Comparison of Moderate-Intensity Statin Plus Ezetimibe vs. High-Intensity Statin for Coronary Plaque Stabilization

NCT ID: NCT06767345

Last Updated: 2025-09-15

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

408 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-12

Study Completion Date

2028-06-25

Brief Summary

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This study is a prospective, multicenter, randomized clinical trial aimed at comparing the effects of moderate-intensity statin plus ezetimibe combination therapy versus high-intensity statin monotherapy on coronary plaque stabilization. Using advanced imaging techniques such as near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS), the trial evaluates whether the combination therapy is non-inferior to monotherapy in stabilizing coronary plaques over 52 weeks. The primary endpoint is the percentage change in coronary atheroma volume (PAV) assessed by grayscale IVUS, with secondary outcomes including changes in lipid core burden, inflammatory markers, and clinical events like myocardial infarction and ischemic stroke. The study plans to enroll 408 patients undergoing coronary intervention across 7 domestic institutions, with rigorous follow-up protocols and adherence to international research guidelines.

Detailed Description

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Conditions

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Coronary Artery Disease Atherosclerosis of Coronary Artery Plaque, Atherosclerotic

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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High Intensity Statin monotherapy

Rosuvastatin 20mg once a daily

Group Type ACTIVE_COMPARATOR

statins, ezetimibe

Intervention Type DRUG

Rosuvastatin 20mg once daily

Combination therapy

Rosuvastatin 10mg plus Ezetimibe 10mg fixed dose single-pill combination

Group Type EXPERIMENTAL

Combination therapy

Intervention Type DRUG

Rosuvastatin 10mg + Ezetimibe 10mg

Interventions

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statins, ezetimibe

Rosuvastatin 20mg once daily

Intervention Type DRUG

Combination therapy

Rosuvastatin 10mg + Ezetimibe 10mg

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Adult men and women over the age of 18 years.
* Patients with coronary artery disease undergoing a coronary intervention procedure using intravascular imaging.
* At least one major native coronary artery ("target vessel") meeting all the following criteria for intracoronary imaging immediately following a qualifying PCI procedure:

* Angiographic evidence of coronary artery stenosis ≥30% by angiographic visual estimation.
* Target vessel is accessible to the imaging catheter and suitable for intracoronary imaging in the proximal 50 mm segment.
* Target vessel is not a bypass graft (aortic or arterial) or a bypassed graft vessel.
* Target vessel has not undergone PCI within the target segment.
* Target vessel is not a candidate for PCI at the time of the procedure or for 6 months thereafter (per investigator's judgment).
* Patients who have provided written informed consent to participate in the study.

Exclusion Criteria

* Left main stem lesion: Left main coronary artery stenosis ≥50% by coronary angiographic visual estimation.
* History of coronary artery bypass graft surgery (CABG).
* Unstable clinical condition (hemodynamic or electrical instability).
* Severe coronary artery calcification or tortuosity interfering with IVUS, NIRS, or evaluation.
* Uncontrolled cardiac arrhythmia (recurrent and symptomatic ventricular tachycardia or atrial fibrillation with rapid ventricular response) not controlled by medication within 3 months prior to screening.
* Active liver disease or liver dysfunction.
* Severe renal dysfunction (eGFR \<30 mL/min/1.73m²)
* Known allergy to contrast media, heparin, aspirin, ticagrelor, or prasugrel.
* Active infection or major hematologic, metabolic, or endocrine dysfunction as determined by the investigator.
* Planned surgery within 12 months.
* Currently enrolled in another investigational device or drug study.
* Estimated life expectancy of less than 2 years.
* Women of childbearing potential (under 50 years of age) who:

* Had their last menstrual period within the last 12 months.
* Have not had tubal ligation, oophorectomy, or hysterectomy.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yuhan Corporation

INDUSTRY

Sponsor Role collaborator

Hanmi Pharmaceutical co., ltd.

OTHER

Sponsor Role collaborator

Korea University Anam Hospital

OTHER

Sponsor Role lead

Responsible Party

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Soon Jun Hong

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Korea University Anam Hospital

Seoul, Seoul, South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Soon Jun Hong

Role: CONTACT

+82-2-920-5445

References

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Preiss D, Seshasai SR, Welsh P, Murphy SA, Ho JE, Waters DD, DeMicco DA, Barter P, Cannon CP, Sabatine MS, Braunwald E, Kastelein JJ, de Lemos JA, Blazing MA, Pedersen TR, Tikkanen MJ, Sattar N, Ray KK. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA. 2011 Jun 22;305(24):2556-64. doi: 10.1001/jama.2011.860.

