Ischemic Heart DiseaseNCT03795714
Association Between IVUS and OCT Parameters and Invasive Physiologic Indices
An observational study of Ischemic Heart Disease, run by Seoul National University Hospital at 2 sites in South Korea.
Trial summary
1. to evaluate diagnostic accuracy and performance of IVUS and OCT-derived quantitative parameters to predict functional significance of stenosis defined using all the available physiologic indices. 2. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Ischemic Heart Disease
- What is being tested?
- IVUS or OCT and Invasive physiologic indices
- How many people
- 166 participants
- Where
- 2 sitesSouth Korea
- Study dates
- 17 Nov 2017to 31 Mar 2019
- 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: 330 patients with suspected ischemic heart disease and who underwent IVUS or OCT assessment and invasive physiologic assessment.
Who may be able to join
- Patients who suspected ischemic heart disease, and underwent invasive physiologic assessment and intravascular ultrasound
Who cannot join
- Cardiogenic shock
- Graft vessel
- In-stent restenosis
Trial locations and contacts
2 sites in 1 country.
South Korea2 sites, 2 recruiting
- Recruiting
Samsung Medical Center
Seoul, 06351
Joo Myung Lee, MD, MPH, PhD, drone80@hanmail.net
Ki Hong Choi, MD, cardiokh@gmail.com
- Recruiting
Seoul national university hospital
Seoul, 110-744
Bon-kown Koo, MD/PhD, 82-2-2072-2062, bkkoo@snu.ac.kr
Bon-kwon Koo, MD/PhD
About this study
Official title: Intravascular Ultrasound and Optical Coherence Tomography-Defined Optimal Criteria and Plaque Characteristics for Defining the Functional Significance of Coronary Stenoses Using Resting and Hyperemic Physiologic Indices
- to evaluate diagnostic accuracy and performance of IVUS and OCT-derived quantitative parameters to predict functional significance of stenosis defined using all the available physiologic indices.
- to explores the association between intravascular imaging-derived plaque characteristics and invasive physiologic indices.
Read the detailed description
Given the inherent limitations of coronary angiography to depict the presence of functionally significant epicardial coronary stenosis and discrepancy between angiographic stenosis severity and the presence of myocardial ischemia, invasive physiologic indices such as fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) has been a standard method to guide decision of revascularization.
Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are an intracoronary imaging method able to provide information about lumen area, vessel area, plaque burden, and plaque characteristics that can be used for the guidance of revascularization procedure. Several previous studies explored the diagnostic performance of intravascular imaging-defined quantitative parameters to predict functional significance defined by FFR, however, quantitative parameter derived from intravascular imaging showed only moderate diagnostic accuracy and the optimal cut-off value of intravascular imaging-derived minimal lumen area (MLA) or minimal lumen diameter (MLD) were varied according to the patient population, interrogated vessels, and the location of target lesions, suggesting limited clinical relevance of judging functional significance of target stenosis using intravascular imaging alone. Nevertheless, the adoption rate of FFR-guided decision has been limited due to various reasons and intravascular image-guided decision has been still used in substantial proportion of the patients.
Recently, new resting pressure-derived indices including resting full-cycle ratio (RFR) or diastolic pressure ratio (dPR) have been introduced as other substitutes for iFR, which does not require administration of hyperemic agents, therefore, possess more convenient in daily practice. Recent study with the largest sample size demonstrated identical diagnostic property and prognostic implication among iFR, RFR, and dPR. As those resting pressure-derived indices might have more generalizability for daily practice, it is expected to raise the adoption rate of physiologic interrogation. Therefore, understanding the association between all the available physiologic indices and intravascular imaging-derived quantitative and qualitative parameters might be important in clinical decision for patient who underwent invasive coronary angiography.
In this regard, the investigators sought to evaluate diagnostic accuracy and performance of intravascular imaging-derived quantitative parameters to predict functional significance of stenosis defined using all the available physiologic indices and further explores the association between IVUS and OCT-derived plaque characteristics and invasive physiologic indices.
