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TerminatedNCT01078051Updated Aug 2, 2019

Drug-Eluting Stent Implantation Versus Optimal Medical Treatment in Patients With Chronic Total Occlusion (DECISION-CTO)

A Phase 4 interventional study of Cypher, xience, Endeavor, Taxus and optimal medical therapy in Coronary Artery Disease, sponsored by Seung-Jung Park. Terminated at 26 sites in 5 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-08-02.

Sponsored by Seung-Jung Park · Phase 4, Interventional, and Treatment

Why this study was terminated
at sponsor's discretion : Benefit is not guaranteed
Phase
Phase 4
Study type
Interventional
Enrollment
840
Allocation
Randomized
Ages
18 Years and older
Sex
All
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Study summary

The purpose of this study is to compare the safety and effectiveness of drug-eluting stent implantation compared to optimal medical treatment in patients with chronic total occlusion.

Read the detailed description

Prospective, two arms, randomized multi-center trial in Asian-pacific region. Following angiography, patients with chronic total occlusion (more than 3 months) have documented myocardial ischemia or symptoms of angina, and eligible for stenting without any exclusion criteria will be randomized 1:1 to: a) drug-eluting stent vs. b) optimal medical treatment. All patients will be followed for at least 3 year.

The subjects with chronic total occlusion but failed to random for any reason, they will be enrolled in registry group.

The random design was closed at the date of 22 July 2019 however already randomized subjects and subjects from registry design continue 10 years follow-up on IRIS-CTO registry.

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Conditions studied

  • Coronary Artery Disease

Keywords

  • chronic total occlusion
  • stent
  • medical therapy
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In context

Coronary Artery Disease

5,598 studies on the registry are indexed under Coronary Artery Disease; 957 are open to participants now.

This study's enrollment of 840 is above the median of 124 across 3,436 interventional studies indexed under Coronary Artery Disease.

Browse Coronary Artery Disease studies →

Lead sponsor

Seung-Jung Park is the lead sponsor of 82 studies on the registry; 15 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

Clinical

  1. Patients with angina or silent ischemia and documented ischemia
  2. Patients who are eligible for intracoronary stenting
  3. Age > 18 years

Angiographic

  1. De novo lesion CTO
  2. Reference vessel size 2.5 mm by visual estimation
  3. At least one CTO lesions located in proximal or mid epicardial coronary artery. (If the patient has two CTO lesions, one CTO lesion should be located in proximal or mid epicardial coronary artery)

CTO definition: TIMI flow 0 and estimated duration over 3 months The duration of the occlusion was determined by the interval from the last episode of acute coronary syndrome, or In patients without a history of acute coronary syndrome, from the first episode of effort angina consistent with the location of the occlusion

  1. Angiographically defined total occlusion over 3 months
  2. If no definite symptom with total occlusion, two experienced operators decide CTO in consideration of angiographical morphology (degree of calcification, bridging collaterals, non-tapered stump, angiographic filling from collaterals)

Exclusion criteria

Exclusion Criteria:

  1. History of bleeding diathesis or coagulopathy
  2. Pregnant state
  3. Three vessel CTO
  4. Known hypersensitivity or contra-indication to contrast agent and heparin
  5. ST-elevation acute myocardial infarction requiring primary stenting
  6. Characteristics of lesion 1) Left main disease 2) In-stent restenosis 3) Graft vessels 4) Distal epicardial coronary artery CTO lesions
  7. Hematological disease
  8. Hepatic dysfunction, liver enzyme (ALT and AST) elevation 3 times normal
  9. Renal dysfunction, creatinine more than 2.0
  10. Contraindication to aspirin, clopidogrel or other commercial antiplatelet agent
  11. Left ventricular ejection fraction
  12. Patients who are actively participating in another drug or device investigational study, which have not completed the primary endpoint follow-up period.
  13. Non-cardiac co-morbid conditions are present with limited life expectancy or that may result in protocol non-compliance (per site investigator's medical judgment).
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Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
840 participants (actual)

Study arms

  • Active comparator
    Optimal medical therapy

    optimal medical therapy

    Drug: optimal medical therapy

  • Active comparator
    drug-eluting stent

    Cypher, xience, Endeavor, Taxus

    Procedure: Cypher, xience, Endeavor, Taxus

Interventions

  • ProcedureCypher, xience, Endeavor, Taxus

    all species of drug-eluting stent implantation

    Also known as: percutaneous coronary intervention

  • Drugoptimal medical therapy

    optimal medical therapy

    Also known as: intensive medical therapy

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What researchers measure

Primary outcomes

  1. Composite outcomes of all cause death, myocardial infarction, stroke, and any revascularization for 3 years after randomization

    at the median of 3 years

    Time frame: at 3 years

Secondary outcomes

  1. All Death (Cardiac death)

    Time frame: at 3 years & 5 years

  2. Angina class; Quality of life, clinical outcomes at 5 years

    Time frame: at 3 years & 5 years

  3. Myocardial infarction, stroke,any revascularization, CTO-vessel related revascularization, hospitalization due to acute coronary syndrome, left ventricular ejection fraction

