Skip to main content
OpenTrials
Recruiting

NCT Number: NCT04923191

The PIONEER-IV Study is Comparing Clinical Outcomes Between Angiography-derived Physiology Guidance to Usual Care in an All-comers PCI Population With Unrestrictive Use of the HT Supreme Sirolimus-eluting Stent

PIONEER-IV is a prospective, single-blind (patient), randomized, 1:1, controlled, multi-center study comparing clinical outcomes between angiography-derived physiology guidance to LRDP and usual care in an all-comers patient population (including patients with high bleeding risk, HBR) undergoing PCI with unrestrictive use of the HT Supreme sirolimus-eluting stent. Patients will be randomized to either angio-based physiology guidance angio-FFR (Quantitative Flow Ratio and coronary angiography-derived FFR, caFFR) or local routine diagnostic procedure (LRDP) and usual care. Patients will be treated with 1-year P2Y12 inhibitor monotherapy after 1-month of dual-antiplatelet therapy in approximately 2540 (2*1270) patients. All patients (both cohorts) must receive dual anti-platelet therapy, being aspirin (ASA) and ticagrelor for 1 month, followed by 11 months of ticagrelor only (i.e. monotherapy). At 1 year, ticagrelor monotherapy is replaced by aspirin monotherapy or left to the discretion of the operator.

Recruiting

Interested in participating?

Request Info

Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

ASZ Aalst, Aalst, Belgium

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patient has chronic stable angina, acute coronary syndromes or silent ischemia;
  • Presence of one or more coronary artery stenoses of ≥50% (by visual assessment) in a native coronary artery (with or without prior stent/other device treatment) or in a saphenous venous or arterial bypass conduit suitable for coronary stent implantation;
  • The vessel should have a reference vessel diameter of at least 2.25 mm by visual assessment (no limitation on the number of treated lesions, vessels, or lesion length);
  • Patient has been informed of the nature of the study and agrees to its provisions and has provided written informed consent as approved by the Ethical Committee and is willing to comply with all protocol-required (follow-up) evaluations.

Exclusion criteria

  • Patient is a woman who is pregnant or nursing (a pregnancy test must be performed within 7 days prior to the index procedure in women of child-bearing potential according to local practice);
  • Known intolerance to cobalt chromium, and medications such as sirolimus, aspirin, heparin, bivalirudin or P2Y12 inhibitors;
  • Planned major elective surgery requiring discontinuation of (dual)anti platelet therapy (DAPT) within 12 months of procedure;
  • Concurrent medical condition with a life expectancy of less than 3 years;
  • Currently participating in another trial and not yet at its primary endpoint;
  • Active pathological bleeding;
  • History of intracranial haemorrhage.

Treatment and study plan

Angiography-derived physiology guidance/Local routine diagnostic procedure (LRDP) and usual care

Other

percutaneous coronary intervention

Primary outcomes

  1. Patient-oriented Composite Endpoint (PoCE)

    Time frame: 12 months

    PoCE is a composite clinical endpoint of:

    • all-cause death;
    • any stroke, Modified Rankin scale, (MRS ≥1);
    • any myocardial infarction;
    • any clinically and physiologically driven revascularization.

Secondary outcomes

  1. Vessel-oriented composite endpoints (VoCE)

    Time frame: 12, 24 and 36 months

    VoCE is a composite clinical endpoint of:

    • Vessel-related cardiovascular Death
    • Target-vessel related MI
    • Clinically and physiologically-oriented Target vessel revascularization
  2. Device-oriented composite endpoint (DoCE)

    Time frame: 12, 24 and 36 months

    DoCE is a composite endpoint of:

    • Cardiovascular Death
    • Target-vessel related MI
    • Clinically and physiologically-oriented Target lesion revascularization
  3. Myocardial Infarction (MI)

    Time frame: 48 hours post-procedure

    Peri-procedure Myocardial Infarction according to 4th universal definition

  4. Device Success Rate

    Time frame: index procedure

    according to the statement from European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the European Society of Cardiology (ESC)

  5. Stent Thrombosis

    Time frame: Procedure, 12, 24 and 36 months

    Definite, Probable, Definite or Probable

  6. Target Vessel Failure (TVF)

    Time frame: 12, 24 and 36 months

    TVF is a composite of:

    • Cardiovascular Death
    • Target-vessel related MI
    • Clinically and physiologically-oriented Target vessel revascularization
  7. Bleeding

    Time frame: 12, 24 and 36 months follow-up

    Bleeding according to Bleeding Academic Research Consortium (BARC) (BARC 2, 3 and 5) classification

Study contacts

Contact information is provided by the study sponsor or research team.

Patrick W Serruys, MD

CONTACT

[email protected]

+31622924061

Yoshinobu Onuma, MD

CONTACT

[email protected]

+353852882318

Sponsors and collaborators

Lead sponsor

National University of Ireland, Galway, Ireland

Other

Registry information

Official study title

Non-inferiority of Angiography-derived Physiology Guidance Versus Usual Care in an All-comers PCI Population Treated With Unrestricted Use of the Healing-Targeted Supreme (HT Supreme) Drug-eluting Stent and P2Y12 Inhibitor Monotherapy After 1-month of Dual-antiplatelet Therapy

Acronym: PIONEER-IV

Important dates

Study start
2021
Primary completion
2026
Study completion
2029
First posted
Jun 11, 2021
Registry last updated
Oct 30, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.