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临床试验/NCT05846893
NCT05846893进行中(未招募)不适用

Randomised Trial of Drug-Coated Balloon Versus Drug-Eluting Stent for Clinical Outcomes in Patients With Large Coronary Artery Disease

B. Braun Medical Industries Sdn. Bhd.39 个研究点 分布在 5 个国家目标入组 1,436 人开始时间: 2023年9月7日最近更新:
适应症
干预措施

试验速览

阶段
不适用
状态
进行中(未招募)
入组人数
1,436
试验地点
39
主要终点
Net Adverse Clinical Event (NACE)

研究概览

简要总结

Prospective, randomised, open-label, international multicenter trial to evaluate the safety and efficacy of drug-coated balloon (DCB) treatment compared to drug-eluting stenting (DES) in patients with large coronary artery disease.

详细描述

Although several reports suggested that DCB application was safe for larger coronary artery lesions and showed good long-term outcomes, there is limited randomised controlled trial (RCT) data on the safety and efficacy of DCB in large coronary artery disease.

Therefore, the study aims to demonstrate the non-inferiority of the drug-coated balloon (DCB) treatment against current-generation drug-eluting stenting (DES) in patients with de novo lesions in large coronary artery disease (reference vessel diameter ≥3.0 mm by visual estimation).

The hypothesis of the study is the clinical outcomes of patients treated with DCB are non-inferior to those treated with current-generation DES.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Patient-related:
  • Patient must be ≥ 18 years of age
  • Patient is able to verbally confirm understanding of the study aim, risks, benefits, and treatment alternatives of receiving DCB or DES and he/she or his/her legally authorized representative provides written informed consent prior to any study-related procedure
  • (i) Clinical evidence of angina, and/or (ii) an abnormal functional study demonstrating myocardial ischemia due to the target lesion(s), or (iii) acute coronary syndrome [unstable angina or non-ST-elevation myocardial infarction (NSTEMI) or uneventful STEMI (≥ 48 hours after primary PCI and no sign of thrombus in lesion(s) to treat)]
  • Patient with lesions suitable for PCI with a DCB (and/or DES) according to the Instructions for Use
  • Patient is able to comply with the study protocol and agrees to undergo the clinical follow-up of 30 days, 6 months, 12 months, 24 months, and 36 months
  • Lesion-related:
  • Presence of significant de novo large vessel coronary artery disease (reference vessel diameter ≥3.0 mm by visual estimation) with either ≥ 70% diameter stenosis or intermediate ≥ 50% to <70% diameter stenosis with abnormal functional test or symptom of ischemia
  • Successful lesion preparation. For randomisation, the lesion must satisfy the following criteria after optimal balloon angioplasty: no flow-limiting dissection (TIMI=3), and residual stenosis is ≤ 30%
  • Multivessel disease with two or more vessels showing diameter stenosis of 50% or more is not an exclusion as long as it fulfills all study's eligibility criteria.
  • In diffuse lesion, inclusion is possible if the proximal reference vessel diameter is 3.0 mm or more.

排除标准

  • Patient-related:
  • Intolerance or allergy to Paclitaxel and/or the delivery matrix (main ingredient: Iopromide)
  • Severe allergy to contrast media
  • Recent STEMI (ongoing or < 48 hours after primary PCI and/or has sign of thrombus in lesion(s) to treat)
  • NSTEMI hemodynamically unstable
  • Known left ventricular ejection fraction of <30%
  • Inability to take dual antiplatelet therapy or anticoagulation, or single antiplatelet therapy for at least six months
  • Non-cardiac co-morbid conditions that may result in protocol non-compliance and inability of patient to complete the study (per the site investigator's medical judgment)
  • Patient with concomitant medical illnesses that require cytostatic, radiation therapy or renal replacement therapy
  • Patient who is currently/ planning to participate in another clinical trial when such participation could confound the treatment or outcomes of this study, except for observational registry
  • Pregnancy or lactation
  • Patient under administrative or judicial custody
  • Lesion-related:
  • Small vessel disease, defined as <3.0 mm of reference vessel diameter by visual estimation
  • In-stent restenosis lesions for study lesions
  • Patient will be excluded if meet any of the following angiographic exclusion criteria after lesion preparation:
  • (i) Flow limiting dissection with TIMI flow < III (ii) Residual diameter stenosis >30%
  • * The case of persistent ischemic symptoms/signs is up to the operator's decision
  • Lesions which are untreatable with PCI or other interventional techniques and coronary artery spasm in the absence of a significant stenosis
  • Left main disease or aorta-ostial lesion requiring revascularization
  • Severely calcified or tortuous vessels precluding DCB or DES application
  • Prior Coronary Artery Bypass Graft (CABG)

研究组 & 干预措施

SeQuent® Please NEO drug-coated balloon catheter

Experimental

干预措施: SeQuent® Please NEO drug-coated balloon catheter (Device)

Current-generation drug-eluting stent

Experimental

干预措施: Current-generation drug-eluting stent (Device)

结局指标

主要结局

Net Adverse Clinical Event (NACE)

时间窗: At 1 year

Net adverse clinical event (NACE): a composite of all-cause death, non-fatal myocardial infarction, clinically driven target vessel revascularization, or major bleeding (BARC type 3 to 5)

次要结局

  • Target vessel myocardial infarction(At 12, 24, and 36 months)
  • Fluoroscopy time of the angioplasty procedure(During the index procedure)
  • Contrast volume of the angioplasty procedure(During the index procedure)
  • All-cause death(At 12, 24, and 36 months)
  • Clinically driven target vessel revascularization(At 12, 24, and 36 months)
  • Major bleeding (BARC type 3 to 5)(At 12, 24, and 36 months)
  • Periprocedural myocardial infarction(At 12, 24, and 36 months)
  • Target lesion revascularization(At 12, 24, and 36 months)
  • Rehospitalization related to study endpoints(At 30 days, 12 months, 24 months, and 36 months)
  • Stroke (ischemic and hemorrhagic)(At 12, 24, and 36 months)
  • Non-fatal myocardial infarction(At 12, 24, and 36 months)
  • Stent/lesion thrombosis in treated lesion defined according to the Academic Research Consortium-2 (ARC-2) criteria(At 12, 24, and 36 months)
  • Total angioplasty procedure time(During the index procedure)
  • Number of devices (DCB/ DES) used for PCI treatment(During the index procedure)
  • Cardiac death(At 12, 24, and 36 months)

研究者

申办方类型
Industry
责任方
Sponsor

研究点 (39)

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