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Intravascular Ultrasound Guided Drug Eluting Stents Implantation in "All-comers" Coronary Lesions （ULTIMATE Trial） (ULTIMATE)

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ClinicalTrials.gov Identifier: NCT02215915
Recruitment Status : Completed
First Posted : August 13, 2014
Last Update Posted : November 3, 2020
Sponsor:
Information provided by (Responsible Party):
Shaoliang Chen, Nanjing First Hospital, Nanjing Medical University

Study Description
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Brief Summary:
A number of 1448 patients scheduled for elective percutaneous coronary intervention (PCI) with a native coronary stenosis suitable for DES implantation and IVUS imaging are openly randomized 1:1 to either IVUS guidance or angiographic guidance groups.

Condition or disease Intervention/treatment Phase
Coronary Artery Disease Procedure: Angiography Procedure: IVUS Procedure: DES implantation Not Applicable

Detailed Description:
The study is prospectively conducted at 8 high-volume PCI centers in China with IVUS expertise. Clinic follow-up are planned in all patients 12 months after implantation of drug eluting stents. Primary endpoint is target vessel failure. The study is powered for primary endpoint, which are likely to reach significance at the level P < 0.05 even at a follow-up drop-out rate up to 10%.
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 1448 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Intravascular Ultrasound Guided Drug Eluting Stents Implantation in "All-comers" Coronary Lesions （ULTIMATE Trial）
Actual Study Start Date : August 1, 2014
Actual Primary Completion Date : May 30, 2017
Actual Study Completion Date : October 30, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Ultrasound

Arms and Interventions
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Arm Intervention/treatment
Experimental: IVUS guided DES implantation
Stent size and length were selected by online IVUS measurements, and adjunct high-pressure dilation was performed according to the discretion of operators based on the IVUS criteria for stent optimization.
 Procedure: IVUS
The size and number of stents and post-dilation will be determined on physician's discrete within the range allowed in this study protocol. All procedure will be performed according to current standard technique. IVUS will be used to assess the anatomic characteristics of lesion and determine appropriate stent size and length. Additional stent implantation or post dilation will be allowed according to attending physician's discrete based on IVUS results.
Other Name: Intravascular ultrasound

Procedure: DES implantation
Other Name: Percutaneous coronary drug-eluting stents implantation
Active Comparator: Angiography guided DES implantation
Stent size and length were chosen by visual estimation, and adjunct high-pressure dilation was performed if an optimal result was not achieved, which was defined as angiographic residual diameter stenosis 20% and absence of angiographically detected dissection.
 Procedure: Angiography
The size and number of stents and post-dilation will be determined on physician's discrete within the range allowed in this study protocol. All procedure will be performed according to current standard technique. Additional stent implantation or post dilation will be allowed according to attending physician's discrete. IVUS will be not used in this arm.

Procedure: DES implantation
Other Name: Percutaneous coronary drug-eluting stents implantation


Outcome Measures
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Primary Outcome Measures :
  1. Target Vessel Failure [ Time Frame: 12 months ]
    The occurrence of cardiac death, target vessel myocardial infraction and target vessel revascularization.


Secondary Outcome Measures :
  1. Mortality [ Time Frame: 12 months ]
    the occurrence of 1-year all cause death

  2. Cardiac death [ Time Frame: 12 months ]
    Death that could not be attributed to a noncardiac etiology was considered cardiac death.

  3. Myocardial infarction [ Time Frame: 12 months ]
    Myocardial infarction was diagnosed by electrocardiographic changes and/or a rise and fall of creatine kinase-myocardial band fraction in the presence of ischemic symptoms.

  4. Target vessel revascularization [ Time Frame: 12 months ]
    Target vessel revascularization was defined as repeated revascularization by PCI or surgery of the target vessel.

  5. Target lesion revascularization [ Time Frame: 12 months ]
    Target lesion revascularization was defined as any revascularization procedure performed at the site of the treated lesion associated with clinical and/or objective evidence of inducible myocardial ischemia.


Other Outcome Measures:
  1. Stent thrombus [ Time Frame: 12 months ]
    Stent thrombus was classified as definite, probable, or possible, according to the definitions provided by the Academic Research Consortium (ARC).Regarding timing, ST was defined as early (<30 days), late (30 days to 1 year), or too late (>1 year).


Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Provision of informed consent prior to any study specific procedures;
  • Men and women 18 years and older;.
  • Established indication to PCI according to the guidelines of American Heart Association and American College of Cardiology;
  • Native coronary lesion suitable for drug-eluting stent placement and IVUS imaging.

Exclusion Criteria:

  • Pregnancy and breast feeding mother;
  • Co-morbidity with an estimated life expectancy of < 50 % at 12 months;
  • Scheduled major surgery in the next 12 months;
  • Inability to follow the protocol and comply with follow-up requirements or any other reason that the investigator feels would place the patient at increased risk;
  • Previous enrolment in this study or treatment with an investigational drug or device under another study protocol in the past 30 days;
  • Known allergy against ticagrelor, or against clopidogrel, or aspirin History of major hemorrhage (intracranial, gastrointestinal, etc.);
  • Chronic total occlusion lesion in either LAD, or LCX or RCA not re-canalized;
  • Severe calcification needing rotational atherectomy；
  • Patient with STEMI (within 24-hour from the onset of chest pain to admission).
Contacts and Locations
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To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02215915


Locations
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China, Jiangsu
Nanjing First Hospital
Nanjing, Jiangsu, China, 210006
Sponsors and Collaborators
Nanjing First Hospital, Nanjing Medical University
Investigators
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Principal Investigator: Shaoliang Chen, MD Nanjing First Hospital, Nanjing Medical University
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Shaoliang Chen, Director of Cardiology and Cath Lab, Vice President of Nanjing First Hospital, Nanjing Medical University, Nanjing First Hospital, Nanjing Medical University
ClinicalTrials.gov Identifier: NCT02215915    
Other Study ID Numbers: 20140729
First Posted: August 13, 2014    Key Record Dates
Last Update Posted: November 3, 2020
Last Verified: November 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by Shaoliang Chen, Nanjing First Hospital, Nanjing Medical University:
Percutaneous coronary intervention
Drug-eluting stent
Intravascular ultrasound
Additional relevant MeSH terms:
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Coronary Artery Disease
Coronary Disease
Myocardial Ischemia
Heart Diseases
 Cardiovascular Diseases
Arteriosclerosis
Arterial Occlusive Diseases
Vascular Diseases