- Conditions
- Ischemic Heart Disease
- Being tested
- IVUS or OCT and Invasive physiologic indices
- Keywords
- Intravascular Ultrasound, Optical Coherence Tomography, Fractional Flow Reserve, Diastolic Pressure Ratio, Resting Full-Cycle Ratio, Ischemic Heart Disease, Instantaneous Wave-free Ratio
- Medical subject headings
- Myocardial Ischemia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
IVUS or OCT and Invasive physiologic indicesDiagnostic test
IVUS or OCT measurement in order to evaluate the lesion morphology and stent optimization, and invasive physiologic measurement in order to functional significance of epicardial stenosis
| Study group | Role | What they receive |
|---|---|---|
| Intravascular Imaging and Physiologic Assessment | 330 patients with suspected ischemic heart disease and who underwent IVUS or OCT assessment and invasive physiologic assessment. Receives: Diagnostic Test: IVUS or OCT and Invasive physiologic indices |
What is being measured
The primary outcome is the main question the study is designed to answer.
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by fractional flow reserve (FFR)
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by instantaneous wave-free ratio (iFR)
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by diastolic pressure ratio (dPR)
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by resting full-cycle ratio (RFR)
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by FFR
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by iFR
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by dPR
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by RFR
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by FFR
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by iFR
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by dPR
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by RFR
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Diagnostic accuracy of plaque burden assessed by intravascular imaging to predict functional significance assessed by FFR
Diagnostic accuracy of plaque burden assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Diagnostic accuracy of plaque burden assessed by IVUS to predict functional significance assessed by iFR
Diagnostic accuracy of plaque burden assessed by IVUS to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Diagnostic accuracy of plaque burden assessed by IVUS to predict functional significance assessed by dPR
Diagnostic accuracy of plaque burden assessed by IVUS to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Diagnostic accuracy of plaque burden assessed by intravascular imaging to predict functional significance assessed by RFR
Diagnostic accuracy of plaque burden assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Secondary outcomes (64)
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by FFR
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by iFR
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by dPR
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by RFR
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by FFR
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by iFR
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by dPR
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by RFR
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by FFR
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by iFR
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by dPR
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by RFR
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Sensitivity of plaque burden assessed by intravascular imaging to predict functional significance assessed by FFR
Sensitivity of plaque burden assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Sensitivity of plaque burden assessed by intravascular imaging to predict functional significance assessed by iFR
Sensitivity of plaque burden assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Sensitivity of plaque burden assessed by intravascular imaging to predict functional significance assessed by dPR
Sensitivity of plaque burden assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Sensitivity of plaque burden assessed by intravascular imaging to predict functional significance assessed by RFR
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by FFR
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by iFR
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by dPR
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by RFR
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by FFR
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by iFR
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by dPR
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by RFR
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by FFR
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by iFR
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by dPR
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by RFR
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Specificity of plaque burden assessed by intravascular imaging to predict functional significance assessed by FFR
Specificity of plaque burden assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Measured: During Cardiac Cath
Specificity of plaque burden assessed by intravascular imaging to predict functional significance assessed by iFR
Specificity of plaque burden assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Measured: During Cardiac Cath
Specificity of plaque burden assessed by intravascular imaging to predict functional significance assessed by dPR
Specificity of plaque burden assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Measured: During Cardiac Cath
Specificity of plaque burden assessed by intravascular imaging to predict functional significance assessed by RFR
Specificity of plaque burden assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Measured: During Cardiac Cath
Linear correlation between percent diameter stenosis and FFR
Linear regression analysis between percent diameter stenosis and FFR
Measured: During Cardiac Cath
