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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02586155
Other study ID # RVX222-CS-015
Secondary ID
Status Completed
Phase Phase 3
First received
Last updated
Start date November 2015
Est. completion date June 21, 2021

Study information

Verified date July 2021
Source Resverlogix Corp
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to determine whether bromodomain extraterminal domain (BET) inhibition treatment with RVX000222 in high-risk type 2 diabetes mellitus patients with coronary artery disease increases the time to major adverse cardiovascular events.


Description:

The majority (75%) of deaths in subjects with diabetes mellitus (DM) are due to atherosclerotic cardiovascular disease (CVD). Recent studies suggest a major adverse cardiovascular event (MACE) rate of >11% over 18 months in type 2 diabetes mellitus (T2DM) despite a baseline LDL-C of <2.1 mmol/L. Bromodomains (BRDs) are a family of evolutionary conserved protein-interaction modules that play key functions in chromatin organization and regulation of gene transcription. One recognized family of bromodomain-containing proteins is the bromodomain and extra-terminal (BET) family. BET inhibition represents a novel, epigenetic approach to treat CAD. RVX000222 affects biological processes important in atherosclerosis and acute coronary events via selective inhibition of BET proteins. RVX000222 is available as a capsule formulation with standard excipients and established stability. The BETonMACE study will focus on prevention of subsequent MACE in subjects with CAD and DM with high intensity statin therapy as co-medication.


Recruitment information / eligibility

Status Completed
Enrollment 2425
Est. completion date June 21, 2021
Est. primary completion date November 30, 2020
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: • ACS event of either unstable angina or myocardial infarction 7-90 days prior Visit 1: Unstable angina: for a qualifying unstable angina event, each of components (a), (b), and (c) must be satisfied: a.) Characteristic ischemic pain or discomfort in chest/associated referral areas, occurring at rest/with minimal exertion b.) ECG changes consistent with acute myocardial ischemia based on new/presumed ST elevation/depression or T-wave inversion c.) Objective evidence of obstructive CAD based on 1+ of the following: i. New/presumed new evidence of myocardial ischemia/infarction by perfusion imaging ii. New/presumed new regional wall motion abnormality iii. Current evidence of at least 1 epicardial coronary artery stenosis =70% by coronary angiography iv. Need for coronary revascularization for the index ACS event, including a percutaneous coronary intervention (PCI) with or without coronary stenting. Prior MI 7-90 days prior screening treated with or without a percutaneous coronary intervention (PCI). For a qualifying event of MI 2 of the following 3 criteria must be satisfied: a.) Characteristic ischemic chest pain/pain in associated referral areas b.) Dynamic elevation of troponin T/I or CKMB if troponinT/I is unavailable at local lab (at least >ULN for lab) c.) Development of new Q-waves in =2 adjacent ECG leads or development of new dominant R wave in V1 - Documented diagnosis of T2DM (1+ of the following criteria): Documented history of T2DM, History of taking diabetes medication, and/or HbA1c =6.5% at Visit 1 - For males HDL-C<40 mg/dL(1.04 mmol/L), for females HDL-C<45 mg/dL(1.17 mmol/L) at Visit 1 - Subjects currently not on high intensity statin therapy could start rosuvastatin at Visit 1 and those currently on therapy besides atorvastatin/rosuvastatin can be switched to rosuvastatin at Visit 1 - Female subjects of non-childbearing potential (post-surgical sterilization/post-menopausal) or if childbearing potential have neg urine pregnancy test and be willing and able to use non-hormonal birth control (non-hormonal IUD, condom or diaphragm) or remain abstinent from Screening to Follow-up Visit - Give signed informed consent Exclusion Criteria: - Heart disease which will w/in 90 days of Visit 1 likely need coronary bypass, PCI, cardiac transplantation, surgical repair and/or replacement - Previous/current diagnosis of severe heart failure or documented LVEF<25% determined by contrast left ventriculography, radionuclide ventriculography or echocardiography. Absence of LVEF measurement in subject w/out a previous/current diagnosis of heart failure does not exclude entry into study - Evidence of cardiac EP instability incl. history of uncontrolled ventricular arrhythmias, atrial fibrillation/flutter or supraventricular tachycardias w/ a ventricular response HR>100bpm at rest w/in 4 wks prior Visit 1 - CABG w/in 90 days prior Visit 1 - Evidence of severe renal impairment as determined by either eGFR<30 mL/min/1.7m2 at Visit 1 or current need for dialysis - Uncontrolled hypertension defined as 2 consecutive measurements of sitting BP of systolic>180 mmHg or diastolic>100 mmHg at Visit 1 - Treatment w/ immunosuppressants w/in 12 mos prior Visit 1 - Use of fibrates at any dose or niacin/nicotinic acid 250+ mg w/in 30 days prior Visit 1 - Known allergy/sensitivity to any ingredient in IMP - History of intolerance to atorvastatin/rosuvastatin - Triglycerides>400 mg/dL (4.52 mmol/L) at Visit 1 - Any medical/surgical condition which might significantly alter absorption, distribution, metabolism or excretion of medication - Evidence of cirrhosis from liver imaging/biopsy, history of hepatic encephalopathy, esophageal/gastric varices, active hepatitis or prior porta-caval shunt procedure or a Child-Pugh score of =5 points - ALT/AST>1.5xULN by central lab at Visit 1 - Tot. bilirubin>ULN by central lab at Visit 1 - History of malignancy of any organ syst treated/untreated w/in the past 2 yrs whether or not there is evidence of local recurrence/metastases except localized basal skin cell carcinoma - History/evidence of drug/alcohol abuse w/in 12 mos of Visit 1 - Pregnancy - Any condition which may place subject at higher risk from his/her participation in the study or is likely to prevent subject from completing/complying w/ requirements of study - Use of other investigational drugs and devices w/in 30 days or 5 half-lives of Visit 1, whichever is longer - History of noncompliance to medical regimens or unwillingness to comply w/ study protocol - Any condition that would confound the evaluation/interpretation of efficacy and/or safety data - Persons directly involved in execution of this protocol

