Preventive Drug-coated Balloon Angioplasty in Vulnerable Atherosclerotic Plaque (RESTORE Trial)

Официальное название

A Multicenter, Prospective, Open-label, Controlled, Randomized Trial of Preventive Drug-coated Balloon Angioplasty in Vulnerable Atherosclerotic Plaque (RESTORE Trial)

Обзор

The objective of this multicenter, prospective, open-label, controlled, randomized trial is to demonstrate the superiority of drug-coated balloon (DCB) treatment on non-flow limited vulnerable plaque as compared to guideline-directed medical therapy (GDMT) in improving clinical cardiovascular outcomes in patients with acute coronary syndrome.

Вмешательства

• Устройство Drug-coated balloon
  Non-culprit lesion will be pretreated before DCB treatment. The bail-out stent treatment is permitted if pretreatment failed.
• Препарат Guideline-directed medical treatment
  All individuals will receive guideline-directed medical treatment.

Первичные конечные точки

• Target lesion failure (TLF) [Срок оценки: At 24 months]

Вторичные конечные точки (12)

• Target lesion failure (TLF) [Срок оценки: At 30 days]
• Target lesion failure (TLF) [Срок оценки: At 6 months]
• Target lesion failure (TLF) [Срок оценки: At 12 months]
• Major cardiac adverse event (MACE) [Срок оценки: At 30 days]
• Major cardiac adverse event (MACE) [Срок оценки: At 6 months]
• Major cardiac adverse event (MACE) [Срок оценки: At 12 months]
• Major cardiac adverse event (MACE) [Срок оценки: At 24 months]
• All-cause death [Срок оценки: At 30 days]
• All-cause death [Срок оценки: At 6 months]
• All-cause death [Срок оценки: At 12 months]
• All-cause death [Срок оценки: At 24 months]
• Cardiac death and target lesion MI [Срок оценки: At 30 days]

Критерии участия

Критерии включения

• Subjects must be between 18 and 80 years of age
• Subject must present with acute myocardial infarction or unstable angina planned for PCI
• Successful stent implantation (i.e., residual stenosis less than 20%) must be done in culprit lesions and any lesions with ischemia evidence (e.g., QFR equal or less than 0.8)
• Subject must have at least one native non-culprit lesion with visually estimated stenosis of 40-80% and QFR >0.8
• Target lesion must have a visually estimated diameter of 2.0-4.0 mm and length of ≤ 50 mm
• Target lesion must have any two of the intravascular imaging criteria of PB >65%, MLA <3.5 mm\^2 (OCT) or 4.0mm\^2 (IVUS), FCT <75 μm, or maximal lipid arc >180°
• Subject must provide written informed consent before any study-related procedure

Критерии исключения

• Subject has known hypersensitivity or contraindication to any of the study drugs (including all asprin, P2Y12 inhibitors, one or more components of the study devices, including paclitaxel, etc) that cannot be adequately pre-medicated
• Subject is receiving immunosuppressant therapy or has known immunosuppressive or severe autoimmune disease that requires chronic immunosuppressive therapy (e.g., human immunodeficiency virus, systemic lupus erythematosus, etc.)
• Hypotension, shock, or need for mechanical support or intravenous vasopressors;
• Creatinine clearance ≤30 ml/min/1.73 m\^2 (as calculated by MDRD formula for estimated GFR)
• Left ventricular ejection fraction<30% by the most recent imaging test within 30 days before procedure (echo, MRI, contrast left ventriculography or others)
• Life expectancy <2 years for any
• Subject is currently participating in another investigational drug or device clinical study that has not yet completed its primary endpoint
• 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.
• The target lesion is located within 10 mm of the proximal or distal of stent
• The target lesion cannot be in the left main coronary artery
• The target lesion is located in a bifurcation lesion (i.e., the diameter of the branch vessels is >2 mm with >50% of stenosis)
• The target lesion is located in severe calcification or tortuosity of vessels
• The target lesion involved in the ostium of LAD, LCX or RCA (within 3 mm of the ostium)
• The target lesion is located within the bypass graft artery

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Китай · 18 центров

• Affiliated Beijing Luhe Hospital of Capital Medical University — Beijin
• Affiliated Hospital of Zunyi Medical University — Zunyi
• Daqing Oilfield General Hospital — Daqing
• The Second Affiliated Hospital of Harbin Medical University — Харбин
• The First Affiliated Hospital of Jiamusi University — Jiamusi
• Mudanjiang Cardiovascular Hospital — Mudanjiang
• Fuwai Central China Cardiovascular Hospital — Чжэнчжоу
• The First Affiliated Hospital of Zhengzhou University — Чжэнчжоу
• … и ещё 10 центров

Идентификаторы

NCT: NCT06365502 · KY2023-156

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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