COMBINE-INTERVENE: COMBINEd Ischemia and Vulnerable Plaque Percutaneous INTERVENtion to Reduce Cardiovascular Events
Multivessel Coronary Artery Disease, Ischemia, Vulnerable Plaque
About this trial
This is an interventional treatment trial for Multivessel Coronary Artery Disease
Eligibility Criteria
Inclusion Criteria:
- Patients undergoing PCI, aged 30-80 years with any clinical presentation
- Angiographic criteria: presence of ≥ 2 de novo target lesions* located in 2 different native coronary arteries feasible for treatment with PCI (operator / Heart team decision)
Angiographic criteria target lesion* (all criteria I-IV should be applicable):
I. DS ≥ 50% on visual estimation II. de novo lesion located in native (non-grafted) vessel III. lesion reference diameter of ≥ 2.0 mm IV. Thrombolysis In Myocardial Infarction (TIMI) 3 flow in all vessels (with exclusion of culprit lesions if MI at presentation)
*Target lesions are either culprit MI lesions or lesions where FFR will be performed. Patients are eligible if they have ≥ 2 target lesions or one culprit and ≥ 1 target lesion.
Exclusion Criteria:
- Patients with MVD requiring coronary artery bypass grafting (CABG) treatment (operator / local heart team decision)
- Lesion located in a grafted segment or in a vein graft
- In-stent restenosis lesions
- Left main trifurcation
- Left main lesion stand-alone (without other lesions)
- Patients with severe tortuous lesions (where FFR and OCT is judged impossible or dangerous)
- Chronic total occlusion
- Spontaneous coronary dissection
- Patients with severe valvular heart disease likely to require cardiac surgery within the next 2 years
- Patients with left ventricle (LV) function less than 30%
- Renal insufficiency (Glomerular Filtration Rate (GFR) < 29 ml/min/1.73m2; Kidney Disease Outcomes Quality Initiative (KDOQI) stage 4 and 5)
- Life expectancy less than 3 years
Sites / Locations
- Different countries in Europe, Asia Pacific and CanadaRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
MVD > 2 50% angiographic stenosis PCI revascularization strategy based FFR and OCT assessment
MVD > 2 50% angiographic stenosis PCI revascularization strategy based FFR assessment (and sham OCT)
MVD > 2 50% angiographic stenosis PCI revascularization strategy based FFR and OCT assessment
MVD > 2 50% angiographic stenosis PCI revascularization strategy based FFR assessment (and sham OCT)