INSIGHTFUL-FFR Clinical Trial

NCT ID: NCT05437900

Last Updated: 2026-01-12

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

PHASE4

Total Enrollment

2500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-09-22

Study Completion Date

2030-06-30

Brief Summary

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Recently, a new device for measuring physiological lesion severity, the pressure microcatheter, was introduced. The pressure microcatheter provides similar information to the conventional measurement technique but differs as it is easily advanced on a customary coronary wire and simplifies pullback maneuvers. The pressure microcatheter has been shown to provide comparable FFR results to pressure wires.

Insightful-FFR is an investigator-driven, multicenter, randomized, open-label and prospective trial of patients with stable coronary artery disease or stabilised non-ST elevation acute coronary syndrome (ACS) with epicardial stenosis considered for PCI aiming at comparing clinical outcomes between pressure microcatheter and pressure wire-guided strategies. The study hypothesis states that the use of a Pressure Microcatheter for clinical decision making would be non-inferior to pressure wire-based strategy

After determining the presence of a coronary artery disease/ stabilized acute coronary syndrome, patients will be randomized to use a pressure microcatheter (investigational device) or a pressure wire (comparator) to guide and optimize percutaneous coronary intervention (PCI). Patients will be followed up in hospital at 12 months and yearly until five years.

Detailed Description

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Conditions

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Coronary Artery Disease Acute Coronary Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients with one or more coronary stenoses will be randomized to either pressure microcatheter or pressure wire-based strategies for clinical decision making. Clinical decision making for PCI could be based either on FFR or NHPR. FFR or NHPR will support clinical decisions to defer or treat at the operator discretion. In cases with a positive FFR (≤ 0.80) or NHPR (≤0.89), patients will undergo a hyperemic FFR pullback to guide the PCI procedure further. PCI will be performed using last-generation drug-eluting stents (DES) at operator's discretion. After completing an angiographically successful PCI, patients will be randomized to FFR-guided stent optimization (PIOS) or standard of care (SOC).

The one-step randomization process in four groups permits an uninterrupted invasive procedure avoiding the logistic issues related to a second randomization during the invasive procedure while preserving the statistical power and balance between groups.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Pressure Microcatheter guided strategy - PIOS-MC

Patients will be treated with the Pressure Microcatheter during PCI. After completing an angiographically successful PCI, patients will be randomized to FFR-guided stent optimization (PIOS).

Group Type EXPERIMENTAL

Pressure Microcatheter guided strategy - PIOS MC

Intervention Type PROCEDURE

Use of Pressure Microcatheter during PCI. After the PCI, the patient will receive treatment according to the incremental optimization strategy (PIOS) .

Pressure Wire guided strategy - PIOS-PW

Patients will be treated with the Pressure Wire during PCI. After completing an angiographically successful PCI, patients will be randomized to FFR-guided stent optimization (PIOS).

Group Type ACTIVE_COMPARATOR

Pressure Wire guided strategy - PIOS - PW

Intervention Type PROCEDURE

Use of Pressure Wire during PCI. After the PCI, the patient will receive treatment according to the incremental optimization strategy (PIOS) .

Pressure Microcatheter guided strategy - Standard of care

Patients will be treated with the Pressure Microcatheter during PCI. After completing an angiographically successful PCI, patients will receive the standard of care treatment.

Group Type EXPERIMENTAL

Pressure Microcatheter guided strategy - Standard of care

Intervention Type PROCEDURE

Use of Pressure Microcatheter during PCI. After the PCI, the patient will receive standard of care treatment.

Pressure Wire guided strategy - Standard of care

Patients will be treated with the Pressure Wire during PCI. After completing an angiographically successful PCI, patients will receive the standard of care treatment.

Group Type ACTIVE_COMPARATOR

Pressure Wire guided strategy - Standard of care

Intervention Type PROCEDURE

Use of Pressure Wire during PCI. After the PCI, the patient will receive standard of care treatment.

Interventions

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Pressure Microcatheter guided strategy - PIOS MC

Use of Pressure Microcatheter during PCI. After the PCI, the patient will receive treatment according to the incremental optimization strategy (PIOS) .

Intervention Type PROCEDURE

Pressure Wire guided strategy - PIOS - PW

Use of Pressure Wire during PCI. After the PCI, the patient will receive treatment according to the incremental optimization strategy (PIOS) .

Intervention Type PROCEDURE

Pressure Microcatheter guided strategy - Standard of care

Use of Pressure Microcatheter during PCI. After the PCI, the patient will receive standard of care treatment.