Linear correlation between percent diameter stenosis and iFR
Linear regression analysis between percent diameter stenosis and iFR
Measured: During Cardiac Cath
Linear correlation between percent diameter stenosis and dPR
Linear regression analysis between percent diameter stenosis and dPR
Measured: During Cardiac Cath
Linear correlation between percent diameter stenosis and RFR
Linear regression analysis between percent diameter stenosis and RFR
Measured: During Cardiac Cath
Linear correlation between minimal lumen diameter and FFR
Linear regression analysis between minimal lumen diameter and FFR
Measured: During Cardiac Cath
Linear correlation between minimal lumen diameter and iFR
Linear regression analysis between minimal lumen diameter and iFR
Measured: During Cardiac Cath
Linear correlation between minimal lumen diameter and dPR
Linear regression analysis between minimal lumen diameter and dPR
Measured: During Cardiac Cath
Linear correlation between minimal lumen diameter and RFR
Linear regression analysis between minimal lumen diameter and RFR
Measured: During Cardiac Cath
Linear correlation between minimal lumen area and FFR
Linear regression analysis between minimal lumen area and FFR
Measured: During Cardiac Cath
Linear correlation between minimal lumen area and iFR
Linear regression analysis between minimal lumen area and iFR
Measured: During Cardiac Cath
Linear correlation between minimal lumen area and dPR
Linear regression analysis between minimal lumen area and dPR
Measured: During Cardiac Cath
Linear correlation between minimal lumen area and RFR
Linear regression analysis between minimal lumen area and RFR
Measured: During Cardiac Cath
Linear correlation between plaque burden and FFR
Linear regression analysis between plaque burden and FFR
Measured: During Cardiac Cath
Linear correlation between plaque burden and iFR
Linear regression analysis between plaque burden and iFR
Measured: During Cardiac Cath
Linear correlation between plaque burden and dPR
Linear regression analysis between plaque burden and dPR
Measured: During Cardiac Cath
Linear correlation between plaque burden and RFR
Linear regression analysis between plaque burden and RFR
Measured: During Cardiac Cath
Discriminatory function of percent diameter stenosis to predict functional significance assessed by FFR
Discriminatory function of percent diameter stenosis to predict functional significance defined by FFR≤0.80
Measured: During Cardiac Cath
Discriminatory function of percent diameter stenosis to predict functional significance assessed by iFR
Discriminatory function of percent diameter stenosis to predict functional significance defined by iFR≤0.89
Measured: During Cardiac Cath
Discriminatory function of percent diameter stenosis to predict functional significance assessed by dPR
Discriminatory function of percent diameter stenosis to predict functional significance defined by dPR≤0.89
Measured: During Cardiac Cath
Discriminatory function of percent diameter stenosis to predict functional significance assessed by RFR
Discriminatory function of percent diameter stenosis to predict functional significance defined by RFR≤0.89
Measured: During Cardiac Cath
Discriminatory function of minimal lumen diameter to predict functional significance assessed by FFR
Discriminatory function of minimal lumen diameter to predict functional significance defined by FFR≤0.80
Measured: During Cardiac Cath
Discriminatory function of minimal lumen diameter to predict functional significance assessed by iFR
Discriminatory function of minimal lumen diameter to predict functional significance defined by iFR≤0.89
Measured: During Cardiac Cath
Discriminatory function of minimal lumen diameter to predict functional significance assessed by dPR
Discriminatory function of minimal lumen diameter to predict functional significance defined by dPR≤0.89
Measured: During Cardiac Cath
Discriminatory function of minimal lumen diameter to predict functional significance assessed by RFR
Discriminatory function of minimal lumen diameter to predict functional significance defined by RFR≤0.89
Measured: During Cardiac Cath
Discriminatory function of minimal lumen area to predict functional significance assessed by FFR
Discriminatory function of minimal lumen area to predict functional significance defined by FFR≤0.80
Measured: During Cardiac Cath
Discriminatory function of minimal lumen area to predict functional significance assessed by iFR
Discriminatory function of minimal lumen area to predict functional significance defined by iFR≤0.89
Measured: During Cardiac Cath
Discriminatory function of minimal lumen area to predict functional significance assessed by dPR
Discriminatory function of minimal lumen area to predict functional significance defined by dPR≤0.89
Measured: During Cardiac Cath
Discriminatory function of minimal lumen area to predict functional significance assessed by RFR
Discriminatory function of minimal lumen area to predict functional significance defined by RFR≤0.89
Measured: During Cardiac Cath
Discriminatory function of plaque burden to predict functional significance assessed by FFR
Discriminatory function of plaque burden to predict functional significance defined by FFR≤0.80
Measured: During Cardiac Cath
Discriminatory function of plaque burden to predict functional significance assessed by iFR
Discriminatory function of plaque burden to predict functional significance defined by iFR≤0.89
Measured: During Cardiac Cath
Discriminatory function of plaque burden to predict functional significance assessed by dPR
Discriminatory function of plaque burden to predict functional significance defined by dPR≤0.89
Measured: During Cardiac Cath
Discriminatory function of plaque burden to predict functional significance assessed by RFR
Discriminatory function of plaque burden to predict functional significance defined by RFR≤0.89
Measured: During Cardiac Cath
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Jan 2019
- Study start17 Nov 2017
- Primary completion31 Jan 2019 (estimated)
- Study completion31 Mar 2019 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Ischemic Heart DiseaseStudies of the same condition, open and under way.
