Chronic Coronary OcclusionEXCELNCT01205776
EXCEL Clinical Trial
A study testing Percutaneous Coronary Intervention and CABG in people with Chronic Coronary Occlusion and Unprotected Left Main Coronary Artery Disease, run by Abbott Medical Devices at 1 site in United States.
Trial summary
To establish the safety and efficacy of the commercially approved XIENCE Family Stent System (inclusive of XIENCE PRIME, XIENCE V, XIENCE Xpedition and XIENCE PRO [for use outside the United States [OUS] only]) in subjects with unprotected left main coronary artery disease by comparing to coronary artery bypass graft… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Chronic Coronary Occlusion, Unprotected Left Main Coronary Artery Disease, Stent Thrombosis
- What is being tested?
- Percutaneous Coronary Intervention and CABG
- Type of treatment
- Medical device, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,905 participants
- Where
- 1 siteUnited States
- Study dates
- 29 Sep 2010to 28 Jun 2019
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Unprotected left main coronary artery (ULMCA) disease with angiographic diameter stenosis (DS) ≥70% requiring revascularization, or
- ULMCA disease with agniographic DS >=50% but < 70% requiring revascularization, with one or more of the following present:
- Non-invasive evidence of ischemia referable to a hemodynamically significant left main lesion (large area of ischemia in both the LAD and LCX territories, or in either the LAD or LCX territory in the absence of other obstructive coronary artery disease to explain the LAD or LCX defect), or stress-induced hypotension or stress-induced fall in LVEF, or stress-induced transient ischemic dilatation of the left ventricle or stress-induced thallium/technetiumlung uptake, and/or
- IVUS minimum lumen area (MLA) <= 6.0mm2, and/or
- Fractional Flow Reserve (FFR) <=0.80
- Left Main Equivalent Disease
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- Clinical and anatomic eligibility for both PCI and CABG
- Silent ischemia, stable angina, unstable angina or recent MI
- Ability to sign informed consent and comply with all study procedures including follow-up for at least three years
Who cannot join
- Clinical exclusion criteria:
- Prior PCI of the left main trunk at any time prior to randomization
- Prior PCI of any other coronary artery lesions within one year prior to randomization
- Prior CABG at any time prior to randomization
- Need for any concomitant cardiac surgery other than CABG, or intent that if the subject randomizes to surgery, any cardiac surgical procedure other than isolated CABG will be performed
- CK-MB greater than the local laboratory upper limit of normal or recent MI with CK-MB still elevated
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- Subjects unable to tolerate, obtain or comply with dual antiplatelet therapy for at least one year
- Subjects requiring or who may require additional surgery within one year
- The presence of any clinical condition(s) which leads the participating interventional cardiologist to believe that clinical equipoise is not present
- The presence of any clinical condition(s) which leads the participating cardiac surgeon to believe that clinical equipoise is not present
- Pregnancy or intention to become pregnant
- Non cardiac co-morbidities with life expectancy less than 3 years
- Other investigational drug or device studies that have not reached their primary endpoint
- Vulnerable population who in the judgment of the investigator is unable to give Informed Consent for reasons of incapacity, immaturity, adverse personal circumstances or lack of autonomy. This may include: Individuals with mental disability, persons in nursing homes, children, impoverished persons, persons in emergency situations, homeless persons, nomads, refugees, and those permanently incapable of giving informed consent. Vulnerable populations also may include members of a group with a hierarchical structure such as university students, subordinate hospital and laboratory personnel, employees of the Sponsor, members of the armed forces, and persons kept in detention
- Angiographic exclusion criteria:
- Left main diameter stenosis <50%
- SYNTAX score ≥33
- Left main reference vessel diameter <2.25 mm or >4.25 mm
- The presence of specific coronary lesion characteristics or other cardiac condition(s) which leads the participating interventional cardiologist to believe that clinical equipoise is not present
- The presence of specific coronary lesion characteristics or other cardiac condition(s) which leads the participating cardiac surgeon to believe that clinical equipoise is not present
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization.
To establish the safety and efficacy of the commercially approved XIENCE Family Stent System (inclusive of XIENCE PRIME, XIENCE V, XIENCE Xpedition and XIENCE PRO [for use outside the United States [OUS] only]) in subjects with unprotected left main coronary artery disease by comparing to coronary artery bypass graft surgery.
- Conditions
- Chronic Coronary Occlusion, Unprotected Left Main Coronary Artery Disease, Stent Thrombosis, Vascular Disease, Myocardial Ischemia, Coronary Artery Stenosis
- Being tested
- Percutaneous Coronary Intervention, CABG
- Keywords
- Drug eluting stents, Stents, Unprotected Left Main Coronary Artery Disease, Coronary artery bypass graft surgery
- Medical subject headings
- Vascular Diseases, Myocardial Ischemia, Coronary Stenosis, Coronary Disease, Coronary Artery Disease, Coronary Restenosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Percutaneous Coronary InterventionDevice
Those patients receiving the XIENCE PRIME™ EECSS or XIENCE V® EECSS or XIENCE Xpedition™ EECSS or XIENCE PRO EECSS
CABGProcedure or surgery
Those patients receiving CABG
| Study group | Role | What they receive |
|---|---|---|
| Percutaneous Coronary Intervention | Active comparator | Those patients receiving the XIENCE PRIME™ EECSS or XIENCE V® EECSS or XIENCE Xpedition™ EECSS or XIENCE PRO EECSS Receives: Device: Percutaneous Coronary Intervention |
| Coronary Artery Bypass Graft | Active comparator | Those patients receiving CABG Receives: Procedure: CABG |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 5 years
Secondary outcomes (91)
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: In-hospital (≤ 7 days of index-procedure)
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 30 days
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 0 to 6 months
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 0 to 1 year
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 0 to 2 years
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 0 to 3 years
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 0 to 4 years
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 0 to 5 years
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: In-hospital (≤ 7 days of index-procedure)
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 0 to 30 days
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 0 to 6 months
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 0 to 1 year
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death.
Myocardial Infarction (MI):
- Q wave MI: Development of new, pathological Q wave on the ECG.
- Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Measured: 0 to 2 years
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
Death:
- Cardiac death is defined as any death in which a cardiac cause cannot be excluded. (This includes but is not limited to acute myocardial infarction, cardiac perforation/pericardial tamponade, arrhythmia or conduction abnormality,cerebrovascular accident within 30 days of the procedure or cerebrovascular accident suspected of being related to the procedure, death due to complication of the procedure, including bleeding, vascular repair, transfusion reaction, or bypass surgery).
- Non-cardiac death is defined as a death not due to cardiac causes (as defined above).
Myocardial Infarction (MI) -Q wave MI: Development of new, pathological Q wave on the ECG.
-Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Unplanned revascularization for ischemia: Any repeat revascularization of either a target vessel or non-target vessel with any of the above criteria for ischemia met.
Measured: 0 to 3 years
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
Death:
- Cardiac death is defined as any death in which a cardiac cause cannot be excluded. (This includes but is not limited to acute myocardial infarction, cardiac perforation/pericardial tamponade, arrhythmia or conduction abnormality,cerebrovascular accident within 30 days of the procedure or cerebrovascular accident suspected of being related to the procedure, death due to complication of the procedure, including bleeding, vascular repair, transfusion reaction, or bypass surgery).
- Non-cardiac death is defined as a death not due to cardiac causes (as defined above).
Myocardial Infarction (MI) -Q wave MI: Development of new, pathological Q wave on the ECG.
-Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Unplanned revascularization for ischemia: Any repeat revascularization of either a target vessel or non-target vessel with any of the above criteria for ischemia met.
Measured: 0 to 4 years
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
Death:
- Cardiac death is defined as any death in which a cardiac cause cannot be excluded. (This includes but is not limited to acute myocardial infarction, cardiac perforation/pericardial tamponade, arrhythmia or conduction abnormality,cerebrovascular accident within 30 days of the procedure or cerebrovascular accident suspected of being related to the procedure, death due to complication of the procedure, including bleeding, vascular repair, transfusion reaction, or bypass surgery).
- Non-cardiac death is defined as a death not due to cardiac causes (as defined above).
Myocardial Infarction (MI) -Q wave MI: Development of new, pathological Q wave on the ECG.
-Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Unplanned revascularization for ischemia: Any repeat revascularization of either a target vessel or non-target vessel with any of the above criteria for ischemia met.
Measured: 0 to 5 years
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
All deaths are considered cardiac unless an unequivocal non-cardiac cause can be established. Specifically, any unexpected death even in subjects with coexisting potentially fatal non-cardiac disease (e.g. cancer, infection) should be classified as cardiac.
- Cardiac death: Any death due to proximate cardiac cause (e.g. MI, low-output failure, fatal arrhythmia), unwitnessed death and death of unknown cause, all procedure related deaths including those related to concomitant treatment.
- Vascular death: Death due to non-coronary vascular causes such as cerebrovascular disease, pulmonary embolism, ruptured aortic aneurysm, dissecting aneurysm, or other vascular cause.
- Non-cardiovascular death: Any death not covered by the above definitions such as death caused by infection, malignancy, sepsis, pulmonary causes, accident, suicide or trauma.
Measured: In-hospital (≤ 7 days of index-procedure)
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
All deaths are considered cardiac unless an unequivocal non-cardiac cause can be established. Specifically, any unexpected death even in subjects with coexisting potentially fatal non-cardiac disease (e.g. cancer, infection) should be classified as cardiac.
