Coronary Sinus Reducer Objective Impact on Symptoms, MRI Ischaemia and Microvascular Resistance

NCT ID: NCT04892537

Last Updated: 2023-10-30

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

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-05-21

Study Completion Date

2024-01-31

Brief Summary

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ORBITA-COSMIC is a randomised, double-blinded, placebo controlled trial of the coronary sinus reducer (CSR). The investigators will compare the effects of CSR versus placebo on myocardial perfusion on MRI, exercise time and symptoms in 50 participants with refractory angina and ischaemia.

Detailed Description

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Conditions

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Refractory Angina

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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CSR

Coronary Sinus Reducer implantation

Group Type ACTIVE_COMPARATOR

Coronary Sinus Reducer

Intervention Type DEVICE

Coronary Sinus Reducer implantation according to standard clinical protocols

Placebo

Placebo procedure

Group Type PLACEBO_COMPARATOR

Placebo Procedure

Intervention Type PROCEDURE

A placebo procedure involving venous sheath implantation in the right internal jugular vein without proceeding to CSR implantation

Interventions

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Coronary Sinus Reducer

Coronary Sinus Reducer implantation according to standard clinical protocols

Intervention Type DEVICE

Placebo Procedure

A placebo procedure involving venous sheath implantation in the right internal jugular vein without proceeding to CSR implantation

Intervention Type PROCEDURE

Other Intervention Names

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CSR

Eligibility Criteria

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Inclusion Criteria

* Stable coronary artery disease (CAD) not eligible for percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG)
* Evidence of ischaemia on stress perfusion CMR
* Angina - Canadian Cardiovascular Society Class II-VI on maximal medical therapy

Exclusion Criteria

* Age\<18 years
* Pregnancy
* Inability to consent
* Recent acute coronary syndrome (3 months)
* Recent revascularisation (6 months)
* Permanent pacemaker or defibrillator leads in the right heart
* Severe left ventricular impairment (\<25%)
* Indication for cardiac resynchronisation therapy (CRT)
* Right atrial pressure ≥15mmHg
* Life expectancy \<1 year
* Severe renal impairment (eGFR\<15)
* Contraindication to CMR
* Contraindication to adenosine
* Ischaemia isolated to inferior wall
* Ongoing participation in a separate interventional study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical Research Council

OTHER_GOV

Sponsor Role collaborator

Imperial College Healthcare Nissen Fund

UNKNOWN

Sponsor Role collaborator

Imperial College London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Basildon and Thurrock Hospitals NHS Foundation Trust

Basildon, , United Kingdom

Site Status NOT_YET_RECRUITING

Royal Bournemouth Hospital

Bournemouth, , United Kingdom

Site Status NOT_YET_RECRUITING

Imperial College Healthcare NHS Trust

London, , United Kingdom

Site Status RECRUITING

St George's Hospital

London, , United Kingdom

Site Status NOT_YET_RECRUITING

The Royal Brompton Hospital

London, , United Kingdom

Site Status NOT_YET_RECRUITING

Countries

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United Kingdom

Central Contacts

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Rasha Al-Lamee, PhD MRCP

Role: CONTACT

020 7594 5735

Michael Foley, MBBS MRCP

Role: CONTACT

020 7594 5735

Facility Contacts

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John Davies, PhD

Role: primary

Peter O'Kane

Role: primary

Rasha Al-Lamee, PhD MRCP

Role: primary

02075945735

Michael Foley, MBBS MRCP

Role: backup

02075945735

James Spratt, MbChB MD

Role: primary

Jonathan Hill

Role: primary

References

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Foley MJ, Rajkumar CA, Ahmed-Jushuf F, Simader FA, Chotai S, Pathimagaraj RH, Mohsin M, Salih A, Wang D, Dixit P, Davies JR, Keeble TR, Cosgrove C, Spratt JC, O'Kane PD, De Silva R, Hill JM, Nijjer SS, Sen S, Petraco R, Mikhail GW, Khamis R, Kotecha T, Harrell FE, Kellman P, Francis DP, Howard JP, Cole GD, Shun-Shin MJ, Al-Lamee RK. Coronary sinus reducer for the treatment of refractory angina (ORBITA-COSMIC): a randomised, placebo-controlled trial. Lancet. 2024 Apr 20;403(10436):1543-1553. doi: 10.1016/S0140-6736(24)00256-3. Epub 2024 Apr 8.

Reference Type DERIVED
PMID: 38604209 (View on PubMed)

Foley MJ, Rajkumar CA, Ahmed-Jushuf F, Simader F, Pathimagaraj RH, Nijjer S, Sen S, Petraco R, Clesham G, Johnson T, Harrell FE Jr, Kellman P, Francis D, Shun-Shin M, Howard J, Cole GD, Al-Lamee R. A double-blind, randomised, placebo-controlled trial of the coronary sinus Reducer in refractory angina: design and rationale of the ORBITA-COSMIC trial. EuroIntervention. 2024 Feb 5;20(3):e216-e223. doi: 10.4244/EIJ-D-23-00567.

Reference Type DERIVED
PMID: 38214677 (View on PubMed)

Other Identifiers

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MR/V001620/1

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

20HH6457

Identifier Type: -

Identifier Source: org_study_id

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