    Time frame: at 3 years & 5 years

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Study locations

26 sites
  • Ruby Hall Clinic
    Pune, I, India
  • Medistra Hospital
    Jakarta, Indonesia
  • Sam Anyang Hospital
    Anyang, Korea, Republic of
  • Soonchunhyang University Hospital, Buchen
    Bucheon, Korea, Republic of
  • Soonchunhyang University Hospital, Cheonan
    Cheonan, Korea, Republic of
  • Chungbuk National University Hospital
    Cheongju, Korea, Republic of
  • Kangwon National University Hospital
    Chuncheon, Korea, Republic of
  • Keimyung University Dongsan Medical Center
    Daegu, Korea, Republic of
  • Chungnam National University Hospital
    Daejeon, Korea, Republic of
  • The Catholic University of Korea, Daejeon ST.Mary's Hospital
    Daejeon, Korea, Republic of
  • GangNeung Asan Hospital
    GangNeung, Korea, Republic of
  • Chonbuk National University Hospital
    Jeonju, Korea, Republic of
  • Chonnam National University Hospital
    Kwangju, Korea, Republic of
  • Dong-A University Medical Center
    Pusan, Korea, Republic of
  • Pusan National University Yangsan Hospital
    Pusan, Korea, Republic of
  • Asan Medical Center
    Seoul, Korea, Republic of
  • Hallym University Medical Center, Hangang Sacred Heart Hospital
    Seoul, Korea, Republic of
  • Kangbuk Samsung Hospital
    Seoul, Korea, Republic of
  • Korea University Guro Hospital
    Seoul, Korea, Republic of
  • The Catholic University of Korea, Kangnam ST.Mary's Hospital
    Seoul, Korea, Republic of
  • Bundang CHA Hospital
    Sŏngnam, Korea, Republic of
  • Ulsan University Hospital
    Ulsan, Korea, Republic of
  • Wonju Christian Hospital
    Wonju, Korea, Republic of
  • National Taiwan University hospital
    Taipei, Taiwan
  • Shin Kong Hospital
    Taipei, Taiwan
  • King chulalongkorn Memorial Hospital
    Bangkok, Thailand
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References and documents

Publications

  • Lee SW, Lee PH, Ahn JM, Park DW, Yun SC, Han S, Kang H, Kang SJ, Kim YH, Lee CW, Park SW, Hur SH, Rha SW, Her SH, Choi SW, Lee BK, Lee NH, Lee JY, Cheong SS, Kim MH, Ahn YK, Lim SW, Lee SG, Hiremath S, Santoso T, Udayachalerm W, Cheng JJ, Cohen DJ, Muramatsu T, Tsuchikane E, Asakura Y, Park SJ. Randomized Trial Evaluating Percutaneous Coronary Intervention for the Treatment of Chronic Total Occlusion. Circulation. 2019 Apr 2;139(14):1674-1683. doi: 10.1161/CIRCULATIONAHA.118.031313. PubMed 30813758 ↗
  • Azzalini L, Vo M, Dens J, Agostoni P. Myths to Debunk to Improve Management, Referral, and Outcomes in Patients With Chronic Total Occlusion of an Epicardial Coronary Artery. Am J Cardiol. 2015 Dec 1;116(11):1774-80. doi: 10.1016/j.amjcard.2015.08.050. Epub 2015 Sep 11. PubMed 26434510 ↗

Individual participant data

Plan to share: No — This is not a publicly funded trial.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 2, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT01078051
Lead sponsor
Seung-Jung Park
Collaborators
CardioVascular Research Foundation, Korea
Responsible party
Seung-Jung Park (MD,PhD, Chairman,Heart Institute, Asan Medical Center,University of Ulsan,College of Medicine, CardioVascular Research Foundation, Korea) — Sponsor-investigator
First posted
Mar 2, 2010
Start date
Mar 22, 2010
Primary completion
Jul 22, 2019
Completion
Jul 22, 2019
Last update
Aug 2, 2019

Study contacts

Seung-Jung Park, MD,PhD
principal investigator · Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is terminated, as verified in Jul 2019. You cannot join it, but the record below documents what was studied.

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