- Cardiac death: Any death due to proximate cardiac cause (e.g. MI, low-output failure, fatal arrhythmia), unwitnessed death and death of unknown cause, all procedure related deaths including those related to concomitant treatment.
- Vascular death: Death due to non-coronary vascular causes such as cerebrovascular disease, pulmonary embolism, ruptured aortic aneurysm, dissecting aneurysm, or other vascular cause.
- Non-cardiovascular death: Any death not covered by the above definitions such as death caused by infection, malignancy, sepsis, pulmonary causes, accident, suicide or trauma.
Measured: 0 to 30 days
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
All deaths are considered cardiac unless an unequivocal non-cardiac cause can be established. Specifically, any unexpected death even in subjects with coexisting potentially fatal non-cardiac disease (e.g. cancer, infection) should be classified as cardiac.
- Cardiac death: Any death due to proximate cardiac cause (e.g. MI, low-output failure, fatal arrhythmia), unwitnessed death and death of unknown cause, all procedure related deaths including those related to concomitant treatment.
- Vascular death: Death due to non-coronary vascular causes such as cerebrovascular disease, pulmonary embolism, ruptured aortic aneurysm, dissecting aneurysm, or other vascular cause.
- Non-cardiovascular death: Any death not covered by the above definitions such as death caused by infection, malignancy, sepsis, pulmonary causes, accident, suicide or trauma.
Measured: 0 to 6 months
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
All deaths are considered cardiac unless an unequivocal non-cardiac cause can be established. Specifically, any unexpected death even in subjects with coexisting potentially fatal non-cardiac disease (e.g. cancer, infection) should be classified as cardiac.
- Cardiac death: Any death due to proximate cardiac cause (e.g. MI, low-output failure, fatal arrhythmia), unwitnessed death and death of unknown cause, all procedure related deaths including those related to concomitant treatment.
- Vascular death: Death due to non-coronary vascular causes such as cerebrovascular disease, pulmonary embolism, ruptured aortic aneurysm, dissecting aneurysm, or other vascular cause.
- Non-cardiovascular death: Any death not covered by the above definitions such as death caused by infection, malignancy, sepsis, pulmonary causes, accident, suicide or trauma.
Measured: 0 to 1 year
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
All deaths are considered cardiac unless an unequivocal non-cardiac cause can be established. Specifically, any unexpected death even in subjects with coexisting potentially fatal non-cardiac disease (e.g. cancer, infection) should be classified as cardiac.
- Cardiac death: Any death due to proximate cardiac cause (e.g. MI, low-output failure, fatal arrhythmia), unwitnessed death and death of unknown cause, all procedure related deaths including those related to concomitant treatment.
- Vascular death: Death due to non-coronary vascular causes such as cerebrovascular disease, pulmonary embolism, ruptured aortic aneurysm, dissecting aneurysm, or other vascular cause.
- Non-cardiovascular death: Any death not covered by the above definitions such as death caused by infection, malignancy, sepsis, pulmonary causes, accident, suicide or trauma.
Measured: 0 to 2 years
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
All deaths are considered cardiac unless an unequivocal non-cardiac cause can be established. Specifically, any unexpected death even in subjects with coexisting potentially fatal non-cardiac disease (e.g. cancer, infection) should be classified as cardiac.
- Cardiac death: Any death due to proximate cardiac cause (e.g. MI, low-output failure, fatal arrhythmia), unwitnessed death and death of unknown cause, all procedure related deaths including those related to concomitant treatment.
- Vascular death: Death due to non-coronary vascular causes such as cerebrovascular disease, pulmonary embolism, ruptured aortic aneurysm, dissecting aneurysm, or other vascular cause.
- Non-cardiovascular death: Any death not covered by the above definitions such as death caused by infection, malignancy, sepsis, pulmonary causes, accident, suicide or trauma.
Measured: 0 to 3 years
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
All deaths are considered cardiac unless an unequivocal non-cardiac cause can be established. Specifically, any unexpected death even in subjects with coexisting potentially fatal non-cardiac disease (e.g. cancer, infection) should be classified as cardiac.
- Cardiac death: Any death due to proximate cardiac cause (e.g. MI, low-output failure, fatal arrhythmia), unwitnessed death and death of unknown cause, all procedure related deaths including those related to concomitant treatment.
- Vascular death: Death due to non-coronary vascular causes such as cerebrovascular disease, pulmonary embolism, ruptured aortic aneurysm, dissecting aneurysm, or other vascular cause.
- Non-cardiovascular death: Any death not covered by the above definitions such as death caused by infection, malignancy, sepsis, pulmonary causes, accident, suicide or trauma.
Measured: 0 to 4 years
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
All deaths are considered cardiac unless an unequivocal non-cardiac cause can be established. Specifically, any unexpected death even in subjects with coexisting potentially fatal non-cardiac disease (e.g. cancer, infection) should be classified as cardiac.
- Cardiac death: Any death due to proximate cardiac cause (e.g. MI, low-output failure, fatal arrhythmia), unwitnessed death and death of unknown cause, all procedure related deaths including those related to concomitant treatment.
- Vascular death: Death due to non-coronary vascular causes such as cerebrovascular disease, pulmonary embolism, ruptured aortic aneurysm, dissecting aneurysm, or other vascular cause.
- Non-cardiovascular death: Any death not covered by the above definitions such as death caused by infection, malignancy, sepsis, pulmonary causes, accident, suicide or trauma.
Measured: 0 to 5 years
Number of Participants With Protocol Defined MI
Myocardial Infarction (MI) - Q wave MI: Development of new, pathological Q wave on the ECG.
-Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Measured: In-hospital (≤ 7 days of post index procedure)
Number of Participants With Protocol Defined MI
Myocardial Infarction (MI) - Q wave MI: Development of new, pathological Q wave on the ECG.
-Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Measured: 0 to 30 days
Number of Participants With Protocol Defined MI
Myocardial Infarction (MI) - Q wave MI: Development of new, pathological Q wave on the ECG.
-Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Measured: 0 to 6 months
Number of Participants With Protocol Defined MI
Myocardial Infarction (MI) - Q wave MI: Development of new, pathological Q wave on the ECG.
-Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Measured: 0 to 1 year
Number of Participants With Protocol Defined MI
Myocardial Infarction (MI) - Q wave MI: Development of new, pathological Q wave on the ECG.
-Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Measured: 0 to 2 years
Number of Participants With Protocol Defined MI
Myocardial Infarction (MI) - Q wave MI: Development of new, pathological Q wave on the ECG.
-Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Measured: 0 to 3 years
Number of Participants With Protocol Defined MI
Myocardial Infarction (MI) - Q wave MI: Development of new, pathological Q wave on the ECG.
-Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Measured: 0 to 4 years
Number of Participants With Protocol Defined MI
Myocardial Infarction (MI) - Q wave MI: Development of new, pathological Q wave on the ECG.
-Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves.
Measured: 0 to 5 years
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Ischemic (Non-hemorrhagic): A stroke caused by an arterial obstruction due to either a thrombotic (e.g., large vessel disease/atherosclerotic or small vessel disease/lacunar) or embolic etiology.
Hemorrhagic: A stroke due to a hemorrhage in the brain as documented by neuroimaging or autopsy. This category will include strokes due to primary intracerebral hemorrhage (intraparenchymal or intraventricular), ischemic strokes with hemorrhagic transformation (i.e., no evidence of hemorrhage on an initial imaging study but appearance on a subsequent scan), subdural hematoma,* and primary subarachnoid hemorrhage.
- All subdural hematomas that develop during the clinical trial should be recorded and classified as either traumatic versus nontraumatic.
Measured: In-hospital (≤ 7 days of index-procedure)
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Ischemic (Non-hemorrhagic): A stroke caused by an arterial obstruction due to either a thrombotic (e.g., large vessel disease/atherosclerotic or small vessel disease/lacunar) or embolic etiology.
Hemorrhagic: A stroke due to a hemorrhage in the brain as documented by neuroimaging or autopsy. This category will include strokes due to primary intracerebral hemorrhage (intraparenchymal or intraventricular), ischemic strokes with hemorrhagic transformation (i.e., no evidence of hemorrhage on an initial imaging study but appearance on a subsequent scan), subdural hematoma,* and primary subarachnoid hemorrhage.
- All subdural hematomas that develop during the clinical trial should be recorded and classified as either traumatic versus nontraumatic.
Measured: 0 to 30 days
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Ischemic (Non-hemorrhagic): A stroke caused by an arterial obstruction due to either a thrombotic (e.g., large vessel disease/atherosclerotic or small vessel disease/lacunar) or embolic etiology.
Hemorrhagic: A stroke due to a hemorrhage in the brain as documented by neuroimaging or autopsy. This category will include strokes due to primary intracerebral hemorrhage (intraparenchymal or intraventricular), ischemic strokes with hemorrhagic transformation (i.e., no evidence of hemorrhage on an initial imaging study but appearance on a subsequent scan), subdural hematoma,* and primary subarachnoid hemorrhage.
- All subdural hematomas that develop during the clinical trial should be recorded and classified as either traumatic versus nontraumatic.
Measured: 0 to 6 months
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Ischemic (Non-hemorrhagic): A stroke caused by an arterial obstruction due to either a thrombotic (e.g., large vessel disease/atherosclerotic or small vessel disease/lacunar) or embolic etiology.