Reference Type BACKGROUND
PMID: 21693744 (View on PubMed)

Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, de Craen AJ, Seshasai SR, McMurray JJ, Freeman DJ, Jukema JW, Macfarlane PW, Packard CJ, Stott DJ, Westendorp RG, Shepherd J, Davis BR, Pressel SL, Marchioli R, Marfisi RM, Maggioni AP, Tavazzi L, Tognoni G, Kjekshus J, Pedersen TR, Cook TJ, Gotto AM, Clearfield MB, Downs JR, Nakamura H, Ohashi Y, Mizuno K, Ray KK, Ford I. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010 Feb 27;375(9716):735-42. doi: 10.1016/S0140-6736(09)61965-6. Epub 2010 Feb 16.

Reference Type BACKGROUND
PMID: 20167359 (View on PubMed)

Davis JW, Weller SC. Intensity of statin therapy and muscle symptoms: a network meta-analysis of 153 000 patients. BMJ Open. 2021 Jun 15;11(6):e043714. doi: 10.1136/bmjopen-2020-043714.

Reference Type BACKGROUND
PMID: 34130955 (View on PubMed)

Maron DJ, Hochman JS, Reynolds HR, Bangalore S, O'Brien SM, Boden WE, Chaitman BR, Senior R, Lopez-Sendon J, Alexander KP, Lopes RD, Shaw LJ, Berger JS, Newman JD, Sidhu MS, Goodman SG, Ruzyllo W, Gosselin G, Maggioni AP, White HD, Bhargava B, Min JK, Mancini GBJ, Berman DS, Picard MH, Kwong RY, Ali ZA, Mark DB, Spertus JA, Krishnan MN, Elghamaz A, Moorthy N, Hueb WA, Demkow M, Mavromatis K, Bockeria O, Peteiro J, Miller TD, Szwed H, Doerr R, Keltai M, Selvanayagam JB, Steg PG, Held C, Kohsaka S, Mavromichalis S, Kirby R, Jeffries NO, Harrell FE Jr, Rockhold FW, Broderick S, Ferguson TB Jr, Williams DO, Harrington RA, Stone GW, Rosenberg Y; ISCHEMIA Research Group. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med. 2020 Apr 9;382(15):1395-1407. doi: 10.1056/NEJMoa1915922. Epub 2020 Mar 30.

Reference Type BACKGROUND
PMID: 32227755 (View on PubMed)

Park SJ, Ahn JM, Kang DY, Yun SC, Ahn YK, Kim WJ, Nam CW, Jeong JO, Chae IH, Shiomi H, Kao HL, Hahn JY, Her SH, Lee BK, Ahn TH, Chang KY, Chae JK, Smyth D, Mintz GS, Stone GW, Park DW; PREVENT Investigators. Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): a multicentre, open-label, randomised controlled trial. Lancet. 2024 May 4;403(10438):1753-1765. doi: 10.1016/S0140-6736(24)00413-6. Epub 2024 Apr 8.

Reference Type BACKGROUND
PMID: 38604213 (View on PubMed)

Kim BK, Hong SJ, Lee YJ, Hong SJ, Yun KH, Hong BK, Heo JH, Rha SW, Cho YH, Lee SJ, Ahn CM, Kim JS, Ko YG, Choi D, Jang Y, Hong MK; RACING investigators. Long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease (RACING): a randomised, open-label, non-inferiority trial. Lancet. 2022 Jul 30;400(10349):380-390. doi: 10.1016/S0140-6736(22)00916-3. Epub 2022 Jul 18.

Reference Type BACKGROUND
PMID: 35863366 (View on PubMed)

Raber L, Ueki Y, Otsuka T, Losdat S, Haner JD, Lonborg J, Fahrni G, Iglesias JF, van Geuns RJ, Ondracek AS, Radu Juul Jensen MD, Zanchin C, Stortecky S, Spirk D, Siontis GCM, Saleh L, Matter CM, Daemen J, Mach F, Heg D, Windecker S, Engstrom T, Lang IM, Koskinas KC; PACMAN-AMI collaborators. Effect of Alirocumab Added to High-Intensity Statin Therapy on Coronary Atherosclerosis in Patients With Acute Myocardial Infarction: The PACMAN-AMI Randomized Clinical Trial. JAMA. 2022 May 10;327(18):1771-1781. doi: 10.1001/jama.2022.5218.

Reference Type BACKGROUND
PMID: 35368058 (View on PubMed)

Other Identifiers

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STOP-PLAQUE

Identifier Type: -

Identifier Source: org_study_id

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