强化降脂治疗改善急性冠脉综合征患者预后的随机对照研究与血脂残余风险评估模型的建立子研究——光学相干断层成像(OCT)研究

注册号:

Registration number:

ChiCTR2200063395 

最近更新日期:

Date of Last Refreshed on:

2023-04-15 22:33:06 

注册时间:

Date of Registration:

2022-09-06 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

强化降脂治疗改善急性冠脉综合征患者预后的随机对照研究与血脂残余风险评估模型的建立子研究——光学相干断层成像(OCT)研究

Public title:

Optical coherence tomography (OCT) study: the sub-study of a randomized controlled trail of intensive lipid-lowering therapy to improve the prognosis of patients with ACS and the establishment of a residual risk assessment model for blood lipids

注册题目简写:

English Acronym:

研究课题的正式科学名称:

强化降脂治疗改善急性冠脉综合征患者预后的随机对照研究与血脂残余风险评估模型的建立子研究——光学相干断层成像(OCT)研究

Scientific title:

Optical coherence tomography (OCT) study: the sub-study of a randomized controlled trail of intensive lipid-lowering therapy to improve the prognosis of patients with ACS and the establishment of a residual risk assessment model for blood lipids

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

吴娜琼 

研究负责人:

周洲 

Applicant:

Naqiong Wu 

Study leader:

Zhou Zhou 

申请注册联系人电话:

Applicant telephone:

+86 13501139869

研究负责人电话:

Study leader's
telephone:

+86 18612568021

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

fuwainaqiongwu@163.com

研究负责人电子邮件:

Study leader's E-mail:

zhouzhou@fuwaihospital.org

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

北京市西城区北礼士路167号

研究负责人通讯地址:

北京市西城区北礼士路167号

Applicant address:

167 Lishi Road North, Xicheng District, Beijing, China

Study leader's address:

167 Lishi Road North, Xicheng District, Beijing, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

中国医学科学院阜外医院

Applicant's institution:

Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

研究负责人所在单位:

中国医学科学院阜外医院

Affiliation of the Leader:

Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2022-1746

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

中国医学科学院阜外医院伦理委员会

Name of the ethic committee:

Ethical review board of Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

伦理委员会批准日期:

Date of approved by ethic committee:

2022-07-12 00:00:00

伦理委员会联系人:

张雪燕

Contact Name of the ethic committee:

Xueyan Zhang

伦理委员会联系地址:

北京市西城区北礼士路167号

Contact Address of the ethic committee:

167 Lishi Road North, Xicheng District, Beijing, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

中国医学科学院阜外医院心血管代谢中心

Primary sponsor:

Cardiometabolic Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College

研究实施负责(组长)单位地址:

北京市西城区北礼士路167号

Primary sponsor's address:

167 Lishi Road North, Xicheng District, Beijing, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

北京市

市(区县):

西城区

Country:

China

Province:

Beijing

City:

Xicheng District

单位(医院):

中国医学科学院阜外医院

具体地址:

北礼士路167号

Institution
hospital:

Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College

Address:

167 Lishi Road North

经费或物资来源:

2021-2025医科院创新工程(重大协同创新工程)

Source(s) of funding:

2021-2025CAMS Innovation Fund for Medical Sciences (CIFMS)

研究疾病:

急性冠脉综合征  

Target disease:

Acute coronary syndrome

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机抽样 

Study design:

Randomly Sampling 

研究目的:

本研究采用加用PCSK9单抗联合他汀和/或依折麦布的强化降脂方案12周使LDL-C<1.0mmol/L作为严格目标值管理组(试验组),以最大可耐受剂量他汀联合(或不联合)依折麦布使LDL-C<1.8mmol/L作为常规目标值管理组(对照组),预期通过OCT证实强化降脂策略可改善支架术后内膜覆盖率,使得缩短双联抗血小板时长成为可能,同时预期强化降脂策略对于非介入干预的冠脉病变,可增加纤维帽厚度,减少脂质弧角度达到稳定斑块的目的。  

Objectives of Study:

