Status:

TERMINATED

The CHORAL Flow Study

Lead Sponsor:

Imperial College London

Conditions:

Coronary Artery Disease

Atherosclerosis

Eligibility:

All Genders

18-80 years

Phase:

PHASE4

Brief Summary

CHORAL Flow is a randomised, double blinded, placebo-controlled trial of the effects of evolocumab on coronary flow at 12 weeks.

Detailed Description

Evolocumab is a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor which has been shown in the Fourier Trial to reduce major cardiovascular events in statin-treated patients with raised L...

Eligibility Criteria

Inclusion

  • Patients aged between 18 and 80 years, with a clinical indication for coronary angiography and:
  • willing to provide consent: Provide written (signed and dated) informed consent and be capable of understanding the study and co-operating with treatment and follow-up.
  • raised levels of fasting (\>9h) LDL-cholesterol (≥2mmol/L) either on optimal statin therapy (90% of overall sample) or intolerants to statins (restricted to 10% of overall sample). Optimal statin therapy will be defined as at least 4 weeks of atorvastatin 40mg or more, with no change in statin dose during this period.
  • at least one other risk factor for vascular disease or established vascular disease.
  • willing and able to use a highly effective method of contraception from screening until 15 weeks after the last dose of IP if a woman of childbearing potential.

Exclusion

  • Patients unable or unwilling to provide written informed consent;
  • Patients unable to undergo cardiac catheterisation;
  • Patients with contraindication to adenosine (severe asthma, second or third degree atrioventricular block, heart rate lower than 40/min at rest, previous formal diagnosis of long QT syndrome, acute decompensated heart failure, severe hypotension, advanced (stage IV) or decompensated chronic obstructive pulmonary disease (COPD);
  • Uncontrolled hypertension (systolic BP \>180mmHg or DBP \>110mmHg, despite ongoing therapy);
  • Clinical heart failure NYHA class III/IV or Ejection Fraction on imaging modality (Echo, MRI) \<40%;
  • Severe valvular heart disease;
  • Severe (\>95% diameter) epicardial coronary stenosis;
  • Recent (last 12 months) clinically significant cerebrovascular event (including ischaemic or haemorrhagic events);
  • End-stage renal failure (eGFR \< 30 mL/min/1.73m2);
  • Advanced liver disease, defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \> 3x ULN
  • Current use of PCSK9 inhibitor;
  • Malignancy with life expectancy \<1y;
  • Currently or within last 3 months enrolled on another CTIMP;
  • Known allergy to evolocumab or incipients;
  • Women of childbearing potential who are unwilling or unable to use a highly effective method of contraception from screening until 15 weeks after the last dose of IP.
  • Subject is pregnant or breast feeding or planning to become pregnant or to breastfeed during screening, during treatment with IP and/ or within 15 weeks after the end of treatment with IP.

Key Trial Info

Start Date :

September 11 2019

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

May 27 2022

Estimated Enrollment :

12 Patients enrolled

Trial Details

Trial ID

NCT04073134

Start Date

September 11 2019

End Date

May 27 2022

Last Update

August 6 2024

Active Locations (1)

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1

Imperial College NHS Foundation Trust

London, United Kingdom, W12 0HS