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Coronary OcclusionANGELINENCT04604197

ANGiographic Evaluation of Left Main Coronary Artery INtErvention

A study testing Angiography and Clinical Follow up and Clinical Follow up in people with Coronary Occlusion and Left Main Coronary Artery Disease, run by Fundación EPIC at 30 sites in Spain.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

To assess if an angiographic follow-up at 6 months after Percutaneous Coronary Intervention in Left Main Coronary Artery Disease decrease the composite objective of death, myocardial infarction, and stroke at 36 months. Read more about this study

Who is it for?
Ages 18 to 85 years
What is being tested?
Angiography and Clinical Follow up and Clinical Follow up
Could I receive a placebo?
No, everyone receives an active treatment
How many people
400 participants
Where
30 sitesSpain
Study dates
16 Apr 2021to 30 Apr 2027
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 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age: 18- 85 years at the date of the PCI.
  • With PCI for presenting de novo lesions in the Left Main Artery by implanting a cobalt-chrome stent with everolimus-eluting fluoropolymer.
  • Informed consent signed.

Who cannot join

  • Refusal to participate in the study.
  • Patients with left main disease who have been admitted with STEMI and have undergone primary angioplasty in a culprit lesion different than the left main. The left main lesion has been treated as a stage procedure and discharged with left ventricular ejection fraction < 35 %.
  • Previous coronary surgery.
  • Creatinine clearance <40 ml / min.
  • Contraindication for double antiaggregation after PCI.
  • Patients life expectancy <36 months.
  • Included in other studies or clinical trials.
  • Pregnant or lactating women.

Trial locations and contacts

30 sites in 1 country.

30 sites in 1 country

Spain30 sites
  • Hospital Universitario de A Coruña

    A Coruña, 15006

  • Hospital General Universitario de Albacete

    Albacete, 02006

  • Hospital General Universitario de Alicante

    Alicante, 03010

  • Hospital Universitario San Juan de Alicante

    Alicante

  • Hospital Universitari Germans Trias I Pujol

    Badalona, Barcelona, 08916

  • Hospital Universitario de Cruces

    Barakaldo, Bizkaia, 48903

  • Hospital Del Mar

    Barcelona, 08003

  • Hospital Universitari Vall D'Hebron

    Barcelona, 08035

  • Hospital Universitari Bellvitge

    Barcelona, 08907

  • Hospital Universitario de Ciudad Real

    Ciudad Real, 13005

  • Hospital Universitario Reina Sofia

    Córdoba, 14004

  • Hospital Universitario Donostia

    Donostia / San Sebastian, Gipuzkoa, 20014

  • Hospital Galdakao-Usansolo

    Galdakao, Vizcaya, 48960

  • Hospital Universitario de Cabueñes

    Gijón, 33394

  • Hospital Universitario Virgen de Las Nieves

    Granada, 18014

  • Hospital General Juan Ramón Jiménez

    Huelva, 21005

  • Hospital Universitario de León

    León, 24071

  • Hospital Universitario Lucus Agusti

    Lugo, 27003

  • Hospital Universitario La Princesa

    Madrid, 28006

  • Hospital Universitario Ramon Y Cajal

    Madrid, 28034

  • Hospital Universitario 12 de Octubre

    Madrid, 28041

  • Hospital Universitario La Paz

    Madrid, 28046

  • Hospital Universitario Regional de Malaga

    Málaga, Malaga, 29010

  • Hospital Universitario Virgen Arrixaca

    Murcia, 30120

  • Hospital Universitario Marques de Valdecilla

    Santander, 39008

  • Hospital Clínico Universitario de Santiago de Compostela

    Santiago de Compostela, 15706

  • Hospital Clinico Universitario de Valencia

    Valencia, 46010

  • Hospital Clinico Universitario de Valladolid

    Valladolid, 47003

  • Hospital Clinico Universitario Lozano Blesa

    Zaragoza, 50009

  • Hospital Universitario Miguel Servet

    Zaragoza, 50009

Other trials in Spain

About this study

To assess if an angiographic follow-up at 6 months after Percutaneous Coronary Intervention in Left Main Coronary Artery Disease decrease the composite objective of death, myocardial infarction, and stroke at 36 months.

