Ischaemic Heart DiseaseOCTOBERNCT03171311
The OCTOBER Trial - European Trial on Optical Coherence Tomography Optimized Bifurcation Event Reduction (OCTOBER)
A study testing Angiographic guided PCI and OCT guided PCI in people with Ischaemic Heart Disease and Ischemic Heart Disease, run by Aarhus University Hospital Skejby at 38 sites in 13 countries.
Trial summary
The purpose is to compare median two-year clinical outcome after OCT guided vs. standard guided revascularization of patients requiring complex bifurcation stent implantation Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Ischaemic Heart Disease, Ischemic Heart Disease
- What is being tested?
- Angiographic guided PCI and OCT guided PCI
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,201 participants
- Where
- 38 sitesin 13 countries
- Study dates
- 5 Jul 2017to May 2029
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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
- Stable angina pectoris, unstable angina pectoris, clinically stable non-STEMI.
- Age ≥18 yrs.
- Abel to provide written Informed consent and willing to comply with the specified follow-up contacts.
- Angiographic inclusion criteria:
- Native coronary bifurcation de novo lesion
- More than 50% diameter stenosis in the main vessel (MV)
Show all 12Show fewer
- More than 50% diameter stenosis in the side branch (SB) within 5 mm of the ostium.
- Reference size at least 2.75 mm in the main vessel (MV) and ≥2.5 mm in the SB.
- Functional inclusion criteria:
- Functional significance of the main vessel lesion or documented ischemia of the main vessel territory or other objective documentation of lesion significance. Objective evidence of ischemia is required for all treated lesions except for lesions with more than 80% diameter stenosis that may be considered significant.
- Procedural inclusion criteria:
- Indication for two-stent technique or one-stent technique with kissing balloon inflation
Who cannot join
- STEMI within 72 hours
- Cardiogenic shock
- Prior coronary artery bypass grafting (CABG) or planned CABG
- Renal failure with glomerular filtration rate (GFR) <50 mL/min per 1.73 m2
- Active bleeding or coagulopathy
- Life expectancy < 2 years
Show all 14Show fewer
- Ejection fraction < 30%
- New York Heart Association (NYHA) class > II
- Relevant allergies (aspirin, clopidogrel, ticagrelor, contrast compounds, everolimus).
- Angiographic exclusion criteria:
- Severe tortuosity around target bifurcation
- Chronic total occlusions
- Massive thrombus in Left main coronary artery
- Medina 0.0.1 lesions
Trial locations and contacts
38 sites in 13 countries.
38 sites in 13 countries
United Kingdom7 sites
Belfast Health and Social Care Trust
Belfast, BT9 7AB
Royal Bournemouth Hospital
Bournemouth, BH77DW
Sussex Cardiac Centre
Brighton, BN2 5BE
Golden Jubilee Hospital
Glasgow, G81 4DY
St George's Hospital
London, SW17 0QT
University Hospital South Manchester, Wythenshawe Hospital
Manchester, M239LT
Morriston Hospital
Swansea, SA6 6NL
Denmark6 sites
Aalborg University Hospital
Aalborg, 9100
Aarhus University Hospital Skejby
Aarhus N, 8200
Gentofte Hospital
Gentofte Municipality, 2820
Rigshospitalet
København Ø, 2100
Odense University Hospital
Odense, 5000
Zealand University Hospital, Roskilde Sygehus
Roskilde, 4000
Norway5 sites
Hospital of Southern Norway, Arendal
Arendal, 4604
Haukeland University Hospital, Bergen
Bergen
Oslo University Hospital, Rikshospitalet
Oslo, 0424
Oslo University Hospital - Ullevål
Oslo, 0450
Trondheim University Hospital
Trondheim
Germany4 sites
Vivantes Klinikum im Friedrichshain
Berlin, State of Berlin, 10249
Universitäres Herzzentrum Hamburg
Hamburg, 20246
Cardiologicum Hamburg
Hamburg, 22041
Universitätsklinikum Schleswig-Holstein Campus Kiel
Kiel, 24105
Sweden4 sites
Sahlgrenska University Hospital
Gothenburg, 413 45
Karolinska University Hospital Huddinge
Huddinge, Stockholm County, 14157
Örebro University Hospital
Örebro, 70185
Södersjukhuset
Stockholm, 118 83
Netherlands3 sites
Northwest Hospital Alkmaar
Alkmaar, 1815
VU University Medical Center (VUMC)
Amsterdam, 1081 HV
St Antonius Ziekenhuis
Nieuwegein, 3435 CM
Belgium2 sites
Ziekenhuis Oost-Limburg (ZOL) Genk
Genk, 3600
Leuven University Hospital
Leuven, 3000
Italy2 sites
Azienda Ospedaliero-Universitaria di Ferrara
Ferrara, Cona, 44124
Gemelli General Hospital, Catholic University of the Sacred Heart
Rome, 00168
About this study
Official title: European Trial on Optical Coherence Tomography Optimized Bifurcation Event Reduction - The OCTOBER Trial -
The purpose is to compare median two-year clinical outcome after OCT guided vs. standard guided revascularization of patients requiring complex bifurcation stent implantation
Read the detailed description
Coronary bifurcation lesions with stenosis in a large side branch may require complex stent implantation techniques with an elevated risk of suboptimal treatment results. Intra vascular optical coherence tomography (OCT) enables improved procedural control of correctable factors and may lead to optimized implantation results.
