Actively Recruiting

Phase Not Applicable
Age: 70Years +
All Genders
NCT06559332

Coronary Artery Disease Assessment Strategies in TAVI Patients

Led by Insel Gruppe AG, University Hospital Bern · Updated on 2026-05-08

546

Participants Needed

1

Research Sites

368 weeks

Total Duration

On this page

Sponsors

I

Insel Gruppe AG, University Hospital Bern

Lead Sponsor

C

Clinical Trials Unit Bern (CTU)

Collaborating Sponsor

AI-Summary

What this Trial Is About

Coronary artery disease (CAD) and aortic stenosis frequently coincide. Before valve intervention, invasive coronary angiography is routinely performed to assess coronary status. As the impact of percutaneous revascularization on clinical outcomes beyond symptom improvement is subject to debate and treatment of aortic stenosis itself reduces ischemic burden and symptoms, the benefit/risk balance of routine invasive coronary angiography prior to transcatheter aortic valve implantation (TAVI) is unclear. The CAT Trial aims to compare a non-invasive risk management strategy to routine invasive coronary angiography for the assessment of coronary artery disease in patients with severe, symptomatic aortic stenosis selected to undergo TAVI with respect to adverse clinical outcomes at 3 years (primary objective) and patient reported outcome measures (secondary objective).

CONDITIONS

Official Title

Coronary Artery Disease Assessment Strategies in TAVI Patients

Who Can Participate

Age: 70Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Severe aortic stenosis defined by aortic valve area 1 cm2 or less and mean gradient 40 mmHg or higher or peak velocity 4.0 m/s or higher
  • If mean gradient is below 40 mmHg and peak velocity below 4 m/s with stroke volume index 35 mL/m2 or less and left ventricular ejection fraction (LVEF) 50% or higher, then CT-derived aortic valve calcium score must be above 2000 Agatston units in men or above 1200 in women
  • If mean gradient is below 40 mmHg and peak velocity below 4 m/s with stroke volume index 35 mL/m2 or less and LVEF below 50%, then either CT-derived aortic valve calcium score must be above 2000 Agatston units in men or above 1200 in women, or low-dose dobutamine stress echocardiography must show flow reserve and aortic valve area 1 cm2 or less
  • Coronary calcium score 400 Agatston units or more or known coronary artery disease
  • Selected for treatment with transfemoral TAVI
  • Written informed consent
Not Eligible

You will not qualify if you...

  • Concomitant valvular heart disease or ascending aortic aneurysm requiring surgery or intervention
  • Unprotected left main coronary stenosis greater than 50% or left main not evaluable based on coronary computed tomography angiography
  • Left ventricular ejection fraction below 30%
  • New regional wall motion abnormalities on echocardiography
  • Myocardial infarction in previous 12 months
  • Coronary angiography in previous 12 months
  • Prior left main stenting

AI-Screening

AI-Powered Screening

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Trial Site Locations

Total: 1 location

1

University Hospital Bern, Department of Cardiology

Bern, Switzerland, 3010

Actively Recruiting

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Research Team

J

Jonas Lanz, MD MSc

CONTACT

T

Thomas Pilgrim, MD MPH

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

SINGLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

DIAGNOSTIC

Number of Arms

2

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