Hemorrhagic: A stroke due to a hemorrhage in the brain as documented by neuroimaging or autopsy. This category will include strokes due to primary intracerebral hemorrhage (intraparenchymal or intraventricular), ischemic strokes with hemorrhagic transformation (i.e., no evidence of hemorrhage on an initial imaging study but appearance on a subsequent scan), subdural hematoma,* and primary subarachnoid hemorrhage.
- All subdural hematomas that develop during the clinical trial should be recorded and classified as either traumatic versus nontraumatic.
Measured: 0 to 1 year
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Ischemic (Non-hemorrhagic): A stroke caused by an arterial obstruction due to either a thrombotic (e.g., large vessel disease/atherosclerotic or small vessel disease/lacunar) or embolic etiology.
Hemorrhagic: A stroke due to a hemorrhage in the brain as documented by neuroimaging or autopsy. This category will include strokes due to primary intracerebral hemorrhage (intraparenchymal or intraventricular), ischemic strokes with hemorrhagic transformation (i.e., no evidence of hemorrhage on an initial imaging study but appearance on a subsequent scan), subdural hematoma,* and primary subarachnoid hemorrhage.
- All subdural hematomas that develop during the clinical trial should be recorded and classified as either traumatic versus nontraumatic.
Measured: 0 to 2 years
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Ischemic (Non-hemorrhagic): A stroke caused by an arterial obstruction due to either a thrombotic (e.g., large vessel disease/atherosclerotic or small vessel disease/lacunar) or embolic etiology.
Hemorrhagic: A stroke due to a hemorrhage in the brain as documented by neuroimaging or autopsy. This category will include strokes due to primary intracerebral hemorrhage (intraparenchymal or intraventricular), ischemic strokes with hemorrhagic transformation (i.e., no evidence of hemorrhage on an initial imaging study but appearance on a subsequent scan), subdural hematoma,* and primary subarachnoid hemorrhage.
- All subdural hematomas that develop during the clinical trial should be recorded and classified as either traumatic versus nontraumatic.
Measured: 0 to 3 years
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Ischemic (Non-hemorrhagic): A stroke caused by an arterial obstruction due to either a thrombotic (e.g., large vessel disease/atherosclerotic or small vessel disease/lacunar) or embolic etiology.
Hemorrhagic: A stroke due to a hemorrhage in the brain as documented by neuroimaging or autopsy. This category will include strokes due to primary intracerebral hemorrhage (intraparenchymal or intraventricular), ischemic strokes with hemorrhagic transformation (i.e., no evidence of hemorrhage on an initial imaging study but appearance on a subsequent scan), subdural hematoma,* and primary subarachnoid hemorrhage.
- All subdural hematomas that develop during the clinical trial should be recorded and classified as either traumatic versus nontraumatic.
Measured: 0 to 4 years
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
Ischemic (Non-hemorrhagic): A stroke caused by an arterial obstruction due to either a thrombotic (e.g., large vessel disease/atherosclerotic or small vessel disease/lacunar) or embolic etiology.
Hemorrhagic: A stroke due to a hemorrhage in the brain as documented by neuroimaging or autopsy. This category will include strokes due to primary intracerebral hemorrhage (intraparenchymal or intraventricular), ischemic strokes with hemorrhagic transformation (i.e., no evidence of hemorrhage on an initial imaging study but appearance on a subsequent scan), subdural hematoma,* and primary subarachnoid hemorrhage.
- All subdural hematomas that develop during the clinical trial should be recorded and classified as either traumatic versus nontraumatic.
Measured: 0 to 5 years
Number of Participants With Disability Following Stroke Event
In case of an event of stroke disability at 90-days±2 weeks will be an overall measurement of severity of stroke as assessed by modified Rankin Scale (mRS) scale.
Stroke disability will be classified using an adaptation of the modified Rankin Scale as follows, the assessment of which will be based on the Modified Rankin Disability Questionnaire.
Scale 0; No stroke symptoms at all. (May have other complaints) Scale 1; No significant disability; symptoms present but no physical or other limitations.
Scale 2; Slight disability; limitations in participation in usual social roles, but independent for activities of daily living (ADL) Scale 3; Some need for assistance but able to walk without assistance Scale 4; Moderately severe disability; need for assistance with some basic ADL, but not requiring constant care Scale 5; Severe disability; requiring constant nursing care and attention.
Measured: 90 days ± 2 weeks
Number of Participants With Ischemia Driven Revascularizations (TLR,TVR and Non-TVR)
A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion; or
- Ischemic ECG changes at rest in a distribution consistent with the target vessel; or
- Typical ischemic symptoms referable to the target lesion; or
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%; or
- Fractional Flow Reserve (FFR) of the target lesion ≤ 0.80
Measured: In-hospital (≤ 7 days of index-procedure)
Number of Participants With Ischemia Driven Revascularizations
A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion; or
- Ischemic ECG changes at rest in a distribution consistent with the target vessel; or
- Typical ischemic symptoms referable to the target lesion; or
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%; or
- Fractional Flow Reserve (FFR) of the target lesion ≤ 0.80
Measured: 0 to 30 days
Number of Participants With Ischemia Driven Revascularizations
A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion; or
- Ischemic ECG changes at rest in a distribution consistent with the target vessel; or
- Typical ischemic symptoms referable to the target lesion; or
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%; or
- Fractional Flow Reserve (FFR) of the target lesion ≤ 0.80
Measured: 0 to 6 months
Number of Participants With Ischemia Driven Revascularizations
A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion; or
- Ischemic ECG changes at rest in a distribution consistent with the target vessel; or
- Typical ischemic symptoms referable to the target lesion; or
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%; or
- Fractional Flow Reserve (FFR) of the target lesion ≤ 0.80
Measured: 0 to 1 year
Number of Participants With Ischemia Driven Revascularizations
A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion; or
- Ischemic ECG changes at rest in a distribution consistent with the target vessel; or
- Typical ischemic symptoms referable to the target lesion; or
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%; or
- Fractional Flow Reserve (FFR) of the target lesion ≤ 0.80
Measured: 0 to 2 years
Number of Participants With Ischemia Driven Revascularizations
A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion; or
- Ischemic ECG changes at rest in a distribution consistent with the target vessel; or
- Typical ischemic symptoms referable to the target lesion; or
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%; or
- Fractional Flow Reserve (FFR) of the target lesion ≤ 0.80
Measured: 0 to 3 years
Number of Participants With Ischemia Driven Revascularizations
A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion; or
- Ischemic ECG changes at rest in a distribution consistent with the target vessel; or
- Typical ischemic symptoms referable to the target lesion; or
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%; or
- Fractional Flow Reserve (FFR) of the target lesion ≤ 0.80
Measured: 0 to 4 years
Number of Participants With Ischemia Driven Revascularizations
A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion; or
- Ischemic ECG changes at rest in a distribution consistent with the target vessel; or
- Typical ischemic symptoms referable to the target lesion; or
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%; or
- Fractional Flow Reserve (FFR) of the target lesion ≤ 0.80
Measured: 0 to 5 years
Number of Participants With All Revascularizations (Ischemia-driven or Non Ischemia-driven)
- A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion;
- Ischemic ECG changes at rest in a distribution consistent with the target vessel;
- Typical ischemic symptoms referable to the target lesion;
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%;
- FFR of the target lesion ≤ 0.80
- A non target vessel revascularization will be considered ischemia-driven if any lesion the non target vessel has a diameter stenosis ≥ 50% by QCA with any of the above criteria for ischemia met.
Measured: In-hospital (≤ 7 days of index-procedure)
Number of Participants With All Revascularizations (Ischemia Driven and Not Ischemia Driven)
- A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion;
- Ischemic ECG changes at rest in a distribution consistent with the target vessel;
- Typical ischemic symptoms referable to the target lesion;
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%;
- FFR of the target lesion ≤ 0.80
- A non target vessel revascularization will be considered ischemia-driven if any lesion the non target vessel has a diameter stenosis ≥ 50% by QCA with any of the above criteria for ischemia met.
Measured: 0 to 30 days
Number of Participants With All Revascularizations (Ischemia Driven and Not Ischemia Driven)
- A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion;
- Ischemic ECG changes at rest in a distribution consistent with the target vessel;
- Typical ischemic symptoms referable to the target lesion;
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%;
- FFR of the target lesion ≤ 0.80
- A non target vessel revascularization will be considered ischemia-driven if any lesion the non target vessel has a diameter stenosis ≥ 50% by QCA with any of the above criteria for ischemia met.
Measured: 0 to 6 months
Number of Participants With All Revascularizations (Ischemia Driven and Not Ischemia Driven)
- A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion;
- Ischemic ECG changes at rest in a distribution consistent with the target vessel;
- Typical ischemic symptoms referable to the target lesion;
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%;
- FFR of the target lesion ≤ 0.80
- A non target vessel revascularization will be considered ischemia-driven if any lesion the non target vessel has a diameter stenosis ≥ 50% by QCA with any of the above criteria for ischemia met.
Measured: 0 to 1 year
Number of Participants With All Revascularizations (Ischemia Driven and Not Ischemia Driven)
- A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion;
- Ischemic ECG changes at rest in a distribution consistent with the target vessel;
- Typical ischemic symptoms referable to the target lesion;
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%;
- FFR of the target lesion ≤ 0.80
- A non target vessel revascularization will be considered ischemia-driven if any lesion the non target vessel has a diameter stenosis ≥ 50% by QCA with any of the above criteria for ischemia met.