It is unknown if routine, systematic use of OCT scans during complex bifurcation stenting improves clinical outcome but present available evidence indicates advantages of OCT guidance that could translate into improved clinical outcome.
Hypothesis: Systematic OCT guided revascularization of patients with bifurcation lesions requiring complex stent implantation provides superior two-year clinical outcome compared to standard revascularization by PCI.
Methods: Investigator initiated and investigator sponsored, randomized (1:1), controlled, prospective, multicenter, superiority trial. Randomization is stratified for 1) Left main or non-Left main artery disease, and 2) up-front planned one-stent technique with kissing balloon inflation, or a two-stent technique.
Systematic OCT guidance is detailed for five complex stent implantation techniques. Standard treatment is angiographic based with optional use of intravascular ultrasound (IVUS).
- Conditions
- Ischaemic Heart Disease, Ischemic Heart Disease
- Being tested
- Angiographic guided PCI, OCT guided PCI
- Medical subject headings
- Coronary Artery Disease, Myocardial Ischemia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Angiographic guided PCIProcedure or surgery
Also called PCI, percutaneous transluminal coronary angioplasty (PTCA)
Angiographic guided PCI is percutaneous coronary intervention performed by standard angiographic guided techniques
OCT guided PCIProcedure or surgery
Also called OCT
OCT guided PCI is percutaneous coronary intervention (PCI) guided by intra vascular optical coherence tomography (OCT) scans
| Study group | Role | What they receive |
|---|---|---|
| Angiographic guided PCI | Active comparator | Angiographic guided PCI is revascularization by percutaneous coronary intervention (PCI) and optional use of intravascular ultrasound (IVUS). Receives: Procedure: Angiographic guided PCI |
| OCT guided PCI | Experimental | OCT guided PCI is percutaneous coronary intervention (PCI) guided by systematic use of intravascular optical coherence tomography (OCT) Receives: Procedure: OCT guided PCI |
What is being measured
The primary outcome is the main question the study is designed to answer.