Study Design


Intervention

Drug:
Apabetalone
100 mg capsule
Placebo
Capsule manufactured to mimic RVX000222 100 mg capsule
Atorvastatin
High-Intensity Statin
Rosuvastatin
High-Intensity Statin

Locations

Country Name City State
Argentina Instituto de Investigaciones Clinicas Bahia Blanca Bahía Blanca
Argentina Bioclinica Buenos Aires Buenos Aires
Argentina Centro Privado de Enfermedades Cardiovasculares Buenos Aires
Argentina Consultorios Asociados Endocronología E Investigación Clínica Aplicada Buenos Aires
Argentina Instituto Cardiovascular de Buenos Aires Buenos Aires
Argentina Sanatorio Guemes Buenos Aires
Argentina CEMAIC Córdoba
Argentina Centro Médico Colón Córdoba
Argentina Centro Médico Luquez Córdoba
Argentina Clínica Privada Del Prado Sociedad de Responsabilidad Limitada Córdoba
Argentina Fundación Clínica Colombo Córdoba
Argentina Hospital Cordoba Córdoba
Argentina Hospital San Roque Córdoba
Argentina Instituto Del Corazón Córdoba
Argentina Instituto Médico DAMIC Córdoba
Argentina Instituto Modelo de Cardiologia Córdoba
Argentina Ipac Caraffa Córdoba
Argentina Sanatorio Allende Córdoba
Argentina Clinica Coronel Suarez Coronel Suárez
Argentina Instituto de Cardiologia de Corrientes Juana Francisca Cabral Corrientes
Argentina Centro Médico Libertad Haedo
Argentina CIMEL Lanús
Argentina Instituto de Investigaciones Clínicas Mar Del Plata Mar Del Plata
Argentina Hospital Central Mendoza
Argentina DIM Clinica Privada Ramos Mejia
Argentina Instituto de Hematologia Y Medicina Clinica Rosario
Argentina Sanatorio Britanico de Rosario Rosario
Argentina Prevencion Cardio Vascular Salta
Argentina Grupo Medico Alem San Isidro
Argentina Bioclinica Tucumán San Miguel De Tucumán
Argentina Centro Modelo de Cardiologia San Miguel De Tucumán
Argentina Investigaciones Clinicas Tucuman San Miguel De Tucumán
Argentina Centro de Investigaciones Clínicas Del Litoral SRL Santa Fe
Argentina Sanatorio San Francisco Santiago Del Estero
Argentina Clínica FUSAVIM Privada Villa María
Argentina Instituto de Investigaciones Clínicas Zárate Zárate
Australia Flinders Medical Centre Bedford Park
Belgium ZNA Middelheim Antwerpen
Belgium Imelda VZW Bonheiden
Belgium AZ Turnhout Turnhout
Bulgaria Multiprofile Hospital For Active Treatment Dr Tota Venkova Gabrovo
Bulgaria Multiprofile Hospital for Active Treatment - Prof. Dr. Paraskev Stoyanov AD Lovech
Bulgaria Multiprofile Hospital For Active Treatment - Pazardzhik AD Pazardzhik
Bulgaria University Multiprofile Hospital for Active Treatment - Dr. Georgi Stranski EAD Pleven
Bulgaria Multiprofile Hospital For Active Treatment - Dr. Bratan Shukerov AD Smolyan
Bulgaria Acibadem City Clinic Multiprofile Hospital for Active Treatment Tokuda Sofia
Bulgaria City Clinic University Multiprofile Hospital for Active Treatment EOOD Sofia
Bulgaria Medical Center Kardiohelp EOOD Sofia
Bulgaria Second Multiprofile Hospital for Active Treatment Sofia Sofia
Bulgaria Synexus Affiliate - Diagnostic and Consulting Center Ascendent Sofia
Bulgaria University Multiprofile Hospital for Active Treatment Aleksandrovska EAD Sofia