Measured: 0 to 2 years
Number of Participants With All Revascularizations (Ischemia Driven and Not Ischemia Driven)
- A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion;
- Ischemic ECG changes at rest in a distribution consistent with the target vessel;
- Typical ischemic symptoms referable to the target lesion;
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%;
- FFR of the target lesion ≤ 0.80
- A non target vessel revascularization will be considered ischemia-driven if any lesion the non target vessel has a diameter stenosis ≥ 50% by QCA with any of the above criteria for ischemia met.
Measured: 0 to 3 years
Number of Participants With All Revascularizations (Ischemia Driven and Not Ischemia Driven)
- A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion;
- Ischemic ECG changes at rest in a distribution consistent with the target vessel;
- Typical ischemic symptoms referable to the target lesion;
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%;
- FFR of the target lesion ≤ 0.80
- A non target vessel revascularization will be considered ischemia-driven if any lesion the non target vessel has a diameter stenosis ≥ 50% by QCA with any of the above criteria for ischemia met.
Measured: 0 to 4 years
Number of Participants With All Revascularizations (Ischemia Driven and Not Ischemia Driven)
- A target lesion (vessel) revascularization will be considered ischemia-driven if the target lesion diameter stenosis is ≥ 50% by QCA (analysis segment measurement, involving the lesion itself and 5 mm of proximal and/or distal margin) and any of the following criteria for ischemia are met:
- A positive functional study corresponding to the area served by the target lesion;
- Ischemic ECG changes at rest in a distribution consistent with the target vessel;
- Typical ischemic symptoms referable to the target lesion;
- IVUS of the target lesion with a minimal lumen area (MLA) of ≤ 4 mm^2 for non left main lesions or ≤ 6 mm^2 for left main lesions. If the lesions are de novo (i.e. not restenotic), the
- plaque burden must also be ≥ 60%;
- FFR of the target lesion ≤ 0.80
- A non target vessel revascularization will be considered ischemia-driven if any lesion the non target vessel has a diameter stenosis ≥ 50% by QCA with any of the above criteria for ischemia met.
Measured: 0 to 5 years
Percentage of Participants With Major Adverse Events (MAE)
Composite of death, myocardial infarction, stroke, transfusion of ≥ 2 units of blood, major arrhythmia, unplanned coronary revascularization for ischemia, any unplanned surgery or radiologic procedure, renal failure, sternal wound dehiscence, infection requiring antibiotics for treatment, intubation for > 48 hours, or post-pericardiotomy syndrome.
Measured: In-hospital
Number of Participants With Stent Thrombosis (ARC Definition) Definite/Probable
Definite stent thrombosis occurred by either angiographic/pathologic confirmation of stent thrombosis.
Angiographic confirmation:The presence of a thrombus that originates in the stent or in the segment 5 mm proximal or distal to the stent\&presence of at least 1 of the following criteria within a 48-hour time window:
- Acute onset of ischemic symptoms at rest
- New ischemic ECG changes
- Typical rise\&fall in cardiac biomarkers
- Non-occlusive thrombus
- Occlusive thrombus.
Pathological confirmation: Evidence of recent thrombus within the stent determined at autopsy or via examination of tissue retrieved following thrombectomy.
Probable stent thrombosis may occur after intracoronary stenting due to:
- Unexplained death within first 30 days
- Irrespective of the time after the index procedure,any MI that is related to documented acute ischemia in the territory of the implanted stent without angiographic confirmation of stent thrombosis\&in the absence of any other obvious cause.
Measured: Early (0-30 days)
Number of Participants With Stent Thrombosis (ARC Definition) Definite/Probable
Definite stent thrombosis occurred by either angiographic/pathologic confirmation of stent thrombosis.
Angiographic confirmation:The presence of a thrombus that originates in the stent or in the segment 5 mm proximal or distal to the stent\&presence of at least 1 of the following criteria within a 48-hour time window:
- Acute onset of ischemic symptoms at rest
- New ischemic ECG changes
- Typical rise\&fall in cardiac biomarkers
- Non-occlusive thrombus
- Occlusive thrombus.
Pathological confirmation: Evidence of recent thrombus within the stent determined at autopsy or via examination of tissue retrieved following thrombectomy.
Probable stent thrombosis may occur after intracoronary stenting due to:
- Unexplained death within first 30 days
- Irrespective of the time after the index procedure,any MI that is related to documented acute ischemia in the territory of the implanted stent without angiographic confirmation of stent thrombosis\&in the absence of any other obvious cause.
Measured: Acute (<= 24 hours)
Number of Participants With Stent Thrombosis (ARC Definition) Definite/ Probable
Definite stent thrombosis occurred by either angiographic/pathologic confirmation of stent thrombosis.
Angiographic confirmation:The presence of a thrombus that originates in the stent or in the segment 5 mm proximal or distal to the stent\&presence of at least 1 of the following criteria within a 48-hour time window:
- Acute onset of ischemic symptoms at rest
- New ischemic ECG changes
- Typical rise\&fall in cardiac biomarkers
- Non-occlusive thrombus
- Occlusive thrombus.
Pathological confirmation: Evidence of recent thrombus within the stent determined at autopsy or via examination of tissue retrieved following thrombectomy.
Probable stent thrombosis may occur after intracoronary stenting due to:
- Unexplained death within first 30 days
- Irrespective of the time after the index procedure,any MI that is related to documented acute ischemia in the territory of the implanted stent without angiographic confirmation of stent thrombosis\&in the absence of any other obvious cause.
Measured: Subacute (1-30 days)
Number of Participants With Stent Thrombosis (ARC Definition) Definite/Probable
Definite stent thrombosis occurred by either angiographic/pathologic confirmation of stent thrombosis.
Angiographic confirmation:The presence of a thrombus that originates in the stent or in the segment 5 mm proximal or distal to the stent\&presence of at least 1 of the following criteria within a 48-hour time window:
- Acute onset of ischemic symptoms at rest
- New ischemic ECG changes
- Typical rise\&fall in cardiac biomarkers
- Non-occlusive thrombus
- Occlusive thrombus.
Pathological confirmation: Evidence of recent thrombus within the stent determined at autopsy or via examination of tissue retrieved following thrombectomy.
Probable stent thrombosis may occur after intracoronary stenting due to:
- Unexplained death within first 30 days
- Irrespective of the time after the index procedure,any MI that is related to documented acute ischemia in the territory of the implanted stent without angiographic confirmation of stent thrombosis\&in the absence of any other obvious cause.
Measured: Late (>30 days - 1 year)
Number of Participants With Stent Thrombosis (ARC Definition) Definite/ Probable
Definite stent thrombosis occurred by either angiographic/pathologic confirmation of stent thrombosis.
Angiographic confirmation:The presence of a thrombus that originates in the stent or in the segment 5 mm proximal or distal to the stent\&presence of at least 1 of the following criteria within a 48-hour time window:
- Acute onset of ischemic symptoms at rest
- New ischemic ECG changes
- Typical rise\&fall in cardiac biomarkers
- Non-occlusive thrombus
- Occlusive thrombus.
Pathological confirmation: Evidence of recent thrombus within the stent determined at autopsy or via examination of tissue retrieved following thrombectomy.
Probable stent thrombosis may occur after intracoronary stenting due to:
- Unexplained death within first 30 days
- Irrespective of the time after the index procedure,any MI that is related to documented acute ischemia in the territory of the implanted stent without angiographic confirmation of stent thrombosis\&in the absence of any other obvious cause.
Measured: Very late (>1 year)
Number of Participants With Graft Stenosis or Occlusion
Graft stenosis or occlusion is defined as Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: In-hospital (≤ 7 days of index-procedure)
Number of Participants With Graft Stenosis or Occlusion
Graft stenosis or occlusion is defined as Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 0 to 30 days
Number of Participants With Graft Stenosis or Occlusion
Graft stenosis or occlusion is defined as Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 0 to 6 months
Number of Participants With Graft Stenosis or Occlusion
Graft stenosis or occlusion is defined as Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 0 to 1 year
Number of Participants With Graft Stenosis or Occlusion
Graft stenosis or occlusion is defined as Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 0 to 2 years
Number of Participants With Graft Stenosis or Occlusion
Graft stenosis or occlusion is defined as Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 0 to 3 years
Number of Participants With Graft Stenosis or Occlusion
Graft stenosis or occlusion is defined as Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 0 to 4 years
Number of Participants With Graft Stenosis or Occlusion
Graft stenosis or occlusion is defined as Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 0 to 5 years
Number of Participants With Requirement for Blood Product Transfusion
All TIMI definitions take into account blood transfusions, so that hemoglobin and hematocrit values are adjusted by 1 g/dl or 3%, respectively, for each unit of blood transfused. Therefore, the true change in hemoglobin or hematocrit if there has been an intervening transfusion between two blood measurements is calculated as follows:
- Δ Hemoglobin = [baseline Hgb - post-transfusion Hgb] + [number of transfused units];
- Δ Hematocrit = [baseline Hct - post-transfusion Hct] + [number of transfused units X 3].
