Drug-Eluting Balloon or Drug-Eluting Stent in Acute Myocardial Infarction: A Randomized Controlled Trial

NCT ID: NCT06746233

Last Updated: 2025-04-01

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

598 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-25

Study Completion Date

2028-12-31

Brief Summary

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The objective of the study is to compare drug-coated balloon (DCB) with the gold standard drug-eluting stent (DES) in percutaneous coronary intervention (PCI) for patients presenting with ST-elevation myocardial infarction (STEMI).

Randomization will be performed after successful culprit-lesion preparation and confirmation that all angiographic entry criteria are met. Patients will be randomly assigned in a 1:1 fashion to receive either treatment with a Paclitaxel-coated balloon alone or second or third-generation DES.

Detailed Description

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Conditions

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ST Elevation Myocardial Infarction (STEMI)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Drug coated balloon (DCB)

Drug (paclitaxel) coated balloon (DCB) with concentration of 3 μg Paclitaxel per 1 mm2

Group Type EXPERIMENTAL

Drug (paclitaxel) coated balloon (DCB)

Intervention Type DEVICE

In the experimental arm, a drug-coated balloon (DCB) with a concentration of 3 μg of Paclitaxel per 1 mm² will be used in patients with STEMI following successful lesion preparation (defined as residual stenosis ≤30%, TIMI flow grade 2-3, and absence of flow-limiting dissection). If the result after DCB treatment is unsatisfactory, a bailout drug-eluting stent (DES) will be implanted.

Second generation of drug eluting stents (DES)

Drug eluting stent (DES)

Group Type ACTIVE_COMPARATOR

Second-generation Drug Eluting Stent (DES)

Intervention Type DEVICE

If the patient is randomized to the DES treatment arm, a second-generation drug-eluting stent (DES) will be implanted using standard techniques.

Interventions

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Drug (paclitaxel) coated balloon (DCB)

In the experimental arm, a drug-coated balloon (DCB) with a concentration of 3 μg of Paclitaxel per 1 mm² will be used in patients with STEMI following successful lesion preparation (defined as residual stenosis ≤30%, TIMI flow grade 2-3, and absence of flow-limiting dissection). If the result after DCB treatment is unsatisfactory, a bailout drug-eluting stent (DES) will be implanted.

Intervention Type DEVICE

Second-generation Drug Eluting Stent (DES)

If the patient is randomized to the DES treatment arm, a second-generation drug-eluting stent (DES) will be implanted using standard techniques.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age \>18 years with a life expectancy of \>1 year;
* Patients fulfilling criteria for STEMI (\>20 min of chest-pain; At least 1 mm ST-elevation in at least two contiguous leads, a new left bundle branch block or a true posterior myocardial infarction confirmed by ECG or echocardiography; Reperfusion is expected to be feasible within 12 h after onset of symptoms)
* Infarct related artery eligible for primary PCI (De novo lesion in a native coronary artery; Reference-vessel diameter ≥2.5 mm and ≤ 4 mm; Absence of severe calcification; Residual diameter stenosis of ≤30% (by visual assessment) after lesion preparation after lesion preparation; Absence of coronary dissection type ≥C.

Exclusion Criteria

* Killip class\>II on admission
* Known contraindication for aspirin, clopidogrel, ticagrelor, heparin or GP IIb/IIIa inhibitor
* Previous myocardial infarction
* Previous PCI in the territory of the infarct-related artery (IRA)
* Previous CABG
* 3-vessel disease requiring revascularization
* Left-main disease
* Extremely angulated or severely calcified vessels
* History of ischemic stroke within the past 6 months or hemorrhagic stroke
* Planned CABG for a non-culprit vessel
* Participation in another investigational trial that has not completed its primary endpoint or could interfere with the endpoints of this study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institute of Cardiovascular Diseases, Vojvodina

OTHER

Sponsor Role lead

Responsible Party

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Mila Kovacevic

Assistant Professor, MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mila Kovačević, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Institute of Cardiovascular Diseases of Vojvodina

Locations

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University Clinical Centre of Nis

Niš, Serbia, Serbia

Site Status NOT_YET_RECRUITING

University Clinical Center of Serbia

Belgrade, , Serbia

Site Status RECRUITING

Institute of Cardiovascular Diseases of Vojvodina

Kamenitz, , Serbia

Site Status RECRUITING

University Clinical Center of Kragujevac

Kragujevac, , Serbia

Site Status NOT_YET_RECRUITING

Countries

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Serbia

Central Contacts

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Mila Kovačević, MD, PhD

Role: CONTACT

+381601594444

Branislav Crnomarković, MD

Role: CONTACT

+381642636495

Facility Contacts

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Bojan Maričić, MD, PhD

Role: primary

+381692918755

Zlatko Mehmedbegović, MD

Role: primary

+381606678761

Mila Kovačević, MD, PhD

Role: primary

+381601594444

Milovan Petrović, MD, PhD

Role: backup

+381641153076

Miodrag Srećković, MD, PhD

Role: primary

+381693371777

References

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Vos NS, Fagel ND, Amoroso G, Herrman JR, Patterson MS, Piers LH, van der Schaaf RJ, Slagboom T, Vink MA. Paclitaxel-Coated Balloon Angioplasty Versus Drug-Eluting Stent in Acute Myocardial Infarction: The REVELATION Randomized Trial. JACC Cardiovasc Interv. 2019 Sep 9;12(17):1691-1699. doi: 10.1016/j.jcin.2019.04.016. Epub 2019 May 21.

