AzTrials
AzTrials

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.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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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
What is being tested?
Percutaneous Coronary Intervention and CABG
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.

United States1 site
  • Abbott Vascular

    Santa Clara, California, 95054

Other trials in United States

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.

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 groups in NCT01205776
Study groupRoleWhat they receive
Percutaneous Coronary InterventionActive comparatorThose 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 GraftActive comparatorThose patients receiving CABG
Receives: Procedure: CABG

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 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)
  1. 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)

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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)

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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)

  18. 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

  19. 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

  20. 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

  21. 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

  22. 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

  23. 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

  24. 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

  25. 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)

  26. 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

  27. 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

  28. 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

  29. 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

  30. 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

  31. 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

  32. 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

  33. 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)

  34. 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

  35. 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

  36. 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

  37. 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

  38. 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

  39. 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

  40. 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

  41. 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

  42. 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)

  43. 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

  44. 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

  45. 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

  46. 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

  47. 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

  48. 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

  49. 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

  50. 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)

  51. 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

  52. 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

  53. 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

  54. 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

  55. 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

  56. 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

  57. 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

  58. 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

  59. 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)

  60. 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)

  61. 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)

  62. 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)

  63. 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)

  64. 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)

  65. 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

  66. 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

  67. 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

  68. 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

  69. 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

  70. 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

  71. 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

  72. 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

  73. 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

  74. 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

  75. 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

  76. 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

  77. 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

  78. 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

  79. 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

  80. 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

  81. 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

  82. 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

  83. 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

  84. 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

  85. Number of Participants With Complete Revascularization (Residual = 0)

    1. 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.)
    2. 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.
    3. 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).
    4. 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

  86. 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)

  87. 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

  88. 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

  89. 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

  90. 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

  91. 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.

  1. First posted20 Sep 2010 (estimated)
  2. Study start29 Sep 2010
  3. Primary completion3 May 2019
  4. Study completion28 Jun 2019

Resources

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)
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
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 41664927
  • Giustino 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 39632005
  • Ali 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 38502720
  • Gaba 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 38465592
  • Gaba 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 37256598
  • Magnuson 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 35861797
  • Myat 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 34212863
  • Gregson 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 33004126
  • Gaba 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 32216919
  • Thuijs 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 32043709
  • Giustino 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 31954680
  • Kandzari 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 31793882
  • Stone 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 31562798
  • Shlofmitz 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 31495220
  • Thuijs 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

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.

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