Bulgaria University Multiprofile Hospital for Active Treatment and Emergency Medicine N. I. Pirogov EAD Sofia
Bulgaria Medical Center Orfey OOD Stara Zagora
Bulgaria Multiprofile Hospital for Active Treatment Sveta Marina EAD Varna
Croatia General Hospital Karlovac Karlovac
Croatia Special Hospital for medicinal rehabilitation Krapinske Toplice Krapinske Toplice
Croatia Clinical Hospital Osijek Osijek
Croatia General Hospital Dr Josip Bencevic Slavonski Brod
Croatia General Hospital Virovitica Virovitica
Croatia Clinical Hospital Sveti duh Zagreb
Germany DRK Kliniken Berlin Westend Berlin
Germany Medizinisches Versorgungszentrum am Küchwald GmbH Chemnitz
Germany Zentrum für Klinische Prüfung in der Facharztzentrum Dresden Neustadt Gbr Dresden
Germany Katholisches Krankenhaus St. Johann Nepomuk Erfurt
Germany Heidelberger Praxisklinik für Kardiologie Heidelberg
Germany Klinikum Hoyerswerda Hoyerswerda
Germany Studienzentrum Dr.Appel Kassel
Germany Asklepios Klinik Langen Langen
Germany Klinikum Leverkusen GmbH Leverkusen
Hungary Bajai Szent Rókus Kórház Baja
Hungary Grof Tisza Istvan Korhaz Berettyoujfalu Berettyóújfalu
Hungary Bajcsy-Zsilinszky Korhaz es Rendelointezet Budapest
Hungary Del-pesti Centrumkorhaz- Orszagos Hematologiai és Infektologiai Intezet Budapest
Hungary Gottsegen Gyorgy Orszagos Kardiologiai Intezet Budapest
Hungary Magyar Honvédség Egészségügyi Központ Budapest
Hungary Semmelweis Egyetem Budapest
Hungary Synexus (DRS) - Synexus Magyarország Kft. Budapest Budapest
Hungary Szent Margit Korhaz Budapest
Hungary Szent Rókus Kórház és Intézményei Budapest
Hungary Selye János Kórház Komárom
Hungary TaNaMed Kft. Mosonmagyaróvár
Hungary Kanizsai Dorottya Kórház Nagykanizsa
Hungary Coromed-SMO Kft. Pécs
Hungary Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont Szeged
Hungary Fejer Megyei Szent Gyorgy Egyetemi Oktato Korhaz Székesfehérvár
Hungary Tolna Megyei Balassa János Kórház Szekszárd
Israel Barzilai Medical Center Ashkelon
Israel Soroka University Medical Centre Be'er Sheva
Israel Hillel Yaffe Medical Center Hadera
Israel Bnei Zion Medical Center Haifa
Israel Lady Davis Carmel Medical Center Haifa
Israel Linn Medical Center Clalit Health Services Haifa
Israel Rambam Medical Center Haifa
Israel Edith Wolfson Medical Center Holon
Israel Hadassah University Hospital Ein Kerem Jerusalem
Israel Hadassah University Hospital Mount Scopus Jerusalem
Israel Shaare Zedek Medical Center Jerusalem
Israel Meir Medical Center Kefar-Sava
Israel Galilee Medical Center Nahariya
Israel Nazareth EMMS Hospital Nazareth
Israel Chaim Sheba Medical Center Ramat Gan
Israel Kaplan Medical Center Rehovot
Israel ZIV Medical Center Safed
Israel Clalit Health Medical Center Tel Aviv
Israel Tel Aviv Sourasky Medical Center Tel-Aviv
Israel Baruch Padeh Poriya Medical Center Tiberias
Mexico Fundacion Cardiovascular de Aguascalientes AC Aguascalientes
Mexico Hospital Cardiológica Aguascalientes Aguascalientes
Mexico Investigacion en Salud y Metabolismo S.C. Chihuahua
Mexico Centro de Investigación Biomedica y Farmaceutica Ciudad de México
Mexico Clinica Integral del Paciente Diabetico y Obeso Ciudad De México