Combined endpoint of major adverse cardiac events (MACE)
Composite of cardiac death, target lesion myocardial infarction, ischaemic driven target lesion revascularization
Measured: 24 months
Secondary outcomes (114)
Study bifurcation oriented composite endpoint
Composite of cardiac death, target bifurcation myocardial infarction, target bifurcation revascularisation
Measured: 1 month
Study bifurcation oriented composite endpoint
Composite of cardiac death, target bifurcation myocardial infarction, target bifurcation revascularisation
Measured: 12 months
Study bifurcation oriented composite endpoint
Composite of cardiac death, target bifurcation myocardial infarction, target bifurcation revascularisation
Measured: 24 months
Study bifurcation oriented composite endpoint
Composite of cardiac death, target bifurcation myocardial infarction, target bifurcation revascularisation
Measured: 36 months
Study bifurcation oriented composite endpoint
Composite of cardiac death, target bifurcation myocardial infarction, target bifurcation revascularisation
Measured: 48 months
Study bifurcation oriented composite endpoint
Composite of cardiac death, target bifurcation myocardial infarction, target bifurcation revascularisation
Measured: 60 months
Patient oriented composite endpoint
Composite of all-cause mortality, myocardial infarction, any revascularisation, stroke
Measured: 1 month
Patient oriented composite endpoint
Composite of all-cause mortality, myocardial infarction, any revascularisation, stroke
Measured: 12 months
Patient oriented composite endpoint
Composite of all-cause mortality, myocardial infarction, any revascularisation, stroke
Measured: 24 months
Patient oriented composite endpoint
Composite of all-cause mortality, myocardial infarction, any revascularisation, stroke
Measured: 36 months
Patient oriented composite endpoint
Composite of all-cause mortality, myocardial infarction, any revascularisation, stroke
Measured: 48 months
Patient oriented composite endpoint
Composite of all-cause mortality, myocardial infarction, any revascularisation, stroke
Measured: 60 months
All-cause mortality
Death of any cause including cardiac deaths and non-natural causes of death
Measured: 1 month
All-cause mortality
Death of any cause including cardiac deaths and non-natural causes of death
Measured: 12 months
All-cause mortality
Death of any cause including cardiac deaths and non-natural causes of death
Measured: 24 months
All-cause mortality
Death of any cause including cardiac deaths and non-natural causes of death
Measured: 36 months
All-cause mortality
Death of any cause including cardiac deaths and non-natural causes of death
Measured: 48 months
All-cause mortality
Death of any cause including cardiac deaths and non-natural causes of death
Measured: 60 months
All-cause mortality
Death of any cause including cardiac deaths and non-natural causes of death
Measured: 120 months
Cardiac death
Death due to cardiac causes or if death is not clearly attributable to other non-cardiac causes
Measured: 1 month
Cardiac death
Death due to cardiac causes or if death is not clearly attributable to other non-cardiac causes
Measured: 12 months
Cardiac death
Death due to cardiac causes or if death is not clearly attributable to other non-cardiac causes
Measured: 24 months
Cardiac death
Death due to cardiac causes or if death is not clearly attributable to other non-cardiac causes
Measured: 36 months
Cardiac death
Death due to cardiac causes or if death is not clearly attributable to other non-cardiac causes
Measured: 48 months
Cardiac death
Death due to cardiac causes or if death is not clearly attributable to other non-cardiac causes
Measured: 60 months
Myocardial infarction
Procedure and non-procedure related myocardial infarction
Measured: 1 month
Myocardial infarction
Procedure and non-procedure related myocardial infarction
Measured: 12 months
Myocardial infarction
Procedure and non-procedure related myocardial infarction
Measured: 24 months
Myocardial infarction
Procedure and non-procedure related myocardial infarction
Measured: 36 months
Myocardial infarction
Procedure and non-procedure related myocardial infarction
Measured: 48 months
Myocardial infarction
Procedure and non-procedure related myocardial infarction
Measured: 60 months
Stent Thrombosis
Definite, possible or probable
Measured: 1 month
Stent Thrombosis
Definite, possible or probable
Measured: 12 months
Stent Thrombosis
Definite, possible or probable
Measured: 24 months
Stent Thrombosis
Definite, possible or probable
Measured: 36 months
Stent Thrombosis
Definite, possible or probable
Measured: 48 months
Stent Thrombosis
Definite, possible or probable
Measured: 60 months
Target lesion myocardial infarction
Myocardial infarction related to an index treated lesion
Measured: 1 month
Target lesion myocardial infarction
Myocardial infarction related to an index treated lesion
Measured: 12 months
Target lesion myocardial infarction
Myocardial infarction related to an index treated lesion
Measured: 24 months
Target lesion myocardial infarction
Myocardial infarction related to an index treated lesion
Measured: 36 months
Target lesion myocardial infarction
Myocardial infarction related to an index treated lesion
Measured: 48 months
Target lesion myocardial infarction