Measured: 30 days
Number of Participants With Requirement for Blood Product Transfusion
All TIMI definitions take into account blood transfusions, so that hemoglobin and hematocrit values are adjusted by 1 g/dl or 3%, respectively, for each unit of blood transfused. Therefore, the true change in hemoglobin or hematocrit if there has been an intervening transfusion between two blood measurements is calculated as follows:
- Δ Hemoglobin = [baseline Hgb - post-transfusion Hgb] + [number of transfused units];
- Δ Hematocrit = [baseline Hct - post-transfusion Hct] + [number of transfused units X 3].
Measured: 3 years
Number of Participants With Requirement for Blood Product Transfusion
All TIMI definitions take into account blood transfusions, so that hemoglobin and hematocrit values are adjusted by 1 g/dl or 3%, respectively, for each unit of blood transfused. Therefore, the true change in hemoglobin or hematocrit if there has been an intervening transfusion between two blood measurements is calculated as follows:
- Δ Hemoglobin = [baseline Hgb - post-transfusion Hgb] + [number of transfused units];
- Δ Hematocrit = [baseline Hct - post-transfusion Hct] + [number of transfused units X 3].
Measured: 4 years
Number of Participants With Requirement for Blood Product Transfusion
All TIMI definitions take into account blood transfusions, so that hemoglobin and hematocrit values are adjusted by 1 g/dl or 3%, respectively, for each unit of blood transfused. Therefore, the true change in hemoglobin or hematocrit if there has been an intervening transfusion between two blood measurements is calculated as follows:
- Δ Hemoglobin = [baseline Hgb - post-transfusion Hgb] + [number of transfused units];
- Δ Hematocrit = [baseline Hct - post-transfusion Hct] + [number of transfused units X 3].
Measured: 5 years
Number of Participants With Thrombolysis in Myocardial Infarction (TIMI) Major or Minor Bleeding
Bleeding will be classified by the TIMI hemorrhage classification
Severity:
Major:
- Intracranial hemorrhage
- A ≥5 g/dL decrease in the hemoglobin concentration
- A ≥15% absolute decrease in the hematocrit
Minor:
- Observed blood loss:
- A ≥ 3 g/dL decrease in the hemoglobin concentration
- A ≥ 10% absolute decrease in the hematocrit
- No observed blood loss:
- A ≥ 4 g/dL decrease in the hemoglobin concentration
- A ≥ 12% absolute decrease in the hematocrit
Minimal:
- Any clinically overt sign of hemorrhage (including imaging) that is associated with a < 3 g/dL decrease in hemoglobin concentration or < 9% decrease in the hematocrit.
Measured: 30 days
Number of Participants With Thrombolysis in Myocardial Infarction (TIMI) Major or Minor Bleeding
Bleeding will be classified by the TIMI hemorrhage classification
Severity:
Major:
- Intracranial hemorrhage
- A ≥5 g/dL decrease in the hemoglobin concentration
- A ≥15% absolute decrease in the hematocrit
Minor:
- Observed blood loss:
- A ≥ 3 g/dL decrease in the hemoglobin concentration
- A ≥ 10% absolute decrease in the hematocrit
- No observed blood loss:
- A ≥ 4 g/dL decrease in the hemoglobin concentration
- A ≥ 12% absolute decrease in the hematocrit
Minimal:
- Any clinically overt sign of hemorrhage (including imaging) that is associated with a < 3 g/dL decrease in hemoglobin concentration or < 9% decrease in the hematocrit.
Measured: 3 years
Number of Participants With Thrombolysis in Myocardial Infarction (TIMI) Major or Minor Bleeding
Bleeding will be classified by the TIMI hemorrhage classification
Severity:
Major:
- Intracranial hemorrhage
- A ≥5 g/dL decrease in the hemoglobin concentration
- A ≥15% absolute decrease in the hematocrit
Minor:
- Observed blood loss:
- A ≥ 3 g/dL decrease in the hemoglobin concentration
- A ≥ 10% absolute decrease in the hematocrit
- No observed blood loss:
- A ≥ 4 g/dL decrease in the hemoglobin concentration
- A ≥ 12% absolute decrease in the hematocrit
Minimal:
- Any clinically overt sign of hemorrhage (including imaging) that is associated with a < 3 g/dL decrease in hemoglobin concentration or < 9% decrease in the hematocrit.
Measured: 4 years
Number of Participants With Thrombolysis in Myocardial Infarction (TIMI) Major or Minor Bleeding
Bleeding will be classified by the TIMI hemorrhage classification
Severity:
Major:
- Intracranial hemorrhage
- A ≥5 g/dL decrease in the hemoglobin concentration
- A ≥15% absolute decrease in the hematocrit
Minor:
- Observed blood loss:
- A ≥ 3 g/dL decrease in the hemoglobin concentration
- A ≥ 10% absolute decrease in the hematocrit
- No observed blood loss:
- A ≥ 4 g/dL decrease in the hemoglobin concentration
- A ≥ 12% absolute decrease in the hematocrit
Minimal:
- Any clinically overt sign of hemorrhage (including imaging) that is associated with a < 3 g/dL decrease in hemoglobin concentration or < 9% decrease in the hematocrit.
Measured: 5 years
Number of Participants With Bleeding Academic Research Consortium (BARC) Bleeding
Type 0: No bleeding Type 1: Bleeding that is not actionable\&does not cause the patient to seek unscheduled performance of studies,hospitalization,or treatment by a healthcare professional Type 2: Any overt, actionable sign of hemorrhage that does not fit the criteria for type 3,4,or 5 but does meet at least 1 of the following criteria:requiring nonsurgical, medical intervention by a healthcare professional; leading to hospitalization or increased level of care; prompting evaluation.
Type 3 Type 3a
- Overt bleeding plus hemoglobin drop of 3 to < 5 g/dL
- Any transfusion with overt bleeding Type 3b
- Overt bleeding plus hemoglobin drop ≥5 g/dL*
- Cardiac tamponade
- Bleeding requiring surgical intervention for control
- Bleeding requiring intravenous vasoactive agents Type 3c
- Intracranial hemorrhage
- Subcategories confirmed by autopsy or imaging or lumbar puncture
- Intraocular bleed compromising vision Type 4: CABG-related bleeding Type 5: Fatal bleeding
Measured: 30 days
Number of Participants With Bleeding Academic Research Consortium (BARC) Bleeding
Type 0: no bleeding Type 1: bleeding that is not actionable\&does not cause the patient to seek unscheduled performance of studies,hospitalization,or treatment by a healthcare professional Type 2: any overt, actionable sign of hemorrhage that does not fit the criteria for type 3,4,or 5 but does meet at least 1 of the following criteria:requiring nonsurgical, medical intervention by a healthcare professional; leading to hospitalization or increased level of care; prompting evaluation.
Type 3 Type 3a
- Overt bleeding plus hemoglobin drop of 3 to < 5 g/dL
- Any transfusion with overt bleeding Type 3b
- Overt bleeding plus hemoglobin drop ≥5 g/dL*
- Cardiac tamponade
- Bleeding requiring surgical intervention for control
- Bleeding requiring intravenous vasoactive agents Type 3c
- Intracranial hemorrhage
- Subcategories confirmed by autopsy or imaging or lumbar puncture
- Intraocular bleed compromising vision Type 4: CABG-related bleeding Type 5: fatal bleeding
Measured: 3 years
Number of Participants With Bleeding Academic Research Consortium (BARC) Bleeding
Type 0: no bleeding Type 1: bleeding that is not actionable\&does not cause the patient to seek unscheduled performance of studies,hospitalization,or treatment by a healthcare professional Type 2: any overt, actionable sign of hemorrhage that does not fit the criteria for type 3,4,or 5 but does meet at least 1 of the following criteria:requiring nonsurgical, medical intervention by a healthcare professional; leading to hospitalization or increased level of care; prompting evaluation.
Type 3 Type 3a
- Overt bleeding plus hemoglobin drop of 3 to < 5 g/dL
- Any transfusion with overt bleeding Type 3b
- Overt bleeding plus hemoglobin drop ≥5 g/dL*
- Cardiac tamponade
- Bleeding requiring surgical intervention for control
- Bleeding requiring intravenous vasoactive agents Type 3c
- Intracranial hemorrhage
- Subcategories confirmed by autopsy or imaging or lumbar puncture
- Intraocular bleed compromising vision Type 4: CABG-related bleeding Type 5: fatal bleeding
Measured: 4 years
Number of Participants With Bleeding Academic Research Consortium (BARC) Bleeding
Type 0: no bleeding Type 1: bleeding that is not actionable\&does not cause the patient to seek unscheduled performance of studies,hospitalization,or treatment by a healthcare professional Type 2: any overt, actionable sign of hemorrhage that does not fit the criteria for type 3,4,or 5 but does meet at least 1 of the following criteria:requiring nonsurgical, medical intervention by a healthcare professional; leading to hospitalization or increased level of care; prompting evaluation.