Mexico Fundación de Atención e Investigación Médica Lindavista S.C. Ciudad de México
Mexico Centro Para el Desarrollo de la Medicina y de Asistencia Especializada SC Culiacan
Mexico Centro de Investigacion y Atencion de Diabetes, Endocrinologia y Nutricion Durango
Mexico Arechavaleta Granell Maria del Rosario Guadalajara
Mexico Centro de Investigacion Medica Biologica Y de Terapia Avanzada SC Guadalajara
Mexico Unidad de Investigacion Clinica Cardiometabolica de Occidente SC Guadalajara
Mexico Hospital Angeles Leon León De Los Aldama
Mexico Centro de Desarrollo Biomédico Merida
Mexico Sanatorio y Servicios Médicos Obregón S.A. de C.V. Mexico City
Mexico Instituto Cardiovascular de Monclova Monclova
Mexico Hospital Universitario Dr. Jose Eleuterio González Monterrey
Mexico IMED Internal Medicine Clin Trials Monterrey
Mexico Unidad de Investigación Clínica En Medicina SC Monterrey
Mexico Diabetes Total, S.A de C.V. Pachuca
Mexico Investigacion Biomedica Aplicada de Hidalgo S.A. de C.V. Pachuca
Mexico Cardioarritmias e Investigación S.C. San Luis Potosi
Mexico Hospital Central Dr Ignacio Morones Prieto San Luis Potosí
Mexico INBIOMEDYC Toluca Toluca
Mexico Centro de Alta Especialidad Dr. Rafael Lucio Veracruz
Mexico Dr. Humberto Alvarez Lopez Zapopan
Netherlands Meander Medisch Centrum Amersfoort
Netherlands OLVG locatie Oost Amsterdam
Netherlands VU Medisch Centrum Amsterdam
Poland Podlaski Osrodek Kardiologii Poradnia Prywatna Bialystok
Poland Malopolskie Centrum Sercowo-Naczyniowe Chrzanow
Poland Polsko-Amerykanskie Kliniki Serca Dabrowa Gornicza
Poland Gabinet Kardiologiczno-Internistyczny Gdynia
Poland Niepubliczny Zaklad Opieki Zdrowotnej Centrum Uslug Medycznych Promont-Med. Kielce
Poland Diamond Clinic Kraków
Poland Szpital Specjalistyczny im. Jozefa Dietla w Krakowie Kraków
Poland Zespol Przychodni Specjalistycznych DIAB-END-COR Sp. z o.o. Kraków
Poland Prywatna Praktyka Lekarska MAZ-MEDICA Maciej R.Mazurkiewicz Lodz
Poland Uniwersytecki Szpital Kliniczny im. Wojskowej Akademii Medycznej Centralny Szpital Weteranow Lódz
Poland Polsko-Amerykanskie Kliniki Serca Nysa
Poland Pro Corde, Dom Medyczny Opole
Poland Medicome Sp. z o.o. Oswiecim
Poland Rodzinne Centrum Zdrowia Otwock
Poland Niepubliczny Zaklad Opieki Zdrowotnej Specjalistyczna Przychodnia Lekarska "MEDIKARD" Plock
Poland Niepubliczny Zaklad Opieki Zdrowotnej Centrum Medyczne SBB Tarnobrzeg
Poland Centrum Medyczne doktorA Warszawa
Poland Instytut Kardiologii im Prymasa Tysiaclecia Kardynala Stefana Wyszynskiego Warszawa
Poland Niepubliczny Zaklad Opieki Zdrowotnej AURUM Warszawa
Poland Centrum Kardiologiczne Pro Corde Sp. z o.o. Niepubliczny Zaklad Opieki Zdrowotnej Wroclaw
Poland Wro Medica Wroclaw
Russian Federation City Clinical Hospital #6 Chelyabinsk
Russian Federation Ural State Medical University Ekaterinburg
Russian Federation Federal Budget Healthcare Institution Medici - sanitary unit of Ministry of internal affairs of Russ Kemerovo
Russian Federation Research Institute of Complex Cardiovascular Pathology Kemerovo
Russian Federation Krasnodar Regional Clinical Hospital #2 Krasnodar