Myocardial infarction related to an index treated lesion
Measured: 60 months
Target lesion revascularisation
Coronary artery bypass grafting or PCI of target lesion
Measured: 1 month
Target lesion revascularisation
Coronary artery bypass grafting or PCI of target lesion
Measured: 12 months
Target lesion revascularisation
Coronary artery bypass grafting or PCI of target lesion
Measured: 24 months
Target lesion revascularisation
Coronary artery bypass grafting or PCI of target lesion
Measured: 36 months
Target lesion revascularisation
Coronary artery bypass grafting or PCI of target lesion
Measured: 48 months
Target lesion revascularisation
Coronary artery bypass grafting or PCI of target lesion
Measured: 60 months
Target bifurcation myocardial infarction
Myocardial infarction related to the index bifurcation
Measured: 1 month
Target bifurcation myocardial infarction
Myocardial infarction related to the index bifurcation
Measured: 12 months
Target bifurcation myocardial infarction
Myocardial infarction related to the index bifurcation
Measured: 24 months
Target bifurcation myocardial infarction
Myocardial infarction related to the index bifurcation
Measured: 36 months
Target bifurcation myocardial infarction
Myocardial infarction related to the index bifurcation
Measured: 48 months
Target bifurcation myocardial infarction
Myocardial infarction related to the index bifurcation
Measured: 60 months
Target bifurcation revascularisation
Coronary artery bypass grafting or PCI of target bifurcation
Measured: 1 month
Target bifurcation revascularisation
Coronary artery bypass grafting or PCI of target bifurcation
Measured: 12 months
Target bifurcation revascularisation
Coronary artery bypass grafting or PCI of target bifurcation
Measured: 24 months
Target bifurcation revascularisation
Coronary artery bypass grafting or PCI of target bifurcation
Measured: 36 months
Target bifurcation revascularisation
Coronary artery bypass grafting or PCI of target bifurcation
Measured: 48 months
Target bifurcation revascularisation
Coronary artery bypass grafting or PCI of target bifurcation
Measured: 60 months
Target vessel revascularisation
Coronary artery bypass grafting or PCI of target vessel
Measured: 1 month
Target vessel revascularisation
Coronary artery bypass grafting or PCI of target vessel
Measured: 12 months
Target vessel revascularisation
Coronary artery bypass grafting or PCI of target vessel
Measured: 24 months
Target vessel revascularisation
Coronary artery bypass grafting or PCI of target vessel
Measured: 36 months
Target vessel revascularisation
Coronary artery bypass grafting or PCI of target vessel
Measured: 48 months
Target vessel revascularisation
Coronary artery bypass grafting or PCI of target vessel
Measured: 60 months
Any revascularisation
Any repeat revascularization except staged revascularization planned during the index procedure
Measured: 1 month
Any revascularisation
Any repeat revascularization except staged revascularization planned during the index procedure
Measured: 12 months
Any revascularisation
Any repeat revascularization except staged revascularization planned during the index procedure
Measured: 24 months
Any revascularisation
Any repeat revascularization except staged revascularization planned during the index procedure
Measured: 36 months
Any revascularisation
Any repeat revascularization except staged revascularization planned during the index procedure
Measured: 48 months
Any revascularisation
Any repeat revascularization except staged revascularization planned during the index procedure
Measured: 60 months
CCS angina class
Canadian Cardiovascular Society (CCS) grading of angina pectoris
Measured: 1 month
CCS angina class
Canadian Cardiovascular Society (CCS) grading of angina pectoris
Measured: 12 months
CCS angina class
Canadian Cardiovascular Society (CCS) grading of angina pectoris
Measured: 24 months
CCS angina class
Canadian Cardiovascular Society (CCS) grading of angina pectoris
Measured: 36 months
CCS angina class
Canadian Cardiovascular Society (CCS) grading of angina pectoris
Measured: 48 months
CCS angina class
Canadian Cardiovascular Society (CCS) grading of angina pectoris
Measured: 60 months
Contrast volume
Contrast volume
Measured: Baseline, after final baseline procedure
Procedure time
Procedure time
Measured: Baseline, after final baseline procedure
Fluoroscopy time
Fluoroscopy time
Measured: Baseline, after final baseline procedure
Number of stents implanted in target lesion
Number of stents implanted in target lesion
Measured: Baseline, after final baseline procedure
Number of stents implanted in non-target lesion
Number of stents implanted in non-target lesion
Measured: Baseline, after final baseline procedure
Total stent length in target lesion
Total stent length in target lesion
Measured: Baseline, just after final baseline procedure
Total stent length in total
Total stent length in total
Measured: Baseline, just after final baseline procedure
Procedural success
TIMI III flow and less than 30% diameter stenosis in target segments
Measured: Baseline, just after final baseline procedure
OCT-guiding group: Successful final OCT acquisition in MV
For OCT-guided enrollments. Successful final OCT acquisition in main vessel. Success defined as analyzable stented segment.
