The PIONEER-IV Study is Comparing Clinical Outcomes Between Angiography-derived Physiology Guidance to Usual Care in an All-comers PCI Population With Unrestrictive Use of the HT Supreme Sirolimus-eluting Stent

NCT ID: NCT04923191

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

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

2540 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-12

Study Completion Date

2029-01-31

Brief Summary

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

PIONEER-IV is a prospective, single-blind (patient), randomized, 1:1, controlled, multi-center study comparing clinical outcomes between angiography-derived physiology guidance to LRDP and usual care in an all-comers patient population (including patients with high bleeding risk, HBR) undergoing PCI with unrestrictive use of the HT Supreme sirolimus-eluting stent. Patients will be randomized to either angio-based physiology guidance angio-FFR (Quantitative Flow Ratio and coronary angiography-derived FFR, caFFR) or local routine diagnostic procedure (LRDP) and usual care. Patients will be treated with 1-year P2Y12 inhibitor monotherapy after 1-month of dual-antiplatelet therapy in approximately 2540 (2\*1270) patients. All patients (both cohorts) must receive dual anti-platelet therapy, being aspirin (ASA) and ticagrelor for 1 month, followed by 11 months of ticagrelor only (i.e. monotherapy). At 1 year, ticagrelor monotherapy is replaced by aspirin monotherapy or left to the discretion of the operator.

Detailed Description

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

Conditions

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

Coronary Artery Disease

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

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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

Angiography-derived Physiology Guidance: angio-FFR (QFR and caFFR)

Quantitative Flow Ratio- QFR, Coronary angiography-derived FFR - caFFR

Group Type OTHER

Angiography-derived physiology guidance/Local routine diagnostic procedure (LRDP) and usual care

Intervention Type OTHER

percutaneous coronary intervention

Local routine diagnostic procedure (LRDP) and usual care

Group Type OTHER

Angiography-derived physiology guidance/Local routine diagnostic procedure (LRDP) and usual care

Intervention Type OTHER

percutaneous coronary intervention

Interventions

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

Angiography-derived physiology guidance/Local routine diagnostic procedure (LRDP) and usual care

percutaneous coronary intervention

Intervention Type OTHER

Eligibility Criteria

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

Inclusion Criteria

* Patient has chronic stable angina, acute coronary syndromes or silent ischemia;
* Presence of one or more coronary artery stenoses of ≥50% (by visual assessment) in a native coronary artery (with or without prior stent/other device treatment) or in a saphenous venous or arterial bypass conduit suitable for coronary stent implantation;
* The vessel should have a reference vessel diameter of at least 2.25 mm by visual assessment (no limitation on the number of treated lesions, vessels, or lesion length);
* Patient has been informed of the nature of the study and agrees to its provisions and has provided written informed consent as approved by the Ethical Committee and is willing to comply with all protocol-required (follow-up) evaluations.

Exclusion Criteria

1. Patient is a woman who is pregnant or nursing (a pregnancy test must be performed within 7 days prior to the index procedure in women of child-bearing potential according to local practice);
2. Known intolerance to cobalt chromium, and medications such as sirolimus, aspirin, heparin, bivalirudin or P2Y12 inhibitors;
3. Planned major elective surgery requiring discontinuation of (dual)anti platelet therapy (DAPT) within 12 months of procedure;
4. Concurrent medical condition with a life expectancy of less than 3 years;
5. Currently participating in another trial and not yet at its primary endpoint;
6. Active pathological bleeding;
7. History of intracranial haemorrhage.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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

National University of Ireland, Galway, Ireland

OTHER

Sponsor Role lead

Responsible Party

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

Patrick Serruys

Professor of Interventional Cardiology & Innovation at the National University of Ireland, Galway, Ireland

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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

ASZ Aalst

Aalst, , Belgium

Site Status RECRUITING

OLVZ Aalst

Aalst, , Belgium

Site Status RECRUITING

Imelda Ziekenhuis

Bonheiden, , Belgium

Site Status RECRUITING

CHU Charleroi

Charleroi, , Belgium

Site Status RECRUITING

Jessa Hospital Hasselt

Hasselt, , Belgium

Site Status RECRUITING

University Hospital Galway

Galway, , Ireland

Site Status RECRUITING

OLVG Amsterdam

Amsterdam, , Netherlands

Site Status RECRUITING

Medisch Spectrum Twente, Thoraxcentrum, Endchede

Enschede, , Netherlands

Site Status RECRUITING

UMC Groningen

Groningen, , Netherlands

Site Status RECRUITING

Medisch Centrum Leeuwarden

Leeuwarden, , Netherlands

Site Status RECRUITING

Maasstad Ziekenhuis

Rotterdam, , Netherlands

Site Status RECRUITING

Den Haag Ziekenhuis

The Hague, , Netherlands

Site Status RECRUITING

Hospital Clínico de Barcelona

Barcelona, , Spain

Site Status RECRUITING

Lucas Augusti Hospital

Lugo, , Spain

Site Status RECRUITING

Hospital Clínico Universitario of Valladolid

Valladolid, , Spain

Site Status RECRUITING

Hospital Álvaro Cunqueiro Vigo

Vigo, , Spain

Site Status RECRUITING

Barts Health NHS Trust, London

London, , United Kingdom

Site Status RECRUITING

Freeman Hospital

Newcastle, , United Kingdom

Site Status RECRUITING

University Hospitals Southampton

Southampton, , United Kingdom

Site Status RECRUITING

Countries

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

Belgium Ireland Netherlands Spain United Kingdom

Central Contacts

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

Patrick W Serruys, MD

Role: CONTACT

+31622924061

Yoshinobu Onuma, MD

Role: CONTACT

+353852882318

Facility Contacts

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

Faisal Sharif, MD

Role: primary

Andreas Baumbach, MD

Role: primary

References

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

He X, Tsung-Ying T, Revaiah PC, Wykrzykowska JJ, Rosseel L, Sharif F, Muramatsu T, Reiber JH, Garg S, Miyashita K, Tobe A, Tao L, Onuma Y, Serruys PW. Nomogram based on virtual hyperemic pullback pressure gradients for predicting the suboptimal post-PCI QFR outcome after stent implantation. Int J Cardiovasc Imaging. 2024 Dec;40(12):2469-2479. doi: 10.1007/s10554-024-03253-1. Epub 2024 Oct 12.

Reference Type DERIVED
PMID: 39395074 (View on PubMed)

Hara H, Serruys PW, O'Leary N, Gao C, Murray A, Breslin E, Garg S, Bureau C, Reiber JH, Barbato E, Aminian A, Janssens L, Rosseel L, Benit E, Campo G, Guiducci V, Casella G, Santarelli A, Franze A, Diaz VAJ, Iniguez A, Brugaletta S, Sabate M, Amat-Santos IJ, Amoroso G, Wykrzykowska J, von Birgelen C, Somi S, Liu T, Hofma SH, Curzen N, Trillo R, Ocaranza R, Mathur A, Smits PC, Escaned J, Baumbach A, Wijns W, Sharif F, Onuma Y; PIONEER IV trial investigator. Angiography-derived physiology guidance vs usual care in an All-comers PCI population treated with the healing-targeted supreme stent and Ticagrelor monotherapy: PIONEER IV trial design. Am Heart J. 2022 Apr;246:32-43. doi: 10.1016/j.ahj.2021.12.018. Epub 2022 Jan 3.

Reference Type DERIVED
PMID: 34990582 (View on PubMed)

Other Identifiers

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

NUIG-2021-001

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

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

PITT PCI Xience Registry
NCT01299207 COMPLETED
Angiolite Registry Study
NCT07004569 RECRUITING