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Status unknownNCT03291925CT-CAUpdated Sep 25, 2017

Primary Non-invasive Cardiac Computed Tomography Versus Routine Invasive Angiography Prior to TAVI

An interventional study of Selective invasive angiography based on CT/CCTA imaging. and Procedure/Surgery: Invasive angiography in Severe Aortic Stenosis and Transcatheter Aortic Valve Implantation, sponsored by BC Centre for Improved Cardiovascular Health. Status unknown at 1 site in Canada. Per ClinicalTrials.gov, last updated 2017-09-25.

Sponsored by BC Centre for Improved Cardiovascular Health · Not applicable, Interventional, and Other

The sponsor has not verified this record recently (last verified Sep 2017), so the status shown — last known as Recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
200
Allocation
Randomized
Sex
All
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Study summary

This pilot study is a prospective, randomized, open-label trial that aims to assess the feasibility of comparing a primary Computed tomography/Cardiac computed tomography angiography (CT/CCTA) strategy (test arm) to a strategy combining routine use of CT/CCTA and invasive CA (control arm) prior to a Transcatheter aortic valve implantation (TAVI) procedure. The study will also estimate the rate of composite coronary adverse events (myocardial infarction, post procedural coronary revascularization and cardiovascular mortality) between the two arms at 90 days follow-up. The primary endpoint will be the feasibility of recruitment and compliance with the study protocol at 2 sites in Canada and 1 site in Denmark. Additional clinical endpoints including: all-cause death at 90 days post procedure, myocardial infarction at 90 days post procedure, unplanned PCI or CABG at 90 days post procedure, stroke at 90 days post procedure, CA and PCI related cumulative vascular complications events. This information will be used to inform the design of the definitive efficacy trial.

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Conditions studied

  • Severe Aortic Stenosis
  • Transcatheter Aortic Valve Implantation

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03

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Severe aortic stenosis (Peak transvalvular gradient of ≥ 40mmHg on TTE or stress Echo, Aortic valve area of \< 1.0cm2)
  • Symptoms suggestive of aortic stenosis (dyspnea, syncope, angina)
  • Eligible for TAVI (Upon evaluation by a multidisciplinary team composed of at least one interventional cardiologist and one cardiothoracic surgeon)

Exclusion criteria

Exclusion Criteria:

  • Severe renal dysfunction Glomerular filtration rate \< 30 ml/min.
  • Severe left ventricular dysfunction LVEF ≤ 30%
  • Recent coronary angiography ≤ 6months from randomization
  • Recent PCI ≤ 6months from randomization
  • Recent or active acute coronary syndrome (New or worsening angina with or without positive biomarkers or ECG changes).
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Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
200 participants (estimated)

Study arms

  • Experimental
    Selective invasive angiography based on CT/CCTA imaging

    Patients will undergo selective invasive angiography based on CT/CCTA imaging. Decision to procede with additional invasive CA will be based on adequacy of CT/CCTA evaluation and likelihood of significant coronary artery disease.

    Procedure: Selective invasive angiography based on CT/CCTA imaging.

  • Active comparator
    Invasive Cardiac Angiography

    Patients will undergo systematic invasive angiography.

    Procedure: Procedure/Surgery: Invasive angiography

Interventions

  • ProcedureSelective invasive angiography based on CT/CCTA imaging.
  • ProcedureProcedure/Surgery: Invasive angiography
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What researchers measure

Primary outcomes

  1. Number of patients enrolled in the study of all those that are eligible

    This is the primary outcome for this pilot study to assess feasibility of a larger trial.

    Time frame: 18 months

Secondary outcomes

  1. All-cause mortality

    Time frame: 90 days

  2. Myocardial Infarction

    According to Valvular Academic Research Consortium-2 (VARC-2) criteria. * Periprocedural MI (≤72h post procedure). * Spontaneous MI.

    Time frame: Peri-procedural (≤72h post procedure) and 90 days

  3. Unplanned revascularization

    Any unplanned coronary revascularization either with Percutaneous Coronary Intervention( PCI) or Coronary Artery Bypass Graft (CABG) post TAVI procedure.

    Time frame: 90 days

  4. Bleeding complication

    According to VARC-2 criteria. * TAVI related ≤ 72h post TAVI * Coronary procedure related ≤ 72h post CA or PCI (if staged TAVI-PCI)

    Time frame: Peri-procedural (≤72h post procedure) and 90 days

  5. Device success

    According to VARC-2 criteria.

    Time frame: 90 days

  6. Acute Kidney Injury

    According to VARC-2 criteria.

    Time frame: 90 days

  7. Stroke

    An acute episode of focal or global neurological dysfunction caused by the brain, spinal cord, or retinal vascular injury as assessed by a clinician and confirmed by at least one cerebral imaging study (CT or MRI). Stroke may be classified as ischaemic or haemorrhagic

    Time frame: 90 days

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Study locations

1 of 1 sites recruiting
  • St. Paul's Hospital
    Vancouver, British Columbia V6Z1Y6, Canada
    • Shirley Wong, PhD · Contact · 3M@icvhealth.ubc.ca · 604-682-2344
    • Leipsic Jonathon, MD · Principal investigator
    Recruiting
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References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

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Registry details

Key details

Study ID
NCT03291925
Lead sponsor
BC Centre for Improved Cardiovascular Health
Collaborators
Edwards Lifesciences
Responsible party
Sponsor
First posted
Sep 25, 2017
Start date
Nov 2016
Primary completion
Sep 2019 (estimated)
Completion
Sep 2019 (estimated)
Last update
Sep 25, 2017

Study contacts

Shirley Wong, PhD
Contact
3M@icvhealth.ubc.ca
604-682-2344
Jonathon Leipsic, MD
principal investigator · St. Paul's Hospital

Oversight

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

Not currently enrolling

This study is status unknown, as verified in Sep 2017. You cannot join it, but the record below documents what was studied.

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