Measured: Baseline, just after final baseline procedure
OCT-guiding group: Successful final OCT acquisition in SB
For OCT-guided enrollments. Successful final OCT acquisition in side branch. Success defined as analyzable stented segment.
Measured: Baseline, just after final baseline procedure
OCT-guiding group: Successful treatment specific OCT acquisitions
OCT performed succesfully in protocol-defined vessels at all protocol-defined time-points during baseline procedure
Measured: Baseline, after final baseline procedure
Post-PCI minimal lumen diameter in the stented proximal main vessel segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in the stented proximal main vessel segment
Measured: Baseline, after final baseline procedure
Post-PCI minimal lumen diameter in the stented distal main vessel segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in the stented distal main vessel segment
Measured: Baseline, after final baseline procedure
Post-PCI minimal lumen diameter in the treated side branch vessel segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in the treated (stent or balloon) side branch vessel segment
Measured: Baseline, just after final baseline procedure
Post-PCI minimal lumen diameter in the proximal main vessel edge segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in the proximal main vessel edge segment (within 5 mm from the stent)
Measured: Baseline, just after final baseline procedure
Post-PCI minimal lumen diameter in the distal main vessel edge segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in the distal main vessel edge segment (within 5 mm from the stent)
Measured: Baseline, just after final baseline procedure
Post-PCI minimal lumen diameter in the side branch vessel edge segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in the side branch vessel edge segment (within 5 mm from stent or balloon)
Measured: Baseline, just after final baseline procedure
Post-PCI minimal lumen diameter in the stented bifurcation core segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in the stented bifurcation core segment
Measured: Baseline, after final baseline procedure
Post-PCI minimal lumen diameter in the stented distal main vessel ostium segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in the stented distal main vessel ostium segment
Measured: Baseline, just after final baseline procedure
Post-PCI minimal lumen diameter in the treated side branch vessel ostium segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in the treated side branch vessel ostium segment
Measured: Baseline, just after final baseline procedure
Post-PCI diameter stenosis in the stented proximal main vessel segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in the stented proximal main vessel segment
Measured: Baseline, just after final baseline procedure
Post-PCI diameter stenosis in the stented distal main vessel segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in the stented distal main vessel segment
Measured: Baseline, after final baseline procedure
Post-PCI diameter stenosis in the treated side branch vessel segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in the treated (stent or balloon) side branch vessel segment
Measured: Baseline, after final baseline procedure
Post-PCI diameter stenosis in the proximal main vessel edge segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in the proximal main vessel edge segment (within 5 mm from the stent)
Measured: Baseline, just after final baseline procedure
Post-PCI diameter stenosis in the distal main vessel edge segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in the distal main vessel edge segment (within 5 mm from the stent)
Measured: Baseline, just after final baseline procedure
Post-PCI diameter stenosis in the side branch vessel edge segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in the side branch vessel edge segment (within 5 mm from stent or balloon)
Measured: Baseline, just after final baseline procedure
Post-PCI diameter stenosis in the stented bifurcation core segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in the stented bifurcation core segment
Measured: Baseline, just after final baseline procedure
Post-PCI diameter stenosis in the stented distal main vessel ostium segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in the stented distal main vessel ostium segment
Measured: Baseline, just after final baseline procedure
Post-PCI diameter stenosis in the treated side branch ostium segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in the treated side branch ostium segment
Measured: Baseline, just after final baseline procedure
Post-PCI minimal lumen diameter in non-bifurcation target stented segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in non-bifurcation target stented segment