Intervention Type PROCEDURE

Pressure Wire guided strategy - Standard of care

Use of Pressure Wire during PCI. After the PCI, the patient will receive standard of care treatment.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. The subject must be at least 18 years of age and younger than 85 years old.
2. Eligible for elective PCI.
3. Stable angina or ACS (non-culprit vessels only and outside of primary intervention during acute STEMI)
4. Subject willing to participate and able to understand, read and sign the Informed Consent.

Exclusion Criteria

1. STEMI as clinical presentation.
2. Chronic total occlusion as a target vessel.
3. Significant contraindication to adenosine administration (e.g. heart block, severe asthma)
4. Uncontrolled or recurrent ventricular tachycardia.
5. Hemodynamic instability.
6. Severe valvular disease.
7. Severe renal dysfunction defined as an eGFR ≤30 mL/min/1.73 m2.
8. Comorbidity with life expectancy ≤ 2 years.
9. Inability to take DAPT (both aspirin and a P2Y12 inhibitor) for at least 12 months in the patient presenting with an ACS, or at least six months in the patient presenting with stable CAD, unless the patient is also taking chronic oral anticoagulation in which case a shorter duration of DAPT may be prescribed per local standard of care.
10. Planned major cardiac or non-cardiac surgery within 24 months after the index procedure. Note: major surgery is any invasive procedure in which an extensive resection is performed, e.g., a body cavity is entered, organs are removed, or normal anatomy is altered. Note: minor surgery is an operation on the superficial structures of the body or a manipulative procedure that does not involve a serious risk. Planned minor surgery is not excluded.
11. Subject has known hypersensitivity or contraindication to any of the study drugs (including all P2Y12 inhibitors, one or more components of the study devices, including everolimus, zotarolimus, biolimus, sirolimus, cobalt, chromium, nickel, platinum, tungsten, acrylic, and fluoropolymers, or radiocontrast dye that cannot be adequately pre- medicated.
12. The subject has received a functioning solid organ transplant or is active on a waiting list for any solid organ transplants with expected transplantation within 24 months.
13. The subject receives immunosuppressant therapy or has known immunosuppressive or severe autoimmune disease that requires chronic immunosuppressive therapy (e.g., human immunodeficiency virus, systemic lupus erythematosus, etc.). Note: corticosteroids are not included as immunosuppressant therapy.
14. The subject has previously received or is scheduled to receive radiotherapy to a coronary artery (vascular brachytherapy) or the chest/mediastinum.
15. Subject has a platelet count \<100,000 cells/mm3 or \>700,000 cells/mm3.
16. The subject has a documented or suspected hepatic disorder defined as cirrhosis or Child-Pugh ≥ Class B.
17. The subject has a history of bleeding diathesis or coagulopathy or has had a significant gastro-intestinal or significant urinary bleed within the past six months. The subject has had a cerebrovascular accident or transient ischemic neurological attack (TIA) within the past six months, any prior intracranial bleed, any permanent neurologic defect, or any known intracranial pathology (e.g., aneurysm, arteriovenous malformation, etc. The subject has a life expectancy of \<2 years for any non-cardiac cause.
18. The subject is currently participating in another investigational drug or device clinical study.
19. Pregnancy or nursing.
20. Presence of other anatomic or comorbid conditions or other medical, social, or psychological conditions that, in the investigator's opinion, could limit the subject's ability to participate in the clinical investigation or to comply with follow-up requirements or impact the scientific soundness of the clinical investigation results.
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Insight Lifetech Co., Ltd.

INDUSTRY

Sponsor Role collaborator

CoreAalst BV

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Emanuele Barbato, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Azienda Ospedaliera Universitaria Sant'Andrea, Roma

Carlos Collet, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

CoreAalst BV

Junbo Ge, MD

Role: PRINCIPAL_INVESTIGATOR

Zhongshan Hospital, Fudan University, Shanghai

Salvatore Brugaletta, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Clinic of Barcelona