Read the detailed description

Percutaneous coronary intervention (PCI) with drug-eluting stents in left main (LM) disease has demonstrated similar results than surgical revascularization in patients with SYNTAX score < 33, being the main drawback of PCI a higher rate of new revascularization. A small study found a reduction in the composite end-point of cardiac death, myocardial infarction and urgent revascularization with a routine angiographic follow-up. The investigators have designed a prospective, randomized, controlled, two-arm multicenter study in patients aged 18-85 with LM disease and SYNTAX score <33 and in cases ≥ 33 based on the Heart Team decision to assess the benefit of a routine angiographic follow-up 6 months after LM stenting. After the index procedure and before hospital discharge the patient will be randomized to routine invasive angiographic follow-up at 6 months plus clinical follow-up at 6 months, 1, 2 and 3 years vs. the control arm, which would be followed clinically at 6 months, 1, 2 and 3 years. Based on our calculations, an adequately powered trial would require 1009 patients per arm but due to the uncertainty of the results and the current economical restrictions we have designed a pilot study in 400 patients to find out the convenience of an adequately powered trial. All the lesions should be treated with an everolimus eluting stent with permanent fluoropolymer. It will be desirable to achieve complete revascularization and it will be highly recommended to perform the procedures guided with an intravascular image technique (OCT or IVUS (IntraVascular UltraSound) according to operator´s criteria). The main outcome will be death, myocardial infarction and cerebrovascular accident at 3 years. The initial percutaneous technique and the decision about the convenience and way of revascularization in case of restenosis in the follow-up will be left at the operator´s discretion, according in the most adequate way to the current guidelines. Nonetheless, the investigators are strongly encouraged to rely on intravascular techniques, based on either imaging or physiology. In those cases with in-stent hyperplasia with doubts about possible restenosis, FFR and RFR (Resting full-cycle ratio) will be performed, with low threshold to achieve a high rate of ruling out the restenosis.

Being tested
Angiography and Clinical Follow up, Clinical Follow up
Keywords
Angiography
Medical subject headings
Coronary Occlusion, Coronary Artery Disease, Coronary Stenosis, Coronary Disease

What participants receive

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

  • Angiography and Clinical Follow upOther

    Angiography and Clinical Follow up

  • Clinical Follow upOther

    Clinical Follow up

Study groups in NCT04604197
Study groupRoleWhat they receive
Angiography and Clinical Follow upExperimentalAfter PCI. The patient is randomized to an angiographic follow-up at 6 months and a Clinical Follow to 36 months
Receives: Other: Angiography and Clinical Follow up
Clinical Follow upActive comparatorAfter PCI. The patient is randomized to a Clinical Follow to 36 months
Receives: Other: Clinical Follow up

What is being measured

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

  1. Composite endpoint: defined as : death, myocardial infarction, and stroke.

    Composite endpoint: defined as : death, myocardial infarction, and stroke.

    Measured: 36 months

Secondary outcomes (8)
  1. All Death

    Occurrence of Death

    Measured: 36 months

  2. Cardiac Death

    Occurrence of Cardiac Death

    Measured: 36 months

  3. Myocardial Infarction

    Occurrence of Myocardial Infarction

    Measured: 36 months

  4. Stroke

    Occurrence of Stroke

    Measured: 36 months

  5. Stent thrombosis (ARC definite/probable)

    Occurrence of thrombosis (ARC definite/probable)

    Measured: 36 months

  6. Major bleeding event (BARC type 2-5)

    Occurrence of Major bleeding event (BARC type 2-5)

    Measured: 36 months

  7. Target Vessel revascularization.

    Occurrence of Target Vessel revascularization.

    Measured: 36 months

  8. Revascularization by CABG ( Coronary Artery Bypass Grafting) or PCI (Percutaneous Coronary Intervention)

    Occurrence of New revascularization by CABG or PCI

    Measured: 36 months

Timeline

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

  1. First posted27 Oct 2020
  2. Study start16 Apr 2021
  3. Primary completion31 Mar 2027 (estimated)
  4. Study completion30 Apr 2027 (estimated)

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
400 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04604197
Sponsor's protocol ID
EPIC23-ANGELINE
Acronym
ANGELINE
Status last verified
Oct 2026
First submitted
21 Oct 2020
Last updated
8 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Cavalcante R, Sotomi Y, Lee CW, Ahn JM, Farooq V, Tateishi H, Tenekecioglu E, Zeng Y, Suwannasom P, Collet C, Albuquerque FN, Onuma Y, Park SJ, Serruys PW. Outcomes After Percutaneous Coronary Intervention or Bypass Surgery in Patients With Unprotected Left Main Disease. J Am Coll Cardiol. 2016 Sep 6;68(10):999-1009. doi: 10.1016/j.jacc.2016.06.024.