Measured: Baseline, after final baseline procedure
Post-PCI minimal lumen diameter in non-bifurcation target proximal edge segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in non-bifurcation target proximal edge segment (within 5mm fra stent)
Measured: Baseline, after final baseline procedure
Post-PCI minimal lumen diameter in non-bifurcation target distal edge segment
Post-PCI minimal lumen diameter by quantitative coronary analysis (QCA) in non-bifurcation target distal edge segment (within 5mm fra stent)
Measured: Baseline, just after final baseline procedure
Post-PCI diameter stenosis in non-bifurcation target stented segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in non-bifurcation target stented segment
Measured: Baseline, just after final baseline procedure
Post-PCI diameter stenosis in non-bifurcation target proximal edge segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in non-bifurcation target proximal edge segment
Measured: Baseline, just after final baseline procedure
Post-PCI diameter stenosis in non-bifurcation target distal edge segment
Post-PCI diameter stenosis by quantitative coronary analysis (QCA) in non-bifurcation target distal edge segment
Measured: Baseline, just after final baseline procedure
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted31 May 2017
- Study start5 Jul 2017
- Primary completion25 Mar 2022
- Study completionMay 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Ischaemic Heart DiseaseStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 1,201 participants (actual)
Sponsor and investigators
- Lead sponsor
- Aarhus University Hospital Skejby
- Sponsor type
- University, hospital or other
- Collaborators
- Abbott
- Responsible party
- Principal investigator, Evald Hoej Christiansen, Aarhus University Hospital Skejby
- Investigators
- Evald H Christiansen, MD, PhD, Study chair, Aarhus University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03171311
- Sponsor's protocol ID
- 1-10-72-161-16
- Acronym
- OCTOBER
- Status last verified
- Oct 2025
- First submitted
- 28 May 2017
- Last updated
- 18 May 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: Is decided after primary endpoint assessment and requires regulatory approval
Publications
Holm NR, Andreasen LD, Neghabat O, Laanmets P, Kumsars I, Bennett J, Olsen NT, Odenstedt J, Hoffmann P, Dens J, Chowdhary S, O'Kane P, Bulow Rasmussen SH, Heigert M, Havndrup O, Van Kuijk JP, Biscaglia S, Mogensen LJH, Henareh L, Burzotta F, H Eek C, Mylotte D, Llinas MS, Koltowski L, Knaapen P, Calic S, Witt N, Santos-Pardo I, Watkins S, Lonborg J, Kristensen AT, Jensen LO, Calais F, Cockburn J, McNeice A, Kajander OA, Heestermans T, Kische S, Eftekhari A, Spratt JC, Christiansen EH; OCTOBER Trial Group. OCT or Angiography Guidance for PCI in Complex Bifurcation Lesions. N Engl J Med. 2023 Oct 19;389(16):1477-1487. doi: 10.1056/NEJMoa2307770. Epub 2023 Aug 27.
PubMed 37634149Holm NR, Andreasen LN, Walsh S, Kajander OA, Witt N, Eek C, Knaapen P, Koltowski L, Gutierrez-Chico JL, Burzotta F, Kockman J, Ormiston J, Santos-Pardo I, Laanmets P, Mylotte D, Madsen M, Hjort J, Kumsars I, Ramunddal T, Christiansen EH. Rational and design of the European randomized Optical Coherence Tomography Optimized Bifurcation Event Reduction Trial (OCTOBER). Am Heart J. 2018 Nov;205:97-109. doi: 10.1016/j.ahj.2018.08.003. Epub 2018 Aug 16.
PubMed 30205242
Study at a glance
From the registry record, last updated by the sponsor on 18 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- European Trial on Optical Coherence Tomography Optimized Bifurcation Event Reduction - The OCTOBER Trial -
- ClinicalTrials.gov ID
- NCT03171311
- Acronym / sponsor ID
- OCTOBER / 1-10-72-161-16
- Conditions
- Ischaemic Heart Disease, Ischemic Heart Disease
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 1,201 participants (actual)
- Lead sponsor
- Aarhus University Hospital SkejbyUniversity, hospital or other
- Collaborators
- Abbott
- Study start
- 5 Jul 2017 (actual)
- Primary completion
- 25 Mar 2022 (actual)
- Study completion
- May 2029 (estimated)
- First posted
- 31 May 2017 (actual)
- 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 is to compare median two-year clinical outcome after OCT guided vs. standard guided revascularization of patients requiring complex bifurcation stent implantation
Detailed description
Coronary bifurcation lesions with stenosis in a large side branch may require complex stent implantation techniques with an elevated risk of suboptimal treatment results. Intra vascular optical coherence tomography (OCT) enables improved procedural control of correctable factors and may lead to optimized implantation results.
