Ryan, Matthew 
ORCID: 0000-0001-8256-195X, Ezad, Saad M ORCID: 0000-0002-3008-5290, Webb, Ian, O'Kane, Peter D ORCID: 0000-0001-5245-4547, Dodd, Matthew ORCID: 0000-0002-6207-6604, Evans, Richard ORCID: 0000-0003-4101-2131, Laidlaw, Lynn ORCID: 0000-0001-6688-6658, Khan, Sohail Q, Weerackody, Roshan, Bagnall, Alan ORCID: 0000-0003-0683-851X et al (show 10 more authors)
(2024)
Percutaneous Left Ventricular Unloading During High-Risk Coronary Intervention: Rationale and Design of the CHIP-BCIS3 Randomized Controlled Trial.
Circulation. Cardiovascular interventions, 17 (3).
e013367-.
Abstract
<h4>Introduction</h4>Percutaneous coronary intervention for complex coronary disease is associated with a high risk of cardiogenic shock. This can cause harm and limit the quality of revascularization achieved, especially when left ventricular function is impaired at the outset. Elective percutaneous left ventricular unloading is increasingly used to mitigate adverse events in patients undergoing high-risk percutaneous coronary intervention, but this strategy has fiscal and clinical costs and is not supported by robust evidence.<h4>Methods</h4>CHIP-BCIS3 (Controlled Trial of High-Risk Coronary Intervention With Percutaneous Left Ventricular Unloading) is a prospective, multicenter, open-label randomized controlled trial that aims to determine whether a strategy of elective percutaneous left ventricular unloading is superior to standard care (no planned mechanical circulatory support) in patients undergoing nonemergent high-risk percutaneous coronary intervention. Patients are eligible for recruitment if they have severe left ventricular systolic dysfunction, extensive coronary artery disease, and are due to undergo complex percutaneous coronary intervention (to the left main stem with calcium modification or to a chronic total occlusion with a retrograde approach). Cardiogenic shock and acute ST-segment-elevation myocardial infarction are exclusions. The primary outcome is a hierarchical composite of all-cause death, stroke, spontaneous myocardial infarction, cardiovascular hospitalization, and periprocedural myocardial infarction, analyzed using the win ratio. Secondary outcomes include completeness of revascularization, major bleeding, vascular complications, health economic analyses, and health-related quality of life. A sample size of 250 patients will have in excess of 80% power to detect a hazard ratio of 0.62 at a minimum of 12 months, assuming 150 patients experience an event across all follow-up.<h4>Conclusions</h4>To date, 169 patients have been recruited from 21 National Health Service hospitals in the United Kingdom, with recruitment expected to complete in 2024.<h4>Registration</h4>URL: https://www.clinicaltrials.gov; Unique identifier: NCT05003817.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CHIP-BCIS3 Investigators, Humans, Myocardial Infarction, Shock, Cardiogenic, Treatment Outcome, Prospective Studies, Quality of Life, State Medicine, Coronary Artery Disease, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Percutaneous Coronary Intervention |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 09 Apr 2024 09:31 |
| Last Modified: | 12 Apr 2024 17:17 |
| DOI: | 10.1161/circinterventions.123.013367 |
| Open Access URL: | https://doi.org/10.1161/CIRCINTERVENTIONS.123.0133... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3180188 |
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