- More trials run by Seoul National University HospitalThe 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 only
- Time perspective
- Retrospective
- Enrolment
- 166 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Seoul National University Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Samsung Medical Center
- Responsible party
- Principal investigator, Bon-Kwon Koo, Seoul National University Hospital
- Investigators
- Bon-Kwon Koo, MD, PhD, Study chair, ProfessorJoo Myung Lee, MD, MPH, PhD, Principal investigator, Assistant Professor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03795714
- Sponsor's protocol ID
- IVUS2017-11-056-001
- Status last verified
- Jan 2019
- First submitted
- 28 Dec 2018
- Last updated
- 22 Jan 2019
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Lee JM, Choi KH, Koo BK, Zhang J, Han JK, Yang HM, Park KW, Song YB, Hahn JY, Choi SH, Gwon HC, Kim HS. Intravascular ultrasound or optical coherence tomography-defined anatomic severity and hemodynamic severity assessed by coronary physiologic indices. Rev Esp Cardiol (Engl Ed). 2020 Oct;73(10):812-821. doi: 10.1016/j.rec.2019.11.001. Epub 2019 Dec 4. English, Spanish.
PubMed 31812517
Study at a glance
From the registry record, last updated by the sponsor on 22 Jan 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Intravascular Ultrasound and Optical Coherence Tomography-Defined Optimal Criteria and Plaque Characteristics for Defining the Functional Significance of Coronary Stenoses Using Resting and Hyperemic Physiologic Indices
- ClinicalTrials.gov ID
- NCT03795714
- Acronym / sponsor ID
- IVUS2017-11-056-001
- Conditions
- Ischemic Heart Disease
- Keywords
- Intravascular Ultrasound, Optical Coherence Tomography, Fractional Flow Reserve, Diastolic Pressure Ratio, Resting Full-Cycle Ratio, Ischemic Heart Disease, Instantaneous Wave-free Ratio
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 166 participants (estimated)
- Lead sponsor
- Seoul National University HospitalUniversity, hospital or other
- Collaborators
- Samsung Medical Center
- Study start
- 17 Nov 2017 (actual)
- Primary completion
- 31 Jan 2019 (estimated)
- Study completion
- 31 Mar 2019 (estimated)
- First posted
- 8 Jan 2019 (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.
- to evaluate diagnostic accuracy and performance of IVUS and OCT-derived quantitative parameters to predict functional significance of stenosis defined using all the available physiologic indices.
- to explores the association between intravascular imaging-derived plaque characteristics and invasive physiologic indices.
Detailed description
Given the inherent limitations of coronary angiography to depict the presence of functionally significant epicardial coronary stenosis and discrepancy between angiographic stenosis severity and the presence of myocardial ischemia, invasive physiologic indices such as fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) has been a standard method to guide decision of revascularization.
Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are an intracoronary imaging method able to provide information about lumen area, vessel area, plaque burden, and plaque characteristics that can be used for the guidance of revascularization procedure. Several previous studies explored the diagnostic performance of intravascular imaging-defined quantitative parameters to predict functional significance defined by FFR, however, quantitative parameter derived from intravascular imaging showed only moderate diagnostic accuracy and the optimal cut-off value of intravascular imaging-derived minimal lumen area (MLA) or minimal lumen diameter (MLD) were varied according to the patient population, interrogated vessels, and the location of target lesions, suggesting limited clinical relevance of judging functional significance of target stenosis using intravascular imaging alone. Nevertheless, the adoption rate of FFR-guided decision has been limited due to various reasons and intravascular image-guided decision has been still used in substantial proportion of the patients.