Russian Federation Moscow City State Budgetary Healthcare Institution City Clinical Hospital named after V.V. Veresayev Moscow
Russian Federation Russian Cardiology Research and Production Center Moscow
Russian Federation City Hospital 13 Nizhniy Novgorod
Russian Federation State Budgetary Healthcare Institution of Novosibirsk Region City Clinical Hospital No. 19 Novosibirsk
Russian Federation Republican Hospital n.a. V.A. Baranov Petrozavodsk
Russian Federation Municipal Budgetary Healthcare Institution City Emergency Hospital Rostov-on-Don
Russian Federation International Medical Center SOGAZ Saint Petersburg
Russian Federation North-West State Medical University n.a. I.I. Mechnikov Saint Petersburg
Russian Federation St Petersburg City Outpatient Clinic #109 Saint Petersburg
Russian Federation Saratov State Medical University Saratov
Russian Federation State Healthcare Institution Regional Clinical Cardiologic Dispensary Saratov
Russian Federation City Hospital #4 Sochi
Russian Federation Research Cardiology Institute of Tomsk Scientific Center of RAMS Siberian Branch Tomsk
Russian Federation State Budgetary Healthcare Institution of Vladimir Region City Hospital No. 4 Vladimir
Serbia Clinical Center of Serbia Belgrade
Serbia Clinical Hospital Centar Zvezdara Belgrade
Serbia Clinical Hospital Center Bezanijska Kosa Belgrade
Serbia Clinical Hospital Centre Zemun Belgrade
Serbia Euromedik Belgrade
Serbia Institute of Cardiovascular Diseases Dedinje Belgrade
Serbia KBC Dr Dragisa Misovic Dedinje Belgrade
Serbia Military Medical Academy Belgrade
Serbia Clinical Center Kragujevac Kragujevac
Serbia Clinical Center Nis Nis
Serbia Institute Niska Banja Niska Banja
Serbia Clinical Centre of Vojvodina Novi Sad
Serbia Institute of Cardiovascular Diseases of Vojvodina Sremska Kamenica
Serbia General Hospital Uzice Uzice
Serbia Health Center Zajecar Zajecar
Slovakia ALIAN, s.r.o Bardejov
Slovakia CARDIOCONSULT, s.r.o. Bratislava
Slovakia Univerzitna nemocnica Bratislava Bratislava
Slovakia Kardio-Onkologia, s.r.o. Dolny Kubin
Slovakia CARDIO D&R, s.r.o. Kosice Kosice
Slovakia Zeleznicne zdravotnictvo Kosice, s.r.o. Kosice
Slovakia KARDIOMED s.r.o. Lucenec
Slovakia MEDI M&M s.r.o. Moldava nad Bodvou
Slovakia Nemocnica s poliklinikou Nove Mesto nad Vahom n.o. Nove Mesto nad Vahom
Slovakia Cardioinvest s. r. o. Nove Zamky
Slovakia DIAB s.r.o. Roznava
Slovakia MEDIVASA, s.r.o. Zilina
Taiwan Changhua Christian Hospital Changhua
Taiwan Kaohsiung Chang Gung Memorial Hospital Kaohsiung
Taiwan Kaohsiung Veterans General Hospital Kaohsiung
Taiwan Mackay Memorial Hospital-Taipei branch New Taipei City
Taiwan China Medical University Hospital Taichung
Taiwan National Cheng Kung University Hospital Tainan City
Taiwan Cathay General Hospital Taipei
Taiwan Chi Mei Medical Center Taipei
Taiwan Far Eastern Memorial Hospital Taipei
Taiwan National Taiwan University Hospital Taipei
Taiwan Taipei Veterans General Hospital Taipei
Taiwan Tri-Service General Hospital Taipei City
Taiwan Chang Gung Medical Foundation Linkou Branch (Clinical Research Center) Taoyuan City