    PubMed 27585503
  • Puri R, de la Torre Hernandez JM, Auffret V. Routine Surveillance Coronary Angiography Post-PCI: Should We ReACT and Change Our Routine? JACC Cardiovasc Interv. 2017 Jan 23;10(2):118-120. doi: 10.1016/j.jcin.2016.11.020. Epub 2016 Dec 28. No abstract available.

    PubMed 28040444
  • Aurigemma C, Burzotta F, Porto I, Niccoli G, Leone AM, Crea F, Trani C. Clinical impact of routine angiographic follow-up after percutaneous coronary interventions on unprotected left main. Cardiol J. 2018;25(5):582-588. doi: 10.5603/CJ.a2018.0092. Epub 2018 Aug 29.

    PubMed 30155864
  • Stone GW, Sabik JF, Serruys PW, Simonton CA, Genereux P, Puskas J, Kandzari DE, Morice MC, Lembo N, Brown WM 3rd, Taggart DP, Banning A, Merkely B, Horkay F, Boonstra PW, van Boven AJ, Ungi I, Bogats G, Mansour S, Noiseux N, Sabate M, Pomar J, Hickey M, Gershlick A, Buszman P, Bochenek A, Schampaert E, Page P, Dressler O, Kosmidou I, Mehran R, Pocock SJ, Kappetein AP; EXCEL Trial Investigators. Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease. N Engl J Med. 2016 Dec 8;375(23):2223-2235. doi: 10.1056/NEJMoa1610227. Epub 2016 Oct 31.

    PubMed 27797291
  • Makikallio T, Holm NR, Lindsay M, Spence MS, Erglis A, Menown IB, Trovik T, Eskola M, Romppanen H, Kellerth T, Ravkilde J, Jensen LO, Kalinauskas G, Linder RB, Pentikainen M, Hervold A, Banning A, Zaman A, Cotton J, Eriksen E, Margus S, Sorensen HT, Nielsen PH, Niemela M, Kervinen K, Lassen JF, Maeng M, Oldroyd K, Berg G, Walsh SJ, Hanratty CG, Kumsars I, Stradins P, Steigen TK, Frobert O, Graham AN, Endresen PC, Corbascio M, Kajander O, Trivedi U, Hartikainen J, Anttila V, Hildick-Smith D, Thuesen L, Christiansen EH; NOBLE study investigators. Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): a prospective, randomised, open-label, non-inferiority trial. Lancet. 2016 Dec 3;388(10061):2743-2752. doi: 10.1016/S0140-6736(16)32052-9. Epub 2016 Oct 31.

    PubMed 27810312
  • Stone GW, Kappetein AP, Sabik JF, Pocock SJ, Morice MC, Puskas J, Kandzari DE, Karmpaliotis D, Brown WM 3rd, Lembo NJ, Banning A, Merkely B, Horkay F, Boonstra PW, van Boven AJ, Ungi I, Bogats G, Mansour S, Noiseux N, Sabate M, Pomar J, Hickey M, Gershlick A, Buszman PE, Bochenek A, Schampaert E, Page P, Modolo R, Gregson J, Simonton CA, Mehran R, Kosmidou I, Genereux P, Crowley A, Dressler O, Serruys PW; EXCEL Trial Investigators. Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease. N Engl J Med. 2019 Nov 7;381(19):1820-1830. doi: 10.1056/NEJMoa1909406. Epub 2019 Sep 28.

    PubMed 31562798

Questions about this trial

What is this clinical trial studying?

A study testing Angiography and Clinical Follow up and Clinical Follow up in people with Coronary Occlusion and Left Main Coronary Artery Disease, run by Fundación EPIC at 30 sites in Spain.

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 3 inclusion and 8 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 8 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 30 sites in Spain. 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?

Composite endpoint: defined as : death, myocardial infarction, and stroke. (time frame: 36 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 NCT04604197, which also lists 6 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 8 Oct 2026.

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