Type 3 Type 3a
- Overt bleeding plus hemoglobin drop of 3 to < 5 g/dL
- Any transfusion with overt bleeding Type 3b
- Overt bleeding plus hemoglobin drop ≥5 g/dL*
- Cardiac tamponade
- Bleeding requiring surgical intervention for control
- Bleeding requiring intravenous vasoactive agents Type 3c
- Intracranial hemorrhage
- Subcategories confirmed by autopsy or imaging or lumbar puncture
- Intraocular bleed compromising vision Type 4: CABG-related bleeding Type 5: fatal bleeding
Measured: 5 years
Number of Participants With Major Adverse Events (MAE)
- death
- myocardial infarction
- stroke
- Transfusion of ≥2 units of blood
- TIMI major or minor bleeding
- major arrhythmia
- unplanned coronary revascularization for ischemia
- any unplanned surgery or therapeutic radiologic procedure
- renal failure
- sternal wound dehiscence
- infection requiring antibiotics for treatment
- intubation for > 48 hours
- post-pericardiotomy syndrome
Measured: 30 days
Number of Participants With Complete Revascularization (Residual = 0)
- Complete anatomic revascularization requires revascularization of all vessels ≥2.0 mm reference vessel diameter with a DS ≥60% (both as measured by core angiographic laboratory analysis). -While this will be the pre-specified criteria for anatomically significant lesions, sensitivity analysis will be performed using different criteria (e.g. ≥2.5 mm vessels, DS ≥70%, etc.)
- From the baseline angiogram, the angiographic core lab will identify and designate those lesions and vessels requiring revascularization in all subjects according to this definition, prior to knowledge of the extent of actual revascularization.
- Following PCI, the angiographic core lab will determine the extent of revascularization (vessels with TIMI 2or3 flow post procedure with a core laboratory DS <50% considered successfully revascularized).
- Following CABG, the angiographic core lab will determine the extent of revascularization or if there is a repeat angiogram during the index hospitalization.
Measured: At Baseline
Number of Participants With Definite Stent Thrombosis (ST) or Symptomatic Graft Occlusion
- Definite ST occurred by either angiographic/pathologic confirmation of ST.
Angiographic confirmation:The presence of a thrombus that originates in the stent/in the segment 5mm proximal/distal to the stent\&presence of at least 1 of the following criteria within 48-hours:
- Acute onset of ischemic symptoms at rest
- New ischemic ECG changes
- Typical rise\&fall in cardiac biomarkers
- Non-occlusive \&occlusive thrombus
Pathological confirmation:Evidence of recent thrombus within the stent determined at autopsy/via examination of tissue retrieved following thrombectomy.
-Symptomatic graft occlusion: Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: In-hospital (≤ 7 days of post index procedure)
Number of Participants With Definite Stent Thrombosis or Symptomatic Graft Occlusion
- Definite ST occurred by either angiographic/pathologic confirmation of ST.
Angiographic confirmation:The presence of a thrombus that originates in the stent/in the segment 5mm proximal/distal to the stent\&presence of at least 1 of the following criteria within 48-hours:
- Acute onset of ischemic symptoms at rest
- New ischemic ECG changes
- Typical rise\&fall in cardiac biomarkers
- Non-occlusive \&occlusive thrombus
Pathological confirmation:Evidence of recent thrombus within the stent determined at autopsy/via examination of tissue retrieved following thrombectomy.
-Symptomatic graft occlusion: Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 1 year
Number of Participants With Definite Stent Thrombosis or Symptomatic Graft Occlusion
- Definite ST occurred by either angiographic/pathologic confirmation of ST.
Angiographic confirmation:The presence of a thrombus that originates in the stent/in the segment 5mm proximal/distal to the stent\&presence of at least 1 of the following criteria within 48-hours:
- Acute onset of ischemic symptoms at rest
- New ischemic ECG changes
- Typical rise\&fall in cardiac biomarkers
- Non-occlusive \&occlusive thrombus
Pathological confirmation:Evidence of recent thrombus within the stent determined at autopsy/via examination of tissue retrieved following thrombectomy.
-Symptomatic graft occlusion: Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 2 years
Number of Participants With Definite Stent Thrombosis or Symptomatic Graft Occlusion
- Definite ST occurred by either angiographic/pathologic confirmation of ST.
Angiographic confirmation:The presence of a thrombus that originates in the stent/in the segment 5mm proximal/distal to the stent\&presence of at least 1 of the following criteria within 48-hours:
- Acute onset of ischemic symptoms at rest
- New ischemic ECG changes
- Typical rise\&fall in cardiac biomarkers
- Non-occlusive \&occlusive thrombus
Pathological confirmation:Evidence of recent thrombus within the stent determined at autopsy/via examination of tissue retrieved following thrombectomy.
-Symptomatic graft occlusion: Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 3 years
Number of Participants With Definite Stent Thrombosis or Symptomatic Graft Occlusion
- Definite ST occurred by either angiographic/pathologic confirmation of ST.
Angiographic confirmation:The presence of a thrombus that originates in the stent/in the segment 5mm proximal/distal to the stent\&presence of at least 1 of the following criteria within 48-hours:
- Acute onset of ischemic symptoms at rest
- New ischemic ECG changes
- Typical rise\&fall in cardiac biomarkers
- Non-occlusive \&occlusive thrombus
Pathological confirmation:Evidence of recent thrombus within the stent determined at autopsy/via examination of tissue retrieved following thrombectomy.
-Symptomatic graft occlusion: Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 4 years
Number of Participants With Definite Stent Thrombosis or Symptomatic Graft Occlusion
- Definite ST occurred by either angiographic/pathologic confirmation of ST.
Angiographic confirmation:The presence of a thrombus that originates in the stent/in the segment 5mm proximal/distal to the stent\&presence of at least 1 of the following criteria within 48-hours:
- Acute onset of ischemic symptoms at rest
- New ischemic ECG changes
- Typical rise\&fall in cardiac biomarkers
- Non-occlusive \&occlusive thrombus
Pathological confirmation:Evidence of recent thrombus within the stent determined at autopsy/via examination of tissue retrieved following thrombectomy.
-Symptomatic graft occlusion: Ischemic symptoms in the presence of ≥50% diameter stenosis in a coronary bypass graft.
Measured: 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Sep 2010 (estimated)
- Study start29 Sep 2010
- Primary completion3 May 2019
- Study completion28 Jun 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (25)Papers the sponsor has linked to this study.
- Other trials for Chronic Coronary OcclusionStudies of the same condition, open and under way.
- More trials run by Abbott Medical DevicesThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 1,905 participants (actual)
Sponsor and investigators
- Lead sponsor
- Abbott Medical Devices
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Gregg W Stone, MD, Principal investigator, Columbia UniversityPatrick W Serruys, MD, Principal investigator, Erasmus Medical CenterJoseph Sabik, MD, Principal investigator, Cleveland Clinical Main CampusA. Pieter Kappetein, MD, Principal investigator, Erasmus Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01205776
- Sponsor's protocol ID
- 10-389
- Acronym
- EXCEL
- Status last verified
- Mar 2020
- First submitted
- 16 Sep 2010
- Last updated
- 7 Apr 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Madhavan MV, Gregson J, Redfors B, Chen S, Sabik JF 3rd, Fujino A, Kotinkaduwa LN, Karmpaliotis D, Moses JW, Ben-Yehuda O, Serruys PW, Pocock S, Kappetein AP, Maehara A, Stone GW. Spontaneous Myocardial Infarction After Left Main Revascularization: The EXCEL Trial. Circulation. 2026 Mar 24;153(12):890-901. doi: 10.1161/CIRCULATIONAHA.125.075875. Epub 2026 Feb 10.
PubMed 41664927Giustino G, Sabik JF 3rd, Serruys PW, Puskas JD, Karmpaliotis D, Kandzari DE, Morice MC, Ragosta M 3rd, Zhang Z, Dressler O, Redfors B, Ben-Yehuda O, Sharma SK, Kappetein AP, Stone GW. Major Bleeding and Mortality After Revascularization of Left Main Disease. J Am Coll Cardiol. 2024 Dec 10;84(24):2335-2346. doi: 10.1016/j.jacc.2024.07.065.
PubMed 39632005Ali ZA, Garcia JJ, Karimi Galougahi K, Horst J, Gallo A, Shin D, Ben-Yehuda O, Chen S, Redfors B, Kappetein AP, Sabik JF 3rd, Serruys PW, Stone GW. Impact of Incomplete Revascularization After PCI in Left Main Disease: The EXCEL Trial. Circ Cardiovasc Interv. 2024 Mar;17(3):e013192. doi: 10.1161/CIRCINTERVENTIONS.123.013192. Epub 2024 Mar 19.
PubMed 38502720Gaba P, Sabik JF, Murphy SA, Bellavia A, O'Gara PT, Smith PK, Serruys PW, Kappetein AP, Park SJ, Park DW, Christiansen EH, Holm NR, Nielsen PH, Sabatine MS, Stone GW, Bergmark BA. Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main Disease With and Without Diabetes: Findings From a Pooled Analysis of 4 Randomized Clinical Trials. Circulation. 2024 Apr 23;149(17):1328-1338. doi: 10.1161/CIRCULATIONAHA.123.065571. Epub 2024 Mar 11.
PubMed 38465592Gaba P, Christiansen EH, Nielsen PH, Murphy SA, O'Gara PT, Smith PK, Serruys PW, Kappetein AP, Park SJ, Park DW, Stone GW, Sabik JF, Sabatine MS, Holm NR, Bergmark BA. Percutaneous Coronary Intervention vs Coronary Artery Bypass Graft Surgery for Left Main Disease in Patients With and Without Acute Coronary Syndromes: A Pooled Analysis of 4 Randomized Clinical Trials. JAMA Cardiol. 2023 Jul 1;8(7):631-639. doi: 10.1001/jamacardio.2023.1177.
