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Coronary Artery DiseaseNCT02892474

HCR vs. CABG Study

An observational study of Coronary Artery Disease, run by Emory University 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

The purpose of the study is to find out if hybrid coronary revascularization (HCR) and coronary artery bypass grafting (CABG) procedure outcomes are similar. HCR is a combination of surgery and catheter procedures to open up clogged heart arteries. CABG is a surgical procedure to open up clogged heart arteries. Read more about this study

Who is it for?
Any age
Conditions the study is for
Coronary Artery Disease
What is being tested?
Hybrid Coronary Revascularization (HCR) and Coronary Artery Bypass Grafting (CABG)
Type of treatment
Surgery or procedure
How many people
75 participants
Where
1 siteUnited States
Study dates
Aug 2016to 27 Jul 2018
Phase
Observational
Are there results?
None posted in the registry

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 Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: The patient population for this trial consists of adult patients with multi-vessel coronary artery disease who are being treated with either hybrid coronary revascularization (HCR) or coronary artery bypass grafting (CABG), as determined by their doctor.

Who may be able to join

  • Able to give informed consent
  • Have multi-vessel coronary artery disease (CAD) involving the Left Anterior Descending (LAD) artery
  • Have a clinical indication for revascularization
  • Are a candidate for either HCR or CABG or both
  • Anatomy suitable for HCR shall include
  • Multi-vessel CAD involving the LAD and/or
  • LAD disease and involvement of a major diagonal artery, both of which require revascularization

Who cannot join

  • Prior cardiac operations
  • Severe left ventricular dysfunction with ejection fraction (EF) < 30%
  • Patients with chest radiation
  • Body mass index (BMI) > 35
  • Severe peripheral vascular disease (PVD)
  • Acute ischemia requiring emergent traditional coronary artery bypass graft (CABG)

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Emory University Hospital Midtown

    Atlanta, Georgia, 30308

Other trials in United States

About this study

Official title: Hybrid Coronary Revascularization Versus Coronary Artery Bypass Surgery for Treatment of Multivessel Coronary Disease

The purpose of the study is to find out if hybrid coronary revascularization (HCR) and coronary artery bypass grafting (CABG) procedure outcomes are similar. HCR is a combination of surgery and catheter procedures to open up clogged heart arteries. CABG is a surgical procedure to open up clogged heart arteries.

Read the detailed description

Currently, it is not clear how the outcomes of hybrid coronary revascularization (HCR) compare with other treatments. The purpose of the study is to find out if HCR and coronary artery bypass grafting (CABG) procedure outcomes are similar. HCR is a combination of surgery and catheter procedures to open up clogged heart arteries. CABG is a surgical procedure to open up clogged heart arteries.

This study will collect information about the medical care participants receive during their planned procedure. No new testing or procedures will be done. Participants will have only the tests or procedures already planned by their doctor. The investigators will look at how well participants do after the procedure by assessing the outcomes of interest 30 days after surgery and, potentially, one year after surgery (funding dependent).

Being tested
Hybrid Coronary Revascularization (HCR), Coronary Artery Bypass Grafting (CABG)
Keywords
Coronary Arteriosclerosis, Hybrid Coronary Revascularization, Coronary Artery Bypass Grafting
Medical subject headings
Coronary Artery Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Hybrid Coronary Revascularization (HCR)Procedure or surgery

    Hybrid coronary revascularization (HCR) is a combination of surgery and catheter procedures to open up clogged heart arteries. HCR is the intentional combination of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). The HCR strategy combines grafting of the left anterior descending artery (LAD) coronary artery using the left internal mammary artery (LIMA) with PCI of non-LAD coronary stenoses. Drug-eluting stents are substituted for saphenous vein grafts (SVG) for non-LAD coronary targets, and the surgical LIMA to LAD bypass is performed, ideally through a minimally invasive, limited access, sternal-sparing approach.

  • Coronary Artery Bypass Grafting (CABG)Procedure or surgery

    Coronary artery bypass grafting (CABG) is a surgery to create a new path for blood flow to the heart. A healthy section of vein or artery from elsewhere in the patient's body will be attached to the coronary artery just above and below the area of concern, to create a way for blood to bypass the blocked part of the coronary artery.

Study groups in NCT02892474
Study groupRoleWhat they receive
Hybrid Coronary Revascularization (HCR)Patients who are scheduled to have the hybrid coronary revascularization (HCR) procedure for treatment of multi-vessel coronary artery disease. The treatment plan is determined by the patient's doctor.
Receives: Procedure: Hybrid Coronary Revascularization (HCR)
Coronary Artery Bypass Grafting (CABG)Patients who are scheduled to have the coronary artery bypass grafting (CABG) procedure for treatment of multi-vessel coronary artery disease. The treatment plan is determined by the patient's doctor.
Receives: Procedure: Coronary Artery Bypass Grafting (CABG)

What is being measured

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

  1. Comparison of major adverse cardiac and cerebrovascular events (MACCE) between groups

    Major adverse cardiac and cerebrovascular events (MACCE) will be assessed at 30 days and at one year after the index procedure. For the purpose of this trial, the components of MACCE include (1) all-cause mortality, (2) repeat revascularization, (3) stroke, and (4) myocardial infarction.