Locations

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OLV Aalst

Aalst, Oost-Vlaanderen, Belgium

Site Status RECRUITING

Universitair ziekenhuis Brussel

Brussels, , Belgium

Site Status RECRUITING

ZOL

Genk, , Belgium

Site Status RECRUITING

Zhongshan Hospital of Fudan University

Shanghai, Xuhui District, China

Site Status ACTIVE_NOT_RECRUITING

QILU Hospital of Shandong University

Shandong, , China

Site Status ACTIVE_NOT_RECRUITING

West China Hospital of Sichuan University

Sichuan, , China

Site Status ACTIVE_NOT_RECRUITING

CHU Lille

Lille, , France

Site Status RECRUITING

Claude Bernard University

Lyon, , France

Site Status ACTIVE_NOT_RECRUITING

ICPS

Paris, , France

Site Status RECRUITING

Herzzentrum Dresden

Dresden, , Germany

Site Status RECRUITING

Klinikum Fürth

Fürth, , Germany

Site Status RECRUITING

Klinikum Herford

Herford, , Germany

Site Status RECRUITING

Catholic Medical Center Koblenz-Montabaur

Koblenz, , Germany

Site Status ACTIVE_NOT_RECRUITING

Herzzentrum Lahr

Lahr, , Germany

Site Status RECRUITING

Universitätsklinik

Mainz, , Germany

Site Status RECRUITING

Nuovo Arcispedale S.Anna Di Ferrara

Ferrara, , Italy

Site Status RECRUITING

Ospedale Civile Sant'Andrea

La Spezia, , Italy

Site Status RECRUITING

Ospedale Santa Maria Goretti

Latina, , Italy

Site Status RECRUITING

Azienda Ospedaliera Universitaria Federico II

Naples, , Italy

Site Status RECRUITING

Azienda Ospedaliera Universitaria Sant'Andrea

Rome, , Italy

Site Status RECRUITING

Amsterdam UMC

Amsterdam, , Netherlands

Site Status RECRUITING

Catharina Ziekenhuis

Eindhoven, , Netherlands

Site Status RECRUITING

UMCN Radboud

Nijmegen, , Netherlands

Site Status RECRUITING

Dr. Jurasz University Hospital No. 1

Bydgoszcz, , Poland

Site Status RECRUITING

John Paul II Specialistic Hospital

Krakow, , Poland

Site Status RECRUITING

National Cardiac Institute

Warsaw, , Poland

Site Status RECRUITING

Hospital Clínic Barcelona

Barcelona, , Spain

Site Status RECRUITING

Germans Trias i Pujol Hopital

Barcelona, , Spain

Site Status RECRUITING

Hospital de Belvitge

Barcelona, , Spain

Site Status RECRUITING

Countries

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Belgium China France Germany Italy Netherlands Poland Spain

Central Contacts

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Sofie Pardaens

Role: CONTACT

0032 53 72 42 30

Facility Contacts

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Hilde Delacroix

Role: primary

Marnix von Kemp, Md

Role: primary

Daan Cottens, MD

Role: primary

Eric Van Belle, MD

Role: primary

Nicolas Amabile, MD

Role: primary

Felix Woitek, MD

Role: primary

Stylianos Pyxaras, MD,PhD

Role: primary

Dominik Gorski, MD

Role: primary

Kambis Mashayekhi, MD, PhD

Role: primary

Tommaso Gori, MD, PhD

Role: primary

Gianluca Campo, MD

Role: primary

Marco Arena, MD

Role: primary

Iginio Colaiori, MD

Role: primary

Giovanni Esposito, MD

Role: primary

Emanuele Barbato, MD

Role: primary

Marcel Beijk, MD

Role: primary

Pim Tonino, MD

Role: primary

Lokien Van Nunen, MD

Role: primary

Adam Sukiennik, MD

Role: primary

Jacek Legutko, MD

Role: primary

Adam Witkowski, MD, PhD

Role: primary

Salvatore Brugaletta, MD, PhD

Role: primary

Oriol Rodriguez, MD

Role: primary

Josep Gomez Lara, MD

Role: primary

References

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Stalikas N, Mizukami T, Bouisset F, Ikeda K, Tajima A, Munhoz D, Mahendiran T, Wilgenhof A, Sakai K, Noorgard B, Engstroem T, Leipsic J, Stefanini G, Bartorelli A, Fairbairn T, Bagnall A, Ko B, Johnson NP, Berry C, Perera D, Christiansen EH, Shinke T, Otake H, Koo BK, Barbato E, Brugaletta S, Collison D, Campo G, Van Belle E, Goori T, Van Nunen L, Witkowski A, Astudillo P, Spratt J, Amano T, Ando H, Sianos G, Sonck J, Andreini D, De Bruyne B, Collet C. Vessel-Specific Myocardial Mass in Patients With Stable Coronary Artery Disease. J Am Heart Assoc. 2025 Nov 18;14(22):e039013. doi: 10.1161/JAHA.124.039013. Epub 2025 Nov 6.

Reference Type DERIVED
PMID: 41195772 (View on PubMed)

Other Identifiers

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CA-053

Identifier Type: -

Identifier Source: org_study_id

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