It is unknown if routine, systematic use of OCT scans during complex bifurcation stenting improves clinical outcome but present available evidence indicates advantages of OCT guidance that could translate into improved clinical outcome.
Hypothesis: Systematic OCT guided revascularization of patients with bifurcation lesions requiring complex stent implantation provides superior two-year clinical outcome compared to standard revascularization by PCI.
Methods: Investigator initiated and investigator sponsored, randomized (1:1), controlled, prospective, multicenter, superiority trial. Randomization is stratified for 1) Left main or non-Left main artery disease, and 2) up-front planned one-stent technique with kissing balloon inflation, or a two-stent technique.
Systematic OCT guidance is detailed for five complex stent implantation techniques. Standard treatment is angiographic based with optional use of intravascular ultrasound (IVUS).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Angiographic guided PCI | Active comparator | Procedure: Angiographic guided PCIAngiographic guided PCI is revascularization by percutaneous coronary intervention (PCI) and optional use of intravascular ultrasound (IVUS). |
| OCT guided PCI | Experimental | Procedure: OCT guided PCIOCT guided PCI is percutaneous coronary intervention (PCI) guided by systematic use of intravascular optical coherence tomography (OCT) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (12 listed)
- Stable angina pectoris, unstable angina pectoris, clinically stable non-STEMI.
- Age ≥18 yrs.
- Abel to provide written Informed consent and willing to comply with the specified follow-up contacts.
- Native coronary bifurcation de novo lesion
- More than 50% diameter stenosis in the main vessel (MV)
Key exclusion criteria (14 listed)
- STEMI within 72 hours
- Cardiogenic shock
- Prior coronary artery bypass grafting (CABG) or planned CABG
- Renal failure with glomerular filtration rate (GFR) <50 mL/min per 1.73 m2
- Active bleeding or coagulopathy
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 |
|---|---|---|
| Angiographic guided PCIAlso: PCI, percutaneous transluminal coronary angioplasty (PTCA)Angiographic guided PCI is percutaneous coronary intervention performed by standard angiographic guided techniques | Procedure or surgery | Angiographic guided PCI |
| OCT guided PCIAlso: OCTOCT guided PCI is percutaneous coronary intervention (PCI) guided by intra vascular optical coherence tomography (OCT) scans | Procedure or surgery | OCT guided PCI |
Primary outcome
Combined endpoint of major adverse cardiac events (MACE)
Time frame: 24 months
Composite of cardiac death, target lesion myocardial infarction, ischaemic driven target lesion revascularization
114 secondary outcomes
Study bifurcation oriented composite endpoint
Time frame: 1 month
Study bifurcation oriented composite endpoint
Time frame: 12 months
Study bifurcation oriented composite endpoint
Time frame: 24 months
Study bifurcation oriented composite endpoint
Time frame: 36 months
Study bifurcation oriented composite endpoint
Time frame: 48 months
Study bifurcation oriented composite endpoint
Time frame: 60 months
Patient oriented composite endpoint
Time frame: 1 month
Patient oriented composite endpoint
Time frame: 12 months
Patient oriented composite endpoint
Time frame: 24 months
Patient oriented composite endpoint
Time frame: 36 months
Patient oriented composite endpoint
Time frame: 48 months
Patient oriented composite endpoint
Time frame: 60 months
All-cause mortality
Time frame: 1 month
All-cause mortality
Time frame: 12 months
All-cause mortality
Time frame: 24 months
All-cause mortality
Time frame: 36 months
All-cause mortality
Time frame: 48 months
All-cause mortality
Time frame: 60 months
All-cause mortality
Time frame: 120 months
Cardiac death
Time frame: 1 month
Cardiac death
Time frame: 12 months
Cardiac death
Time frame: 24 months
Cardiac death
Time frame: 36 months
Cardiac death
Time frame: 48 months
Cardiac death
Time frame: 60 months
Myocardial infarction
Time frame: 1 month
Myocardial infarction
Time frame: 12 months
Myocardial infarction
Time frame: 24 months
Myocardial infarction
Time frame: 36 months
Myocardial infarction
Time frame: 48 months
Myocardial infarction
Time frame: 60 months
Stent Thrombosis
Time frame: 1 month
Stent Thrombosis
Time frame: 12 months
Stent Thrombosis
Time frame: 24 months
Stent Thrombosis
Time frame: 36 months
Stent Thrombosis
Time frame: 48 months
Stent Thrombosis
Time frame: 60 months
Target lesion myocardial infarction
Time frame: 1 month
Target lesion myocardial infarction
Time frame: 12 months
Target lesion myocardial infarction
Time frame: 24 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 May 2026.