The paticiants are divided into two groups: the strict target management group(experiment group) and the routine target management group (control group). PCSK9 inhibitors combined with statin and/or ezetimibe was used for 12 weeks to lower LDL-C <1.0mmol/L in the experiment group. For control group, the LDL-C target is < 1.8 mmol/L with statin and/or ezetimibe. It is expected that the intensive lipid-lowering therapy confirmed by OCT can improve the intimal coverage after stenting, which could shorten the duration of dual antiplatelet therapy. In additon, the intensive lipid-lowering therapy may increase the thickness of the fibrous cap and reduce the lipid arc angle for non-interventional coronary lesions to stabilize the plaque.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.严重心衰(Killip分级III或IV级)或心源性休克,LVEF <30%;
2.既往脑血管病史;
3.肝肾功能不全(如eGFR<60 ml/kg/m2或血清肌酐酸水平>2.5 mg/dL,或正在进行透析)或肌酸激酶升高>5倍正常上限;
4.恶性肿瘤;
5.对他汀或依折麦布不耐受者;
6.对针剂不耐受;
7.病人有其它疾病(如癌症、神经缺陷型中风)或有药物滥用史(酒精等);经医生判断可能会不遵守协议,影响相关数据的解释或寿命有限(即少于1年);
8.依从性差;
9.有抗凝指征的患者;
10.阿司匹林、肝素、比伐卢定、抗血小板药(氯吡格雷、和噻氯匹啶)、雷帕霉素、乳酸聚合物、造影剂或不锈钢过敏或禁忌征人群;
11.孕期或哺乳期妇女,或处于孕龄但未采用避孕措施的妇女.
光学相干断层扫描(optical coherence tomography,OCT)排除标准:
1.靶血管严重扭曲、钙化、成角,经研究者判断放置OCT导管会引发危险或并发症;
2.靶血管存在慢性完全闭塞或TIMI血流为0级。

Exclusion criteria:

1. Patients with severe heart failure (Killip class III or IV) or with cardiogenic shock, LVEF <30%;
2. Patients with the history of cerebrovascular disease;
3. Patients with liver and renal insufficiency (such as the patients with eGFR<60 ml/kg/m2 or with serum creatinine Acid level > 5 mg/dL, or ongoing dialysis) or with creatine kinase elevation 5 times more than the upper limit of normal;
4. patients with malignant tumors;
5. Patients with intolerance to statins or ezetimibe;
6. Patients with intolerance to injections;
7. The patients with other diseases (such as cancer, neurodeficient stroke) or a history of drug abuse (alcohol, etc.); Patients who, in the judgment of the physician, may not adhere to the protocol, affect the interpretation of the relevant data or have a limited lifespan (less than 1 year);
8. patients with poor compliance;
9. Patients with indications for anticoagulation;
10. People with allergies or contraindications to aspirin, heparin, bivalirudin, antiplatelet drugs (clopidogrel, and ticlopidine), rapamycin, lactic acid polymers, contrast agents, or stainless steel;
11. Pregnant or breastfeeding women, or women of gestational age but not using contraceptive measures.
Optical coherence tomography (OCT) exclusion criteria:
1. The target vessels are severely distorted, calcified, and angled , according to the investigator's judgment, the placement of OCT catheter will cause risks or complications;
2. The target vessel has chronic total occlusion or its TIMI blood flow is grade 0.

研究实施时间:

Study execute time:

From 2022-09-01 00:00:00 To 2023-06-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2022-09-01 00:00:00 To 2023-03-01 00:00:00

干预措施:

Interventions:

组别:

试验组

样本量:

18

Group:

experimental group

Sample size:

干预措施:

强化降脂(PCSK9单克隆抗体+他汀±依折麦布)

干预措施代码:

Intervention:

Intensive Lipid-Lowering Therapy(PCSK9 Monoclonal Antibodies+statins ±ezetimibe)

Intervention code:

组别:

对照组

样本量:

18

Group:

control group

Sample size:

干预措施:

常规降脂(他汀±依折麦布)

干预措施代码:

Intervention:

Conventional Lipid-Lowering Therapy(statins ±ezetimibe)

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

北京市 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

中国医学科学院阜外医院 

单位级别:

三级甲等 

Institution
hospital:

Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

支架内皮覆盖率

指标类型:

主要指标

Outcome:

Stent endothelial coverage

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

非介入冠脉病变的纤维帽厚度

指标类型:

次要指标

Outcome:

Fibrotic cap thickness in non-interventional coronary lesions

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

非介入冠脉病变的脂质弧长度

指标类型:

次要指标

Outcome:

Lipid arc length in non-interventional coronary lesions

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

Nil

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 75 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

采用IRT获得随机号,进入相应组别

Randomization Procedure (please state who generates the random number sequence and by what method):

Using IRT to allow patients to obtain random numbers and enter the corresponding groups

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Blinding:

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

项目组根据研究进程择期选择具体方式公开原始数据

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

According to the progress of the research, raw research data should be made freely available to all researchers in specific ways

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

研究者根据受试者的原始观察记录,将数据及时、完整、正确、清晰地载入病例报告表,录入采用相应的数据库系统双人双机录入,之后对数据库进行两遍比对。电子数据文件分类保存,并有多个备份保存于不同磁盘或者记录介质上,妥善保存,防止损坏。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Based on the original observation records, researchers will completely write accurate data into case report forms in time.Input the data into corresponding database system by two special researchers with two computers respectively.After that, researchers compare two database twice and electronic data will be conserved and backup.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2022-09-06 00:12:09