Coronary Artery DiseaseNCT02892474
HCR vs. CABG Study
An observational study of Coronary Artery Disease, run by Emory University at 1 site in United States.
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
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).
- Conditions
- Coronary Artery Disease
- 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 group | Role | What 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.
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)
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
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
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
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
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)
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)
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)
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)
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)
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)
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)
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
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
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
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.
- First posted8 Sep 2016 (estimated)
- Study startAug 2016
- Primary completion27 Jul 2018
- Study completion27 Jul 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Coronary Artery DiseaseStudies of the same condition, open and under way.
- More trials run by Emory UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Prospective
- Enrolment
- 75 participants (actual)
Sponsor and investigators
- Lead sponsor
- Emory University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Michael Halkos, Emory University
- Investigators
- Michael Halkos, MD, Principal investigator, Emory University
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
Study at a glance
From the registry record, last updated by the sponsor on 2 Oct 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Hybrid Coronary Revascularization Versus Coronary Artery Bypass Surgery for Treatment of Multivessel Coronary Disease
- ClinicalTrials.gov ID
- NCT02892474
- Acronym / sponsor ID
- IRB00089868
- Conditions
- Coronary Artery Disease
- Keywords
- Coronary Arteriosclerosis, Hybrid Coronary Revascularization, Coronary Artery Bypass Grafting
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 75 participants (actual)
- Lead sponsor
- Emory UniversityUniversity, hospital or other
- Study start
- Aug 2016 (actual)
- Primary completion
- 27 Jul 2018 (actual)
- Study completion
- 27 Jul 2018 (actual)
- First posted
- 8 Sep 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
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).
Study design
- Observational model
- Case-control
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Hybrid Coronary Revascularization (HCR) | – | Procedure: 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. |
| Coronary Artery Bypass Grafting (CABG) | – | Procedure: 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. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- 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.
Key inclusion criteria (7 listed)
- 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
Key exclusion criteria (6 listed)
- 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)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Hybrid Coronary Revascularization (HCR)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. | Procedure or surgery | Hybrid Coronary Revascularization (HCR) |
| Coronary Artery Bypass Grafting (CABG)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. | Procedure or surgery | Coronary Artery Bypass Grafting (CABG) |
Primary outcome
Comparison of major adverse cardiac and cerebrovascular events (MACCE) between groups
Time frame: Up to one year
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.
15 secondary outcomes
Comparison of all-cause mortality between groups
Time frame: Up to one year
Comparison of repeat revascularization between groups
Time frame: Up to one year
Comparison of stroke between groups
Time frame: Up to one year
Comparison of ischemia-driven repeat revascularization between groups
Time frame: Up to one year
Comparison of ventilator time between groups
Time frame: During hospitalization (typically 3-8 days)
Comparison of surgical re-exploration between groups
Time frame: During hospitalization (typically 3-8 days)
Comparison of chest tube drainage complications between groups
Time frame: During hospitalization (typically 3-8 days)
Comparison of hospital length of stay between groups
Time frame: During hospitalization (typically 3-8 days)
Comparison of wound infection between groups
Time frame: During hospitalization (typically 3-8 days)
Comparison of atrial fibrillation between groups
Time frame: During hospitalization (typically 3-8 days)
Comparison of blood transfusion between groups
Time frame: During hospitalization (typically 3-8 days)
Comparison of hospital readmission between groups
Time frame: Up to one year
Comparison of Angina Score between groups
Time frame: Up to one year
Comparison of Duke Activity Scale Index (DASI) scores between groups
Time frame: Up to one year
Comparison of EuroQol EQ-5D scores between groups
Time frame: Up to one year
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Oct 2019.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Michael Halkos, MD principal investigator
Emory University
1 site in 1 country: see every site and its status.
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.