Actively Recruiting

Phase Not Applicable
Age: 20Years +
All Genders
ID05831085

A Comparison of Imaging- and Physiology-Guided Percutaneous Coronary Intervention and Coronary-Artery Bypass Grafting in Patients With Diabetes and Three-Vessel Coronary Artery Disease

Led by Duk-Woo Park, MD · Updated on 2025-12-30

1500

Participants Needed

27

Research Sites

26 weeks

Total Duration

On this page

Sponsors

D

Duk-Woo Park, MD

Lead Sponsor

C

CardioVascular Research Foundation, Korea

Collaborating Sponsor

AI-Summary

What this Trial Is About

Researchers are comparing two advanced heart procedures for patients with type 2 diabetes and significant three-vessel coronary artery disease (CAD) that does not involve the left main artery. The study aims to evaluate outcomes between imaging- and physiology-guided percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in this group. This randomized trial is led by Dr. Duk-Woo Park and focuses on major heart and brain-related events over two years. Participants will receive either state-of-the-art PCI, which includes advanced imaging and physiological assessments, the use of modern drug-eluting stents, and optimal medical therapy including cardiovascular and anti-diabetic medications, or they will undergo standard CABG surgery. Treatments are designed specifically for patients with diabetes and complex three-vessel coronary artery disease. The trial randomly assigns participants to one of these two treatment groups. During the study, participants will be closely monitored for major adverse cardiac or cerebrovascular events over two years, with extended follow-up to five years assessing outcomes such as death, heart attacks, repeat procedures, stroke, bleeding, hospital stays, and quality of life measures. Regular evaluations will include changes in angina symptoms, medication use, and healthcare costs. This comprehensive monitoring aims to understand the long-term effects and cost-effectiveness of the two revascularization strategies.

CONDITIONS

Brief Title

Diabetes-Centered Evaluation of Revascularization Strategy of Functional and Imaging-CombiNEd State-of-the-Art Percutaneous Coronary Intervention or Coronary-Artery Bypass Grafting in Patients With Diabetes Mellitus and Multivessel Coronary Artery Disease

Who Can Participate

Age: 20Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Age 20 years or older with angina and/or evidence of myocardial ischemia
  • Diagnosis of type 2 diabetes requiring insulin or oral diabetes medications, or confirmed elevated blood glucose levels
  • Significant three-vessel coronary artery disease with 50% or greater narrowing in each of the three major vessels, excluding left main artery
  • Agreement to follow the study protocol and schedule, with signed informed consent
Not Eligible

You will not qualify if you...

  • Unprotected left main coronary artery disease
  • Complex coronary anatomy or other heart conditions making PCI unsuitable
  • Recent ST-elevation myocardial infarction within 5 days prior to randomization
  • Cardiogenic shock or need for mechanical/pharmacologic support
  • Severe left ventricular dysfunction with ejection fraction below 30%
  • Need for other cardiac or non-cardiac surgery except maze procedure or pulmonary vein isolation
  • Inability or contraindication to take aspirin or P2Y12 inhibitors for at least 6 months
  • Prior coronary artery bypass graft surgery
  • Extremely calcified or tortuous vessels preventing imaging or physiology evaluation
  • More than one major vessel with chronic total occlusion; one allowed
  • Requirement for additional surgery within 1 year
  • End-stage kidney disease needing replacement therapy
  • Liver cirrhosis
  • Pregnancy or breastfeeding
  • Medical conditions with life expectancy less than 2 years
  • Active participation in another investigational drug or device study not completed primary endpoint follow-up

AI-Screening

AI-Powered Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment

Duration - Hospital stay up to 7 days

Participants receive either imaging- and physiology-guided percutaneous coronary intervention or coronary-artery bypass grafting to treat their three-vessel coronary artery disease with diabetes.

1 procedure visit and hospital stay

Follow-up

Duration - Up to 5 years

Participants are monitored for major cardiac events, quality of life, and medication use over time after treatment.

Regular visits at 1, 6, 12, 18, 24, 36, and 60 months

Trial Site Locations

Total: 27 locations

1

Palo Alto VA Medical Center

Palo Alto, California, United States, 94304

Not Yet Recruiting

2

Fuwai Hospital, Chinese Academy of Medical Sciences (CAMS)

Beijing, China

Not Yet Recruiting

3

Second Affiliated Hospital of Zhejiang University School of Medicine

Hanzhou, China

Actively Recruiting

4

Medanta - The Medicity

Gurugram, India

Actively Recruiting

5

Fortis Escorts Heart Institute

New Delhi, India

Not Yet Recruiting

6

Sarawak Heart Centre

Kota Samarahan, Malaysia

Actively Recruiting

7

University Clinical Center of Serbia

Belgrade, Serbia

Not Yet Recruiting

8

National Heart Centre Singapore (NHCS)

Singapore, Singapore

Not Yet Recruiting

9

Daegu Catholic University Medical Center

Daegu, South Korea

Not Yet Recruiting

10

Keimyung University Dongsan Medical Center

Daegu, South Korea

Actively Recruiting

11

Yeungnam University Medical Center

Daegu, South Korea

Not Yet Recruiting

12

Chungnam National University Hospital

Daejeon, South Korea

Not Yet Recruiting

13

Konyang University Hospital

Daejeon, South Korea

Withdrawn

14

Gangneung Asan Hospital

Gangneung, South Korea

Not Yet Recruiting

15

Chonnam National University Hospital

Gwangju, South Korea

Actively Recruiting

16

National Health Insurance Service Ilsan Hospital

Ilsan, South Korea

Actively Recruiting

17

Gachon University Gil Hospital

Incheon, South Korea

Not Yet Recruiting

18

Dong-A Medical Center

Pusan, South Korea

Actively Recruiting

19

Asan Medical Center

Seoul, South Korea

Actively Recruiting

20

Hanyang University Seoul Hospital

Seoul, South Korea

Not Yet Recruiting

21

Samsung Medical Center

Seoul, South Korea

Actively Recruiting

22

SNU Boramae Medical Center

Seoul, South Korea

Not Yet Recruiting

23

The Catholic University of Korea, St. Vincent's Hospital

Suwon, South Korea

Not Yet Recruiting

24

The Catholic University of Korea, Uijeongbu ST. Mary's Hospital

Uijeongbu-si, South Korea

Actively Recruiting

25

Ulsan University Hospital

Ulsan, South Korea

Actively Recruiting

26

National Taiwan University Hospital

Taipei, Taiwan

Not Yet Recruiting

27

Siriraj Hospital

Bangkok, Thailand

Actively Recruiting

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Research Team

J

Jung-hee Ham, Project manager

How is the study designed?

Study Type

INTERVENTIONAL

Masking

SINGLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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