Recently, new resting pressure-derived indices including resting full-cycle ratio (RFR) or diastolic pressure ratio (dPR) have been introduced as other substitutes for iFR, which does not require administration of hyperemic agents, therefore, possess more convenient in daily practice. Recent study with the largest sample size demonstrated identical diagnostic property and prognostic implication among iFR, RFR, and dPR. As those resting pressure-derived indices might have more generalizability for daily practice, it is expected to raise the adoption rate of physiologic interrogation. Therefore, understanding the association between all the available physiologic indices and intravascular imaging-derived quantitative and qualitative parameters might be important in clinical decision for patient who underwent invasive coronary angiography.
In this regard, the investigators sought to evaluate diagnostic accuracy and performance of intravascular imaging-derived quantitative parameters to predict functional significance of stenosis defined using all the available physiologic indices and further explores the association between IVUS and OCT-derived plaque characteristics and invasive physiologic indices.
Study design
- Observational model
- Case only
- Time perspective
- Retrospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Intravascular Imaging and Physiologic Assessment | – | Diagnostic Test: IVUS or OCT and Invasive physiologic indices330 patients with suspected ischemic heart disease and who underwent IVUS or OCT assessment and invasive physiologic assessment. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
- Study population
- 330 patients with suspected ischemic heart disease and who underwent IVUS or OCT assessment and invasive physiologic assessment.
Key inclusion criteria (1 listed)
- Patients who suspected ischemic heart disease, and underwent invasive physiologic assessment and intravascular ultrasound
Key exclusion criteria (3 listed)
- Cardiogenic shock
- Graft vessel
- In-stent restenosis
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 |
|---|---|---|
| IVUS or OCT and Invasive physiologic indicesIVUS or OCT measurement in order to evaluate the lesion morphology and stent optimization, and invasive physiologic measurement in order to functional significance of epicardial stenosis | Diagnostic test | Intravascular Imaging and Physiologic Assessment |
Primary outcome
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by fractional flow reserve (FFR)
Time frame: During Cardiac Cath
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by instantaneous wave-free ratio (iFR)
Time frame: During Cardiac Cath
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by diastolic pressure ratio (dPR)
Time frame: During Cardiac Cath
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by resting full-cycle ratio (RFR)
Time frame: During Cardiac Cath
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by FFR
Time frame: During Cardiac Cath
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by iFR
Time frame: During Cardiac Cath
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by dPR
Time frame: During Cardiac Cath
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by RFR
Time frame: During Cardiac Cath
Diagnostic accuracy of minimal lumen diameter assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by FFR
Time frame: During Cardiac Cath
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by iFR
Time frame: During Cardiac Cath
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance defined by iFR ≤0.89
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by dPR
Time frame: During Cardiac Cath
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance defined by dPR ≤0.89
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by RFR
Time frame: During Cardiac Cath
Diagnostic accuracy of minimal lumen area assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
Diagnostic accuracy of plaque burden assessed by intravascular imaging to predict functional significance assessed by FFR
Time frame: During Cardiac Cath
Diagnostic accuracy of plaque burden assessed by intravascular imaging to predict functional significance defined by FFR ≤0.80
Diagnostic accuracy of plaque burden assessed by IVUS to predict functional significance assessed by iFR
Time frame: During Cardiac Cath
Diagnostic accuracy of plaque burden assessed by IVUS to predict functional significance defined by iFR ≤0.89
Diagnostic accuracy of plaque burden assessed by IVUS to predict functional significance assessed by dPR
Time frame: During Cardiac Cath
Diagnostic accuracy of plaque burden assessed by IVUS to predict functional significance defined by dPR ≤0.89
Diagnostic accuracy of plaque burden assessed by intravascular imaging to predict functional significance assessed by RFR
Time frame: During Cardiac Cath
Diagnostic accuracy of plaque burden assessed by intravascular imaging to predict functional significance defined by RFR ≤0.89
64 secondary outcomes
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by FFR
Time frame: During Cardiac Cath
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by iFR
Time frame: During Cardiac Cath
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by dPR
Time frame: During Cardiac Cath
Sensitivity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by RFR
Time frame: During Cardiac Cath
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by FFR
Time frame: During Cardiac Cath
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by iFR