- Derived from this study: PubMed 37634149Holm NR, Andreasen LD, Neghabat O, Laanmets P, Kumsars I, Bennett J, Olsen NT, Odenstedt J, Hoffmann P, Dens J, Chowdhary S, O'Kane P, Bulow Rasmussen SH, Heigert M, Havndrup O, Van Kuijk JP, Biscaglia S, Mogensen LJH, Henareh L, Burzotta F, H Eek C, Mylotte D, Llinas MS, Koltowski L, Knaapen P, Calic S, Witt N, Santos-Pardo I, Watkins S, Lonborg J, Kristensen AT, Jensen LO, Calais F, Cockburn J, McNeice A, Kajander OA, Heestermans T, Kische S, Eftekhari A, Spratt JC, Christiansen EH; OCTOBER Trial Group. OCT or Angiography Guidance for PCI in Complex Bifurcation Lesions. N Engl J Med. 2023 Oct 19;389(16):1477-1487. doi: 10.1056/NEJMoa2307770. Epub 2023 Aug 27.
- Derived from this study: PubMed 30205242Holm NR, Andreasen LN, Walsh S, Kajander OA, Witt N, Eek C, Knaapen P, Koltowski L, Gutierrez-Chico JL, Burzotta F, Kockman J, Ormiston J, Santos-Pardo I, Laanmets P, Mylotte D, Madsen M, Hjort J, Kumsars I, Ramunddal T, Christiansen EH. Rational and design of the European randomized Optical Coherence Tomography Optimized Bifurcation Event Reduction Trial (OCTOBER). Am Heart J. 2018 Nov;205:97-109. doi: 10.1016/j.ahj.2018.08.003. Epub 2018 Aug 16.
- Individual participant dataSharing planned: Undecided. Is decided after primary endpoint assessment and requires regulatory approval
Related trials for Ischaemic Heart Disease
Not yet recruitingObservational study
Assessment of Transnational Performance of the Universal Cardiac Surgical Risk Score Across International Sites
Heart Valve Diseases, Cardiac Surgical Procedures
Not yet recruiting
Sirolimus-Coated Versus Paclitaxel-Coated Balloon for Recurrent Coronary In-Stent Restenosis After Prior Paclitaxel-Coated Balloon Treatment (SPRIT)
Coronary In-stent Restenosis, Coronary Artery Disease
RecruitingObservational study
Cardiovascular Risk Assessment For Kidney Transplantation - Utility of Computed Tomography Coronary Angiography in the Assessment of Patients Awaiting Kidney Transplantation
Cardiovascular Diseases, Kidney Transplant; Complications
Enrolling by invitation
The DANE-HEART Trial - Computed Tomography Coronary Angiography for Primary Prevention
Coronary Atherosclerosis and Other Heart Disease, Cardiovascular Diseases
Recruiting
CT Stress Myocardial Perfusion, Fractional Flow Reserve and Angiography in Patients With Stable Chest Pain Syndromes
Coronary Artery Disease, Chest Syndrome
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.
Evald H Christiansen, MD, PhD study chair
Aarhus University Hospital
38 sites in 13 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Angiographic guided PCI and OCT guided PCI in people with Ischaemic Heart Disease and Ischemic Heart Disease, run by Aarhus University Hospital Skejby at 38 sites in 13 countries.
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 12 inclusion and 14 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: under way, not looking for participants, as of the sponsor's last update on 18 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 38 sites in United Kingdom, Denmark, Norway, Germany, Sweden and 8 more countries. 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?
This study is still under way. Results are not available in the source record yet.
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?
Combined endpoint of major adverse cardiac events (MACE) (time frame: 24 months). 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 NCT03171311, which also lists 2 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 18 May 2026.