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Gobic D, Tomulic V, Lulic D, Zidan D, Brusich S, Jakljevic T, Zaputovic L. Drug-Coated Balloon Versus Drug-Eluting Stent in Primary Percutaneous Coronary Intervention: A Feasibility Study. Am J Med Sci. 2017 Dec;354(6):553-560. doi: 10.1016/j.amjms.2017.07.005. Epub 2017 Jul 19.

Reference Type BACKGROUND
PMID: 29208251 (View on PubMed)

Jeger RV, Farah A, Ohlow MA, Mangner N, Mobius-Winkler S, Leibundgut G, Weilenmann D, Wohrle J, Richter S, Schreiber M, Mahfoud F, Linke A, Stephan FP, Mueller C, Rickenbacher P, Coslovsky M, Gilgen N, Osswald S, Kaiser C, Scheller B; BASKET-SMALL 2 Investigators. Drug-coated balloons for small coronary artery disease (BASKET-SMALL 2): an open-label randomised non-inferiority trial. Lancet. 2018 Sep 8;392(10150):849-856. doi: 10.1016/S0140-6736(18)31719-7. Epub 2018 Aug 28.

Reference Type BACKGROUND
PMID: 30170854 (View on PubMed)

Tang Y, Qiao S, Su X, Chen Y, Jin Z, Chen H, Xu B, Kong X, Pang W, Liu Y, Yu Z, Li X, Li H, Zhao Y, Wang Y, Li W, Tian J, Guan C, Xu B, Gao R; RESTORE SVD China Investigators. Drug-Coated Balloon Versus Drug-Eluting Stent for Small-Vessel Disease: The RESTORE SVD China Randomized Trial. JACC Cardiovasc Interv. 2018 Dec 10;11(23):2381-2392. doi: 10.1016/j.jcin.2018.09.009.

Reference Type BACKGROUND
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Indermuehle A, Bahl R, Lansky AJ, Froehlich GM, Knapp G, Timmis A, Meier P. Drug-eluting balloon angioplasty for in-stent restenosis: a systematic review and meta-analysis of randomised controlled trials. Heart. 2013 Mar;99(5):327-33. doi: 10.1136/heartjnl-2012-302945. Epub 2013 Jan 18.

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Kawai T, Watanabe T, Yamada T, Morita T, Furukawa Y, Tamaki S, Kawasaki M, Kikuchi A, Seo M, Nakamura J, Tachibana K, Kida H, Sotomi Y, Sakata Y, Fukunami M. Coronary vasomotion after treatment with drug-coated balloons or drug-eluting stents: a prospective, open-label, single-centre randomised trial. EuroIntervention. 2022 Jun 3;18(2):e140-e148. doi: 10.4244/EIJ-D-21-00636.

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Kleber FX, Schulz A, Waliszewski M, Hauschild T, Bohm M, Dietz U, Cremers B, Scheller B, Clever YP. Local paclitaxel induces late lumen enlargement in coronary arteries after balloon angioplasty. Clin Res Cardiol. 2015 Mar;104(3):217-25. doi: 10.1007/s00392-014-0775-2. Epub 2014 Oct 28.

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PMID: 25349065 (View on PubMed)

Ann SH, Balbir Singh G, Lim KH, Koo BK, Shin ES. Anatomical and Physiological Changes after Paclitaxel-Coated Balloon for Atherosclerotic De Novo Coronary Lesions: Serial IVUS-VH and FFR Study. PLoS One. 2016 Jan 29;11(1):e0147057. doi: 10.1371/journal.pone.0147057. eCollection 2016.

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Madhavan MV, Kirtane AJ, Redfors B, Genereux P, Ben-Yehuda O, Palmerini T, Benedetto U, Biondi-Zoccai G, Smits PC, von Birgelen C, Mehran R, McAndrew T, Serruys PW, Leon MB, Pocock SJ, Stone GW. Stent-Related Adverse Events >1 Year After Percutaneous Coronary Intervention. J Am Coll Cardiol. 2020 Feb 18;75(6):590-604. doi: 10.1016/j.jacc.2019.11.058.

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De Luca G, Damen SA, Camaro C, Benit E, Verdoia M, Rasoul S, Liew HB, Polad J, Ahmad WA, Zambahari R, Postma S, Kedhi E, Suryapranata H; Collaborators. Final results of the randomised evaluation of short-term dual antiplatelet therapy in patients with acute coronary syndrome treated with a new-generation stent (REDUCE trial). EuroIntervention. 2019 Dec 6;15(11):e990-e998. doi: 10.4244/EIJ-D-19-00539.

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Other Identifiers

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ICDVojvodina 1482-1/3

Identifier Type: -

Identifier Source: org_study_id

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