PubMed 37256598Magnuson EA, Chinnakondepalli K, Vilain K, Serruys PW, Sabik JF, Kappetein AP, Stone GW, Cohen DJ; EXCEL Investigators. Cost-Effectiveness of Percutaneous Coronary Intervention Versus Bypass Surgery for Patients With Left Main Disease: Results From the EXCEL Trial. Circ Cardiovasc Interv. 2022 Jul;15(7):e011981. doi: 10.1161/CIRCINTERVENTIONS.122.011981. Epub 2022 Jul 19.
PubMed 35861797Myat A, Hildick-Smith D, de Belder AJ, Trivedi U, Crowley A, Morice MC, Kandzari DE, Lembo NJ, Brown WM III, Serruys PW, Kappetein AP, Sabik JF III, Stone G. Geographical variations in left main coronary artery revascularisation: a prespecified analysis of the EXCEL trial. EuroIntervention. 2022 Jan 28;17(13):1081-1090. doi: 10.4244/EIJ-D-21-00338.
PubMed 34212863Gregson J, Stone GW, Ben-Yehuda O, Redfors B, Kandzari DE, Morice MC, Leon MB, Kosmidou I, Lembo NJ, Brown WM 3rd, Karmpaliotis D, Banning AP, Pomar J, Sabate M, Simonton CA, Dressler O, Kappetein AP, Sabik JF 3rd, Serruys PW, Pocock SJ. Implications of Alternative Definitions of Peri-Procedural Myocardial Infarction After Coronary Revascularization. J Am Coll Cardiol. 2020 Oct 6;76(14):1609-1621. doi: 10.1016/j.jacc.2020.08.016.
PubMed 33004126Gaba P, Serruys PW, Sabik JF 3rd, Kappetein AP, Chen S, Morice MC, Kandzari DE, Crowley A, Mehran R, Stone GW. Effect of Baseline Anemia on Outcomes After Left Main Coronary Revascularization. J Am Coll Cardiol. 2020 Mar 31;75(12):1493-1495. doi: 10.1016/j.jacc.2020.01.037. No abstract available.
PubMed 32216919Thuijs DJFM, Milojevic M, Stone GW, Puskas JD, Serruys PW, Sabik JF 3rd, Dressler O, Crowley A, Head SJ, Kappetein AP. Impact of left ventricular ejection fraction on clinical outcomes after left main coronary artery revascularization: results from the randomized EXCEL trial. Eur J Heart Fail. 2020 May;22(5):871-879. doi: 10.1002/ejhf.1681. Epub 2020 Feb 11.
PubMed 32043709Giustino G, Serruys PW, Sabik JF 3rd, Mehran R, Maehara A, Puskas JD, Simonton CA, Lembo NJ, Kandzari DE, Morice MC, Taggart DP, Gershlick AH, Ragosta M 3rd, Kron IL, Liu Y, Zhang Z, McAndrew T, Dressler O, Genereux P, Ben-Yehuda O, Pocock SJ, Kappetein AP, Stone GW. Mortality After Repeat Revascularization Following PCI or CABG for Left Main Disease: The EXCEL Trial. JACC Cardiovasc Interv. 2020 Feb 10;13(3):375-387. doi: 10.1016/j.jcin.2019.09.019. Epub 2020 Jan 15.
PubMed 31954680Kandzari DE, Gershlick AH, Serruys PW, Leon MB, Morice MC, Simonton CA, Lembo NJ, Mansour S, Sabate M, Sabik JF 3rd, Kappetein AP, Dressler O, Stone GW. Procedural characteristics and clinical outcomes in patients undergoing percutaneous coronary intervention for left main trifurcation disease: the EXCEL trial. EuroIntervention. 2020 Dec 18;16(12):e982-e988. doi: 10.4244/EIJ-D-19-00686.
PubMed 31793882Stone GW, Kappetein AP, Sabik JF, Pocock SJ, Morice MC, Puskas J, Kandzari DE, Karmpaliotis D, Brown WM 3rd, Lembo NJ, Banning A, Merkely B, Horkay F, Boonstra PW, van Boven AJ, Ungi I, Bogats G, Mansour S, Noiseux N, Sabate M, Pomar J, Hickey M, Gershlick A, Buszman PE, Bochenek A, Schampaert E, Page P, Modolo R, Gregson J, Simonton CA, Mehran R, Kosmidou I, Genereux P, Crowley A, Dressler O, Serruys PW; EXCEL Trial Investigators. Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease. N Engl J Med. 2019 Nov 7;381(19):1820-1830. doi: 10.1056/NEJMoa1909406. Epub 2019 Sep 28.
PubMed 31562798Shlofmitz E, Genereux P, Chen S, Dressler O, Ben-Yehuda O, Morice MC, Puskas JD, Taggart DP, Kandzari DE, Crowley A, Redfors B, Mehdipoor G, Kappetein AP, Sabik JF 3rd, Serruys PW, Stone GW. Left Main Coronary Artery Disease Revascularization According to the SYNTAX Score. Circ Cardiovasc Interv. 2019 Sep;12(9):e008007. doi: 10.1161/CIRCINTERVENTIONS.118.008007. Epub 2019 Sep 9.
PubMed 31495220Thuijs DJFM, Habib RH, Head SJ, Puskas JD, Taggart DP, Stone GW, Zhang Z, Serruys PW, Sabik JF 3rd, Kappetein AP. Prognostic performance of the Society of Thoracic Surgeons risk score in patients with left main coronary artery disease undergoing revascularisation: a post hoc analysis of the EXCEL trial. EuroIntervention. 2020 May 20;16(1):36-43. doi: 10.4244/EIJ-D-19-00417.
PubMed 31422924
Study at a glance
From the registry record, last updated by the sponsor on 7 Apr 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization.
- ClinicalTrials.gov ID
- NCT01205776
- Acronym / sponsor ID
- EXCEL / 10-389
- Conditions
- Chronic Coronary Occlusion, Unprotected Left Main Coronary Artery Disease, Stent Thrombosis, Vascular Disease, Myocardial Ischemia, Coronary Artery Stenosis
- Keywords
- Drug eluting stents, Stents, Unprotected Left Main Coronary Artery Disease, Coronary artery bypass graft surgery
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,905 participants (actual)
- Lead sponsor
- Abbott Medical DevicesIndustry (pharma, biotech, devices)
- Study start
- 29 Sep 2010 (actual)
- Primary completion
- 3 May 2019 (actual)
- Study completion
- 28 Jun 2019 (actual)
- First posted
- 20 Sep 2010 (estimated)
- Results
- Posted 29 Mar 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To establish the safety and efficacy of the commercially approved XIENCE Family Stent System (inclusive of XIENCE PRIME, XIENCE V, XIENCE Xpedition and XIENCE PRO [for use outside the United States [OUS] only]) in subjects with unprotected left main coronary artery disease by comparing to coronary artery bypass graft surgery.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Percutaneous Coronary Intervention | Active comparator | Device: Percutaneous Coronary InterventionThose patients receiving the XIENCE PRIME™ EECSS or XIENCE V® EECSS or XIENCE Xpedition™ EECSS or XIENCE PRO EECSS |
| Coronary Artery Bypass Graft | Active comparator | Procedure: CABGThose patients receiving CABG |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (9 listed)
- Unprotected left main coronary artery (ULMCA) disease with angiographic diameter stenosis (DS) ≥70% requiring revascularization, or
- ULMCA disease with agniographic DS >=50% but < 70% requiring revascularization, with one or more of the following present:
- Left Main Equivalent Disease
- Clinical and anatomic eligibility for both PCI and CABG
- Silent ischemia, stable angina, unstable angina or recent MI
Key exclusion criteria (20 listed)
- Clinical exclusion criteria:
- Prior PCI of the left main trunk at any time prior to randomization
- Prior PCI of any other coronary artery lesions within one year prior to randomization
- Prior CABG at any time prior to randomization
- Need for any concomitant cardiac surgery other than CABG, or intent that if the subject randomizes to surgery, any cardiac surgical procedure other than isolated CABG will be performed
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Percutaneous Coronary InterventionThose patients receiving the XIENCE PRIME™ EECSS or XIENCE V® EECSS or XIENCE Xpedition™ EECSS or XIENCE PRO EECSS | Device | Percutaneous Coronary Intervention |
| CABGThose patients receiving CABG | Procedure or surgery | Coronary Artery Bypass Graft |
Primary outcome
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
Time frame: 5 years
All deaths includes Cardiac death, Vascular death and Non-cardiovascular death. Myocardial Infarction (MI): * Q wave MI: Development of new, pathological Q wave on the ECG. * Non-Q wave MI: Elevation of CK levels to ≥ two times the upper limit of normal (ULN) with elevated CK-MB in the absence of new pathological Q waves. Stroke is defined as the rapid onset of a new persistent neurologic deficit attributed to an obstruction in cerebral blood flow and/or cerebral hemorrhage with no apparent non-vascular cause (e.g., trauma, tumor, or infection).
