least one stenosis and meets the following imaging findings:

1. The degree of coronary artery stenosis≥50% and ≤90% by visual measurement;
2. The reference diameter of the stenotic segment≥2.25 mm by visual measurement;
3. The investigator visually observes the target vessel through angiographic images, and consider that PCI surgery is technically feasible.

Exclusion Criteria

1. Acute ST-segment elevation myocardial infarction within 6 days;
2. Cardiogenic shock or left ventricular ejection fraction≤50%;
3. eGFR \< 30 mL/min (1.73 m2);
4. Severe coagulation dysfunctions or bleeding disorders;
5. Allergic to iodine contrast medium or contraindications for adenosine administration;
6. Severe aortic stenosis;
7. Life expectancy less than 1 year;
8. Pregnant women or women planning a recent pregnancy;
9. Participation in any other clinical trials of devices or drugs (ongoing or within the past 1 month);
10. The investigator believes that the particitant has other conditions that are not suitable for clinical trials.

1. TIMI flow in the target vessel\<grade III ;
2. Presence of myocardial bridge and systolic compression ≥50% in the target vessel;
3. Presence of artificial bypass in the target vessel;
4. Left main coronary artery or right coronary artery ostial lesions;
5. Stent implantation in the target vessel within 3 months;
6. Target vessel provides collateral support to chronically total occluded vessels;
7. Presence of factors affecting angiographic analysis and stenosis visualization, including incomplete vessel opacification, or overlap with other coronary branches of extreme vessel foreshortening.
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Rainmed Ltd., Suzhou, China

UNKNOWN

Sponsor Role collaborator

Peking University First Hospital

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Yong Huo

Chief physician of cardiology Department

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Yong Huo, MD

Role: STUDY_CHAIR

Peking University First Hospital

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University

Beijing, Beijing Municipality, China

Site Status RECRUITING

Peking University People's Hospital

Beijing, Beijing Municipality, China

Site Status RECRUITING

Xiamen Cardiovascular Hospital Xiamen University

Xiamen, Fujian, China

Site Status RECRUITING

Guangdong Provincial People's Hospital

Guangzhou, Guangdong, China

Site Status COMPLETED

The University of Hong Kong Shenzhen hospital

Shenzhen, Guangdong, China

Site Status RECRUITING

The People's Hospital of Hebi

Hebi, Henan, China

Site Status RECRUITING

The First Affiliated Hospital of Xinxiang Medical College

Xinxiang, Henan, China

Site Status RECRUITING

Jiangxi Provincial People's Hospital

Nanchang, Jiangxi, China

Site Status RECRUITING

QILU Hospital of Shandong University

Jinan, Shandong, China

Site Status RECRUITING

Zhongshan Hospital affiliated to Fudan University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

West China Hospital, Sichuan University

Chengdu, Sichuan, China

Site Status RECRUITING

Affiliated Hospital of Yunnan University

Kunming, Yunnan, China

Site Status RECRUITING

Department of Cardiology, Peking University First Hospital

Beijing, , China

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

China

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Yanjun Gong, MD

Role: CONTACT

8610-83575607

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Hongxiu Liu, MD

Role: primary

Yahui Lu, MD

Role: primary

Jian Liu

Role: backup

Suiji Li, MD

Role: primary

Cong Chen, MD

Role: primary

0086+1866496688

Gaozhen Cao, MD

Role: backup

0086+18307555105

Xueliang Gao, MD

Role: primary

Peng Liu, MD

Role: backup

Guoan Zhao, MD

Role: primary

Hongmin Zhu, MD

Role: primary

Jianmin Yang, MD

Role: primary

Chenguang Li, MD

Role: primary

Chen Li, MD

Role: primary

Xinjin Zhang, MD

Role: primary

Yanjun Gong, MD

Role: primary

8610-83575607

References

Explore related publications, articles, or registry entries linked to this study.

Li J, Gong Y, Wang W, Yang Q, Liu B, Lu Y, Xu Y, Huo Y, Yi T, Liu J, Li Y, Xu S, Zhao L, Ali ZA, Huo Y. Accuracy of computational pressure-fluid dynamics applied to coronary angiography to derive fractional flow reserve: FLASH FFR. Cardiovasc Res. 2020 Jun 1;116(7):1349-1356. doi: 10.1093/cvr/cvz289.

Reference Type BACKGROUND
PMID: 31693092 (View on PubMed)

Tonino PA, De Bruyne B, Pijls NH, Siebert U, Ikeno F, van' t Veer M, Klauss V, Manoharan G, Engstrom T, Oldroyd KG, Ver Lee PN, MacCarthy PA, Fearon WF; FAME Study Investigators. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med. 2009 Jan 15;360(3):213-24. doi: 10.1056/NEJMoa0807611.

Reference Type BACKGROUND
PMID: 19144937 (View on PubMed)

De Bruyne B, Pijls NH, Kalesan B, Barbato E, Tonino PA, Piroth Z, Jagic N, Mobius-Winkler S, Rioufol G, Witt N, Kala P, MacCarthy P, Engstrom T, Oldroyd KG, Mavromatis K, Manoharan G, Verlee P, Frobert O, Curzen N, Johnson JB, Juni P, Fearon WF; FAME 2 Trial Investigators. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. N Engl J Med. 2012 Sep 13;367(11):991-1001. doi: 10.1056/NEJMoa1205361. Epub 2012 Aug 27.

Reference Type BACKGROUND
PMID: 22924638 (View on PubMed)

Davies JE, Sen S, Dehbi HM, Al-Lamee R, Petraco R, Nijjer SS, Bhindi R, Lehman SJ, Walters D, Sapontis J, Janssens L, Vrints CJ, Khashaba A, Laine M, Van Belle E, Krackhardt F, Bojara W, Going O, Harle T, Indolfi C, Niccoli G, Ribichini F, Tanaka N, Yokoi H, Takashima H, Kikuta Y, Erglis A, Vinhas H, Canas Silva P, Baptista SB, Alghamdi A, Hellig F, Koo BK, Nam CW, Shin ES, Doh JH, Brugaletta S, Alegria-Barrero E, Meuwissen M, Piek JJ, van Royen N, Sezer M, Di Mario C, Gerber RT, Malik IS, Sharp ASP, Talwar S, Tang K, Samady H, Altman J, Seto AH, Singh J, Jeremias A, Matsuo H, Kharbanda RK, Patel MR, Serruys P, Escaned J. Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI. N Engl J Med. 2017 May 11;376(19):1824-1834. doi: 10.1056/NEJMoa1700445. Epub 2017 Mar 18.

Reference Type BACKGROUND
PMID: 28317458 (View on PubMed)

Gotberg M, Christiansen EH, Gudmundsdottir IJ, Sandhall L, Danielewicz M, Jakobsen L, Olsson SE, Ohagen P, Olsson H, Omerovic E, Calais F, Lindroos P, Maeng M, Todt T, Venetsanos D, James SK, Karegren A, Nilsson M, Carlsson J, Hauer D, Jensen J, Karlsson AC, Panayi G, Erlinge D, Frobert O; iFR-SWEDEHEART Investigators. Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI. N Engl J Med. 2017 May 11;376(19):1813-1823. doi: 10.1056/NEJMoa1616540. Epub 2017 Mar 18.

Reference Type BACKGROUND
PMID: 28317438 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

SZRMD2020001

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

CT-FFR-guided Strategy for In-stent Restenosis
NCT05611190 NOT_YET_RECRUITING NA