Coronary Microvascular Dysfunction Clinical Trial
— PCIOfficial title:
A Study on the Impact of Bivalirudin Usage During Percutaneous Coronary Intervention for High-risk Plaques in the Coronary Artery on Post Percutaneous Coronary Intervention Coronary Microcirculation.
In this study, investigators enrolled patients with coronary heart disease who were scheduled to undergo percutaneous coronary intervention (PCI) and had high-risk plaques according to computed tomography angiography (CTA). During the PCI procedure, patients will be randomly assigned to receive either bivalirudin or standard heparin anticoagulation therapy. Investigators will compare the post-PCI coronary angiography-derived index of microcirculatory resistance (CaIMR), thrombolysis in myocardial infarction (TIMI) blood flow grade, CTFC (corrected TIMI frame count), TIMI myocardial perfusion grading(TMPG), levels of troponin, and major adverse cardiac events (MACE) during a follow-up period of 6 months between the two groups. Investigators aim to explore the potential benefits of bivalirudin perioperative anticoagulation therapy in improving coronary microvascular dysfunction (CMD) after PCI for high-risk plaques in coronary artery lesions.
Status | Recruiting |
Enrollment | 70 |
Est. completion date | March 4, 2025 |
Est. primary completion date | March 1, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: 1. aged 18 years or older; 2. diagnosed with non-ST-segment elevation myocardial infarction or unstable angina pectoris; 3. scheduled to undergo elective coronary angiography and intervention; 4. coronary computed tomography angiography showing high-risk plaque features within 3 months prior to the procedure; 5. voluntary participation in the study and signed informed consent. Exclusion Criteria: 1. prior PCI of the target vessel within 3 months; 2. cardiogenic shock, active bleeding, bleeding disorders, irreversible coagulation dysfunction, severe liver dysfunction (Child-Pugh class C), severe renal dysfunction (eGFR < 30 ml/min/1.73m2), and dependence on dialysis; 3. life expectancy less than 1 year; 4. chronic total occlusion of the target vessel; 5. poor opacification of the target vessel, severe vessel overlap or distortion, and inability to completely expose the lesion site; 6. allergy to contrast agents, verapamil, or its excipients; 7. severe uncontrolled hypertension (systolic blood pressure = 160 mmHg and/or diastolic blood pressure = 100 mmHg); 8. subacute bacterial endocarditis. |
Country | Name | City | State |
---|---|---|---|
China | Peking university first hospital | Beijing | Beijing |
Lead Sponsor | Collaborator |
---|---|
Peking University First Hospital |
China,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | CaIMR | The caIMR value of the target vessel immediately after PCI. | 3 days | |
Primary | CMD | The proportion of target vessels with caIMR = 25 and caIMR = 40 immediately after PCI. | 3 days | |
Secondary | clinical events | (1) MACE (including cardiac death, target vessel revascularization, target vessel myocardial infarction, and heart failure readmission) at 30 days and 6 months after PCI; (2) Major adverse events (including all-cause death, non-fatal myocardial infarction, unplanned revascularization, definite or probable stent thrombosis, and clinically significant bleeding events) at 30 days and 6 months. | 6 months | |
Secondary | biomarker_eNOs | Serum levels of eNOs after PCI. | 3 days | |
Secondary | biomarker_ET-1 | Serum levels of ET-1 after PCI. | 3 days | |
Secondary | biomarker_myocardial injury markers | Peak levels of myocardial injury markers (CK-MB and CTNI) after PCI. | 3 days | |
Secondary | imaging examination_microcirculation | Other indicators for assessing microcirculation during the procedure (including TMPG, TIMI frame count, and myocardial staining grade). | 3 days | |
Secondary | imaging examination_longitudinal myocardial strain | Changes in global longitudinal myocardial strain of the left ventricle measured by post-PCI echocardiography compared to baseline values. | 3 days |
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