91 secondary outcomes
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
Time frame: In-hospital (≤ 7 days of index-procedure)
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
Time frame: 30 days
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
Time frame: 0 to 6 months
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
Time frame: 0 to 1 year
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
Time frame: 0 to 2 years
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
Time frame: 0 to 3 years
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
Time frame: 0 to 4 years
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke
Time frame: 0 to 5 years
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
Time frame: In-hospital (≤ 7 days of index-procedure)
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
Time frame: 0 to 30 days
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
Time frame: 0 to 6 months
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
Time frame: 0 to 1 year
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
Time frame: 0 to 2 years
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
Time frame: 0 to 3 years
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
Time frame: 0 to 4 years
Number of Participants With Death, Protocol Defined MI, Protocol Defined Stroke or Unplanned Revascularization for Ischemia
Time frame: 0 to 5 years
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
Time frame: In-hospital (≤ 7 days of index-procedure)
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
Time frame: 0 to 30 days
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
Time frame: 0 to 6 months
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
Time frame: 0 to 1 year
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
Time frame: 0 to 2 years
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
Time frame: 0 to 3 years
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
Time frame: 0 to 4 years
Number of Participants With All-cause Mortality (Cardiac Death and Non-cardiac Death)
Time frame: 0 to 5 years
Number of Participants With Protocol Defined MI
Time frame: In-hospital (≤ 7 days of post index procedure)
Number of Participants With Protocol Defined MI
Time frame: 0 to 30 days
Number of Participants With Protocol Defined MI
Time frame: 0 to 6 months
Number of Participants With Protocol Defined MI
Time frame: 0 to 1 year
Number of Participants With Protocol Defined MI
Time frame: 0 to 2 years
Number of Participants With Protocol Defined MI
Time frame: 0 to 3 years
Number of Participants With Protocol Defined MI
Time frame: 0 to 4 years
Number of Participants With Protocol Defined MI
Time frame: 0 to 5 years
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Time frame: In-hospital (≤ 7 days of index-procedure)
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Time frame: 0 to 30 days
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Time frame: 0 to 6 months
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Time frame: 0 to 1 year
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Time frame: 0 to 2 years
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Time frame: 0 to 3 years
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Time frame: 0 to 4 years
Number of Participants With All Stroke (Ischemic Stroke, and Hemorrhagic Stroke)
Time frame: 0 to 5 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Apr 2020.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 41664927Madhavan MV, Gregson J, Redfors B, Chen S, Sabik JF 3rd, Fujino A, Kotinkaduwa LN, Karmpaliotis D, Moses JW, Ben-Yehuda O, Serruys PW, Pocock S, Kappetein AP, Maehara A, Stone GW. Spontaneous Myocardial Infarction After Left Main Revascularization: The EXCEL Trial. Circulation. 2026 Mar 24;153(12):890-901. doi: 10.1161/CIRCULATIONAHA.125.075875. Epub 2026 Feb 10.
- Derived from this study: PubMed 39632005Giustino G, Sabik JF 3rd, Serruys PW, Puskas JD, Karmpaliotis D, Kandzari DE, Morice MC, Ragosta M 3rd, Zhang Z, Dressler O, Redfors B, Ben-Yehuda O, Sharma SK, Kappetein AP, Stone GW. Major Bleeding and Mortality After Revascularization of Left Main Disease. J Am Coll Cardiol. 2024 Dec 10;84(24):2335-2346. doi: 10.1016/j.jacc.2024.07.065.
- Derived from this study: PubMed 38502720Ali ZA, Garcia JJ, Karimi Galougahi K, Horst J, Gallo A, Shin D, Ben-Yehuda O, Chen S, Redfors B, Kappetein AP, Sabik JF 3rd, Serruys PW, Stone GW. Impact of Incomplete Revascularization After PCI in Left Main Disease: The EXCEL Trial. Circ Cardiovasc Interv. 2024 Mar;17(3):e013192. doi: 10.1161/CIRCINTERVENTIONS.123.013192. Epub 2024 Mar 19.
- Derived from this study: PubMed 38465592Gaba P, Sabik JF, Murphy SA, Bellavia A, O'Gara PT, Smith PK, Serruys PW, Kappetein AP, Park SJ, Park DW, Christiansen EH, Holm NR, Nielsen PH, Sabatine MS, Stone GW, Bergmark BA. Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main Disease With and Without Diabetes: Findings From a Pooled Analysis of 4 Randomized Clinical Trials. Circulation. 2024 Apr 23;149(17):1328-1338. doi: 10.1161/CIRCULATIONAHA.123.065571. Epub 2024 Mar 11.
- Derived from this study: PubMed 37256598Gaba P, Christiansen EH, Nielsen PH, Murphy SA, O'Gara PT, Smith PK, Serruys PW, Kappetein AP, Park SJ, Park DW, Stone GW, Sabik JF, Sabatine MS, Holm NR, Bergmark BA. Percutaneous Coronary Intervention vs Coronary Artery Bypass Graft Surgery for Left Main Disease in Patients With and Without Acute Coronary Syndromes: A Pooled Analysis of 4 Randomized Clinical Trials. JAMA Cardiol. 2023 Jul 1;8(7):631-639. doi: 10.1001/jamacardio.2023.1177.
- Derived from this study: PubMed 35861797Magnuson EA, Chinnakondepalli K, Vilain K, Serruys PW, Sabik JF, Kappetein AP, Stone GW, Cohen DJ; EXCEL Investigators. Cost-Effectiveness of Percutaneous Coronary Intervention Versus Bypass Surgery for Patients With Left Main Disease: Results From the EXCEL Trial. Circ Cardiovasc Interv. 2022 Jul;15(7):e011981. doi: 10.1161/CIRCINTERVENTIONS.122.011981. Epub 2022 Jul 19.
- Derived from this study: PubMed 34212863Myat A, Hildick-Smith D, de Belder AJ, Trivedi U, Crowley A, Morice MC, Kandzari DE, Lembo NJ, Brown WM III, Serruys PW, Kappetein AP, Sabik JF III, Stone G. Geographical variations in left main coronary artery revascularisation: a prespecified analysis of the EXCEL trial. EuroIntervention. 2022 Jan 28;17(13):1081-1090. doi: 10.4244/EIJ-D-21-00338.
- Derived from this study: PubMed 33004126Gregson J, Stone GW, Ben-Yehuda O, Redfors B, Kandzari DE, Morice MC, Leon MB, Kosmidou I, Lembo NJ, Brown WM 3rd, Karmpaliotis D, Banning AP, Pomar J, Sabate M, Simonton CA, Dressler O, Kappetein AP, Sabik JF 3rd, Serruys PW, Pocock SJ. Implications of Alternative Definitions of Peri-Procedural Myocardial Infarction After Coronary Revascularization. J Am Coll Cardiol. 2020 Oct 6;76(14):1609-1621. doi: 10.1016/j.jacc.2020.08.016.
- Derived from this study: PubMed 32216919Gaba P, Serruys PW, Sabik JF 3rd, Kappetein AP, Chen S, Morice MC, Kandzari DE, Crowley A, Mehran R, Stone GW. Effect of Baseline Anemia on Outcomes After Left Main Coronary Revascularization. J Am Coll Cardiol. 2020 Mar 31;75(12):1493-1495. doi: 10.1016/j.jacc.2020.01.037. No abstract available.
- Derived from this study: PubMed 32043709Thuijs DJFM, Milojevic M, Stone GW, Puskas JD, Serruys PW, Sabik JF 3rd, Dressler O, Crowley A, Head SJ, Kappetein AP. Impact of left ventricular ejection fraction on clinical outcomes after left main coronary artery revascularization: results from the randomized EXCEL trial. Eur J Heart Fail. 2020 May;22(5):871-879. doi: 10.1002/ejhf.1681. Epub 2020 Feb 11.
- Derived from this study: PubMed 31954680Giustino G, Serruys PW, Sabik JF 3rd, Mehran R, Maehara A, Puskas JD, Simonton CA, Lembo NJ, Kandzari DE, Morice MC, Taggart DP, Gershlick AH, Ragosta M 3rd, Kron IL, Liu Y, Zhang Z, McAndrew T, Dressler O, Genereux P, Ben-Yehuda O, Pocock SJ, Kappetein AP, Stone GW. Mortality After Repeat Revascularization Following PCI or CABG for Left Main Disease: The EXCEL Trial. JACC Cardiovasc Interv. 2020 Feb 10;13(3):375-387. doi: 10.1016/j.jcin.2019.09.019. Epub 2020 Jan 15.
- Derived from this study: PubMed 31793882Kandzari DE, Gershlick AH, Serruys PW, Leon MB, Morice MC, Simonton CA, Lembo NJ, Mansour S, Sabate M, Sabik JF 3rd, Kappetein AP, Dressler O, Stone GW. Procedural characteristics and clinical outcomes in patients undergoing percutaneous coronary intervention for left main trifurcation disease: the EXCEL trial. EuroIntervention. 2020 Dec 18;16(12):e982-e988. doi: 10.4244/EIJ-D-19-00686.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Gregg W Stone, MD principal investigator
Columbia University
Patrick W Serruys, MD principal investigator
Erasmus Medical Center
Joseph Sabik, MD principal investigator
Cleveland Clinical Main Campus
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Percutaneous Coronary Intervention and CABG in people with Chronic Coronary Occlusion and Unprotected Left Main Coronary Artery Disease, run by Abbott Medical Devices at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 9 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 Apr 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 29 Mar 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Participants With All-cause Death, Protocol Defined MI or Protocol Defined Stroke (time frame: 5 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01205776, which also lists 25 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Apr 2020; AzTrials last refreshed its copy on 27 Oct 2026.