Time frame: During Cardiac Cath
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by dPR
Time frame: During Cardiac Cath
Sensitivity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by RFR
Time frame: During Cardiac Cath
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by FFR
Time frame: During Cardiac Cath
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by iFR
Time frame: During Cardiac Cath
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by dPR
Time frame: During Cardiac Cath
Sensitivity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by RFR
Time frame: During Cardiac Cath
Sensitivity of plaque burden assessed by intravascular imaging to predict functional significance assessed by FFR
Time frame: During Cardiac Cath
Sensitivity of plaque burden assessed by intravascular imaging to predict functional significance assessed by iFR
Time frame: During Cardiac Cath
Sensitivity of plaque burden assessed by intravascular imaging to predict functional significance assessed by dPR
Time frame: During Cardiac Cath
Sensitivity of plaque burden assessed by intravascular imaging to predict functional significance assessed by RFR
Time frame: During Cardiac Cath
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by FFR
Time frame: During Cardiac Cath
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by iFR
Time frame: During Cardiac Cath
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by dPR
Time frame: During Cardiac Cath
Specificity of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by RFR
Time frame: During Cardiac Cath
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by FFR
Time frame: During Cardiac Cath
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by iFR
Time frame: During Cardiac Cath
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by dPR
Time frame: During Cardiac Cath
Specificity of minimal lumen diameter assessed by intravascular imaging to predict functional significance assessed by RFR
Time frame: During Cardiac Cath
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by FFR
Time frame: During Cardiac Cath
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by iFR
Time frame: During Cardiac Cath
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by dPR
Time frame: During Cardiac Cath
Specificity of minimal lumen area assessed by intravascular imaging to predict functional significance assessed by RFR
Time frame: During Cardiac Cath
Specificity of plaque burden assessed by intravascular imaging to predict functional significance assessed by FFR
Time frame: During Cardiac Cath
Specificity of plaque burden assessed by intravascular imaging to predict functional significance assessed by iFR
Time frame: During Cardiac Cath
Specificity of plaque burden assessed by intravascular imaging to predict functional significance assessed by dPR
Time frame: During Cardiac Cath
Specificity of plaque burden assessed by intravascular imaging to predict functional significance assessed by RFR
Time frame: During Cardiac Cath
Linear correlation between percent diameter stenosis and FFR
Time frame: During Cardiac Cath
Linear correlation between percent diameter stenosis and iFR
Time frame: During Cardiac Cath
Linear correlation between percent diameter stenosis and dPR
Time frame: During Cardiac Cath
Linear correlation between percent diameter stenosis and RFR
Time frame: During Cardiac Cath
Linear correlation between minimal lumen diameter and FFR
Time frame: During Cardiac Cath
Linear correlation between minimal lumen diameter and iFR
Time frame: During Cardiac Cath
Linear correlation between minimal lumen diameter and dPR
Time frame: During Cardiac Cath
Linear correlation between minimal lumen diameter and RFR
Time frame: During Cardiac Cath
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jan 2019.
- Derived from this study: PubMed 31812517Lee JM, Choi KH, Koo BK, Zhang J, Han JK, Yang HM, Park KW, Song YB, Hahn JY, Choi SH, Gwon HC, Kim HS. Intravascular ultrasound or optical coherence tomography-defined anatomic severity and hemodynamic severity assessed by coronary physiologic indices. Rev Esp Cardiol (Engl Ed). 2020 Oct;73(10):812-821. doi: 10.1016/j.rec.2019.11.001. Epub 2019 Dec 4. English, Spanish.
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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.
Bon-Kwon Koo, MD, PhD study chair
Professor
Joo Myung Lee, MD, MPH, PhD principal investigator
Assistant Professor
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Ischemic Heart Disease, run by Seoul National University Hospital at 2 sites in South Korea.
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 1 inclusion and 3 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: status not confirmed, as of the sponsor's last update on 22 Jan 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in South Korea. 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?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Joo Myung Lee, MD, MPH, PhD (82-10-8884-8439, drone80@hanmail.net), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Diagnostic accuracy of percent diameter stenosis assessed by intravascular imaging to predict functional significance assessed by fractional flow reserve (FFR) (time frame: During Cardiac Cath). The study lists 16 primary outcomes in all. 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 NCT03795714, which also lists 1 linked publication.
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 22 Jan 2019; AzTrials last refreshed its copy on 31 Oct 2026.