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OCT or Angiography Guided De-escalation of DAPT
Sponsor: Shenyang Northern Hospital
Summary
Optical coherence tomography (OCT) offers a high-resolution intravascular imaging modality to accurately assess vessel and lumen geometry and identify the hallmark of a culprit lesion including plaque disruption and thrombus. In addition, the incorporation of the MLD MAX algorithm into daily practice guides an efficient and easily-memorable workflow for optimized OCT-guided percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Regarding the antithrombotic therapy after revascularization, the 2023 ESC guidelines recommend the P2Y12 receptor inhibitor de-escalation (i.e. switching from ticagrelor to clopidogrel) in ACS patients may be considered as an alternative strategy to the default treatment regimen in order to reduce the risk of bleeding events. Based on the above conclusions, we designed a single-center, prospective, randomized controlled, exploratory study trial to evaluate whether the utility of OCT for guiding PCI with DES followed by antiplatelet de-escalation therapy could further reduce the stent-induced intimal hyperplasia of STEMI patients after stent implantation.
Official title: Evaluation of Neointimal Coverage After Guiding De-escalation of Antiplatelet Treatment in Patients With ST-elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention by Optical Coherence Tomography or Angiography of STEMI Patients
Key Details
Gender
All
Age Range
18 Years - 75 Years
Study Type
INTERVENTIONAL
Enrollment
80
Start Date
2024-04-01
Completion Date
2026-12-01
Last Updated
2024-04-01
Healthy Volunteers
Yes
Conditions
Interventions
OCT-guided PCI
OCT-guided PCI based on MLD MAX algorithm
Conventional angiography-based PCI
Conventional angiography-based PCI
DAPT de-escalation
Aspirin and clopidogrel 30 days after DES implantation
default DAPT regimen
Aspirin and ticagrelor 30 days after DES implantation
Locations (1)
Northern Hospital
Shenyang, Liaoning, China