Sponsors (4)

Lead Sponsor Collaborator
Resverlogix Corp ICON plc, Medidata Solutions, PPD

Countries where clinical trial is conducted

Argentina,  Australia,  Belgium,  Bulgaria,  Croatia,  Germany,  Hungary,  Israel,  Mexico,  Netherlands,  Poland,  Russian Federation,  Serbia,  Slovakia,  Taiwan, 

References & Publications (1)

Ray KK, Nicholls SJ, Buhr KA, Ginsberg HN, Johansson JO, Kalantar-Zadeh K, Kulikowski E, Toth PP, Wong N, Sweeney M, Schwartz GG; BETonMACE Investigators and Committees. Effect of Apabetalone Added to Standard Therapy on Major Adverse Cardiovascular Event — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Incidence of First Occurrence of Adjudication-confirmed Narrowly Defined MACE Incidence of first occurrence of MACE narrowly defined as a single composite endpoint of Cardiovascular (CV) Death (including undetermined cause of death) or Non-fatal Myocardial Infarction (MI) or Stroke. If a subject has multiple events, only the first event contributing to the composite endpoint is counted. 120 weeks
Secondary Incidence of First Occurrence of Adjudication-confirmed Broadly Defined MACE First occurrence of MACE broadly defined as a single composite endpoint of Cardiovascular Death (CVD) (including undetermined cause of death) or Non-fatal Myocardial Infarction (MI), Stroke, or Hospitalization for CVD events (including unstable angina and evidence of new or presumed new progressive obstructive coronary disease or emergency revascularization procedures at any time and urgent revascularization procedures =30 days after the index event as defined by Hicks et al., 2014) . If a subject has multiple events, only the first event contributing to the composite endpoint is counted. 120 weeks
Secondary Incidence of Hospitalization for Congestive Heart Failure (CHF) 120 weeks
Secondary Incidence of All-cause Mortality 120 weeks
Secondary Change in Apolipoprotein A1 (ApoA-I) Concentration From Baseline Over Time Within and Between Treatment Groups 120 weeks
Secondary Change in Apolipoprotein B (apoB) Concentration From Baseline Over Time Within and Between Treatment Groups 120 weeks
Secondary Change in LDL-C Concentration From Baseline Over Time Within and Between Treatment Groups 120 weeks
Secondary Change in HDL-C Concentration From Baseline Over Time Within and Between Treatment Groups 120 weeks
Secondary Change in Triglyceride (TG) Concentration From Baseline Over Time Within and Between Treatment Groups 120 weeks
Secondary Change in Hemoglobin (Hb) A1c From Baseline Over Time Within and Between Treatment Groups 120 weeks
Secondary Change in Glucose From Baseline Over Time Between and Within Treatment Groups 120 weeks
Secondary Change in Alkaline Phosphatase (ALP) From Baseline Over Time Within and Between Treatment Groups 172 weeks
Secondary Change in C Reactive Protein (CRP) Concentration From Baseline Over Time Within and Between Treatment Groups 52 weeks
Secondary Change in Estimated Glomerular Filtration Rate (eGFR) From Baseline Over Time Within and Between Treatment Groups for Subjects With Impaired Renal Function at Baseline (eGFR <60 mL/Min/1.7m2) 120 weeks
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