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Clinical Impact of Intravascular Ultrasound-Based Artificial Intelligence Technologies (INNOVATE-PCI)

Recruiting
Conditions
Coronary Artery Disease
Registration Number
NCT05807841
Lead Sponsor
Asan Medical Center
Brief Summary

This study is a prospective, multicenter study in the real practice to validate the diagnostic performances and clinical impact of coronary angiography \& intravascular ultrasound (IVUS)-based models developed by machine learning (ML).

Detailed Description

The aim of the study is to evaluate the performances and prognostic impact of coronary angiography \& IVUS-based algorithms for decision making and stent optimization in a multicenter, prospective cohort. Between January 2020 and June 2025, a total of 3,000 patients who performed coronary angiography (± FFR) and have at least one coronary stenosis requiring PCI (as culprit) will be enrolled from 15 centers in South Korea. In addition, the deferred lesions with visual estimated diameter stenosis of \>30% will be evaluated as non-culprits. Brief study design is as depicted in the following figure.

Supervised ML algorithms include: 1) angiography- and IVUS-based algorithms for predicting FFR, 2) IVUS-based algorithm for plaque characterization, 3) IVUS-based algorithm for predicting stent expansion, and 4) post-stenting IVUS-based algorithm for predicting stent failure. In the prospective cohort, the performance of each model will be assessed. This registry trial composed of the treated (culprit) and the deferred (nonculprit) coronary lesions has two primary objectives as follow; 1) Primary objectives in treated (culprit) lesions is to see the impact of the integrated ML model on the development of culprit-related 2-year target vessel failure (TVF). 2) Primary objectives in deferred (nonculprit) lesions is to see the impact of the integrated ML model on the development of nonculprit-related 2-year TVF.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
3000
Inclusion Criteria
  • Age 19 years or older
  • Symptomatic angina patients with objective myocardial ischemia
  • Patients with at least one major epicardial coronary artery that requires stent implantation
  • Subject who signs with informed consent form

Patient exclusion Criteria:

  • ST-segment elevation MI at admission
  • Patients who underwent coronary artery bypass surgery or heart transplantation
  • Left ventricular ejection fraction <30%
  • Cardiogenic shock
  • Patients whose life expectancy <2 years
  • Woman who are breastfeeding, pregnant or planning to become pregnant during study
  • Patients in whom anti-platelets or heparin is contraindicated

Lesion exclusion Criteria:

  • Left main culprit lesion (angiographic diameter stenosis >50%)
  • Thrombus-containing lesion
  • In-stent restenosis
  • Side branch lesion
  • Chronic total occlusion
  • Small vessel with reference diameter <2.5mm
  • Coronary spasm despite administration of nitrate
  • Inability for imaging catheter to pass through tight stenosis, calcification, angulations
  • Poor image quality
  • Angiographically visible collateral vessels
Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
nonculprit-related TVF2 years after stent implantation

composite of cardiac death, MI, and clinically-driven TVR at 2 years

culprit-related TVF2 years after stent implantation

composite of cardiac death, myocardial infarction (MI), stent thrombosis, and clinically-driven target vessel revascularization (TVR) at 2 years after SynergyTM implantation

Secondary Outcome Measures
NameTimeMethod
repeat revascularization2 years after stent implantation

repeat revascularization

each component of primary measures2 years after stent implantation

each of cardiac death, non-fetal MI, ST and target vessel revascularization

all cause death2 years after stent implantation

all cause death

stroke2 years after stent implantation

stroke

bleeding2 years after stent implantation

bleeding

Trial Locations

Locations (16)

Soon Chun Hyang University Hospital Bucheon

🇰🇷

Bucheon, Korea, Republic of

Gosin University Gospel Hospital

🇰🇷

Busan, Korea, Republic of

Inje University Pusan Paik Hospital

🇰🇷

Busan, Korea, Republic of

Gyeongsang National University Changwon Hospital

🇰🇷

Changwon, Korea, Republic of

Kangwon National University Hospital

🇰🇷

Chuncheon, Korea, Republic of

Keimyung University Dongsan Medical Center

🇰🇷

Daegu, Korea, Republic of

The Catholic university of korea, daejeon st. mary's hospital

🇰🇷

Daejeon, Korea, Republic of

Gangneung Asan Hospital

🇰🇷

Gangneung, Korea, Republic of

Jesushospital

🇰🇷

Jeonju, Korea, Republic of

Chungnam National University Sejong Hospital

🇰🇷

Sejong, Korea, Republic of

Seung-Whan Lee

🇰🇷

Seoul, Korea, Republic of

Kangbuk Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

The Catholic university of korea, Eunpyeong st. mary's hospital

🇰🇷

Seoul, Korea, Republic of

Veterans Hospital Service Medical Center

🇰🇷

Seoul, Korea, Republic of

The Catholic University of Korea ST.VINCENT'S Hospital

🇰🇷

Suwon, Korea, Republic of

Ulsan University Hospital

🇰🇷

Ulsan, Korea, Republic of

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