    Measured: Up to one year

Secondary outcomes (15)
  1. Comparison of all-cause mortality between groups

    All-cause mortality will be assessed at 30 days and at one year after the index procedure.

    Measured: Up to one year

  2. Comparison of repeat revascularization between groups

    Repeat revascularization (all-cause) will be assessed at 30 days and at one year after the index procedure.

    Measured: Up to one year

  3. Comparison of stroke between groups

    The incidence and severity of strokes experienced between the groups will be assessed at 30 days and at one year after the index procedure, using the NIH Stroke Scale (NIHSS). The NIHSS is a 15-item neurologic examination stroke scale used to evaluate the effect of acute cerebral infarction on the levels of consciousness, language, neglect, visual-field loss, extraocular movement, motor strength, ataxia, dysarthria, and sensory loss. A trained observer rates the patent's ability to answer questions and perform activities. Ratings for each item are scored with 3 to 5 grades with 0 as normal, and there is an allowance for untestable items. The single patient assessment requires less than 10 minutes to complete.

    Measured: Up to one year

  4. Comparison of ischemia-driven repeat revascularization between groups

    The incidence of ischemia-driven revascularization experienced between the groups will be assessed at 30 days and at one year after the index procedure.

    Measured: Up to one year

  5. Comparison of ventilator time between groups

    The amount of time each patient spends on a ventilator during the index hospitalization will be collected.

    Measured: During hospitalization (typically 3-8 days)

  6. Comparison of surgical re-exploration between groups

    The incidence of re-exploration due to postoperative bleeding will be collected during the index hospitalization.

    Measured: During hospitalization (typically 3-8 days)

  7. Comparison of chest tube drainage complications between groups

    Chest tube drainage complications will be collected during the index hospitalization.

    Measured: During hospitalization (typically 3-8 days)

  8. Comparison of hospital length of stay between groups

    Hospital length of stay will be collected during the index hospitalization.

    Measured: During hospitalization (typically 3-8 days)

  9. Comparison of wound infection between groups

    The incidence of wound infection will be collected during the index hospitalization.

    Measured: During hospitalization (typically 3-8 days)

  10. Comparison of atrial fibrillation between groups

    The incidence of atrial fibrillation will be collected during the index hospitalization.

    Measured: During hospitalization (typically 3-8 days)

  11. Comparison of blood transfusion between groups

    The incidence of blood transfusions will be collected during the index hospitalization.

    Measured: During hospitalization (typically 3-8 days)

  12. Comparison of hospital readmission between groups

    Hospital readmission (all-cause and cardiac) will be assessed at 30 days and at one year after the index procedure.

    Measured: Up to one year

  13. Comparison of Angina Score between groups

    Angina will be assessed at Baseline (prior to surgery), 30 days after the procedure, and at one year after the index procedure.

    The Canadian Cardiovascular Society Angina Grading Scale will be used to categorize angina:

    • Class I - Ordinary physical activity does not cause angina, such as walking and climbing stairs. Angina with strenuous or rapid or prolonged exertion at work or recreation
    • Class II - Slight limitation of ordinary activity. Walking or climbing stairs rapidly, walking uphill, walking or stair climbing after meals, or in cold, or in wind, or under emotional stress or only during the few hours after awakening
    • Class III - Marked limitation of ordinary physical activity. Walking one or two blocks on the level and climbing one flight of stairs in normal conditions and at normal pace
    • Class IV - Inability to carry on a physical activity without discomfort - angina syndrome may be present at rest

    Measured: Up to one year

  14. Comparison of Duke Activity Scale Index (DASI) scores between groups

    The Duke Activity Scale Index (DASI) will be administered at Baseline (prior to surgery), 30 days after the procedure, and at one year after the index procedure. The DASI is a 12 item survey that asks about a patient's functional capacity in order to estimate peak oxygen uptake. Respondents answer "yes" or "no" to questions about their ability to do activities of different intensity levels.

    Measured: Up to one year

  15. Comparison of EuroQol EQ-5D scores between groups

    The EuroQol EQ-5D will be administered at Baseline (prior to surgery), 30 days after the procedure, and at one year after the index procedure. The EuroQol EQ-5D is a 6 item survey that asks about how a patient is feeling on the day of the survey in terms of mobility, self-care, usual activities, pain/discomfort, anxiety/depression, and how they rate their health on a scale of 0 to 100 (where 0 is the worst health imaginable and 100 is the best health imaginable).

    Measured: Up to one year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Sep 2016 (estimated)
  2. Study startAug 2016
  3. Primary completion27 Jul 2018
  4. Study completion27 Jul 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
75 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02892474
Sponsor's protocol ID
IRB00089868
Status last verified
Oct 2019
First submitted
2 Sep 2016
Last updated
2 Oct 2019
Results posted
No
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

An observational study of Coronary Artery Disease, run by Emory University 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 7 inclusion and 6 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 2 Oct 2019. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Comparison of major adverse cardiac and cerebrovascular events (MACCE) between groups (time frame: Up to one year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 2 Oct 2019; AzTrials last refreshed its copy on 31 Oct 2026.

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