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Chronic Coronary SyndromeCAPITAL-PLAQUENCT06896708

Effect of Intensive Lipid-Lowering Therapy on Coronary Atherosclerotic Plaque Progression in Young and Middle-Aged Patients With Chronic Coronary Syndrome

A study testing Intensive lipid-lowering strategy and Standard lipid-lowering strategy in people with Chronic Coronary Syndrome, run by Liu yong at 7 sites in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This is a multicenter, open-label, parallel-group, randomized trial to determine if intensive lipid-lowering therapy (goal for LDL-C <1.0 mmol/L and ≥50% reduction frome baseline) could delay progression of coronary atherosclerotic obstructive leisions compared with guideline recommended lipid-lowering therapy (goal… Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Chronic Coronary Syndrome
What is being tested?
Intensive lipid-lowering strategy and Standard lipid-lowering strategy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
766 participants
Where
7 sitesChina
Study dates
12 Aug 2025to 1 Mar 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • 1. Aged 18-60 years at screening 2. Stable angina symptoms with suspected or confirmed coronary artery disease; 2. CCTA examination demonstrating: at least one major coronary artery with a diameter of ≥1.5mm that has not been intervened and at least one leision with 50%-70% stenosis.
  • 3. Subjects who have been using statin therapy alone for at least 4 weeks prior to enrollment with a baseline LDL-C ≥1.8mmol/L or subjects who have not initiated lipid-lowering therapy prior to enrollment with a baseline LDL-C≥2.6mmol/L.

Who cannot join

  • Left main coronary artery disease or severe three-vessel disease;
  • Ultra-high-risk ASCVD patients: ≥2 severe ASCVD events or 1 severe ASCVD event with ≥2 high-risk factors;
  • Use of PCSK9 inhibitors or ezetimibe within 8 weeks prior to study enrollment;
  • The baseline LDL-C was relatively high (LDL-C≥2.6 mmol/L in those taking statins and ≥4.9 mmol/L in those not taking statins).
  • Familial hypercholesterolemia;
  • Known allergy/intolerance to lipid-lowering drugs used in the trial;
  • Patients with severe congestive heart failure, liver or kidney dysfunction, or malignancy;
  • Pregnant or breastfeeding female patients.

Trial locations and contacts

7 sites in 1 country. Contact the study team or a site near you to ask about taking part.

7 sites in 1 country

China7 sites, 7 recruiting
  • The First Affiliated Hospital of Chongqing Medical University

    Chongqing, Chongqing Municipality, 400015

    Not yet recruiting
  • The First Affiliated Hospital of Dalian Medical University

    Dalian, Liaoning, 116000

    Not yet recruiting
  • The Ninth Clinical Medical College of Guangzhou University of Chinese Medicine

    Dongguan, Guangdong, 523000

    Not yet recruiting
  • The Third Affiliated Hospital of Guangzhou Medical University

    Guangzhou, Guangdong, 510000

    Not yet recruiting
  • Guangdong Provincial People's Hospital

    Guangzhou, Guangdong, 510100

    Yong Liu, MD, PhD, +86 2083827812, liuyong@gdph.org.cn

    Recruiting
  • The Eighth Affiliated Hospital of Sun Yat-sen University

    Shenzhen, Guangdong, 518033

    Not yet recruiting
  • Zhongshan People's Hospital

    Zhongshan, Guangdong, 528400

    Not yet recruiting

Other trials in China

About this study

Official title: Coronary Computed Tomography Study to Assess the Effect of Intensive Lipid-Lowering Therapy on Coronary Atherosclerotic Plaque Progression in Young and Middle-Aged Patients With Chronic Coronary Syndrome: A Nationwide, Multicentre, Randomized Controlled Trial

This is a multicenter, open-label, parallel-group, randomized trial to determine if intensive lipid-lowering therapy (goal for LDL-C <1.0 mmol/L and ≥50% reduction frome baseline) could delay progression of coronary atherosclerotic obstructive leisions compared with guideline recommended lipid-lowering therapy (goal for LDL-C <1.8 mmol/L and ≥50% reduction frome baseline) among participants between 18-60 years old with non-invasively managed chronic coronary syndrome (at least one lesion with a 50%-70% stenosis).

Read the detailed description

Coronary artery disease (CAD) remains the leading cause of mortality worldwide, driven predominantly by the intricate dynamics between lipid metabolism and atherosclerosis. In recent years, the incidence of CAD among middle-aged and young patients has been increasing rapidly, with high-risk of recurrent cardiovascular adverse events. Inadequate lipid control is a significant contributing factor to the progession of CAD. 2024 ESC Guidelines for the managementof chronic coronary syndromes (CCS) and 2024 Chinese guidelines for the diagnosis and management of patients with chronic coronary syndrome highlight the importance of moderate-intensity lipid-lowering therapy control for patients with CCS, goal for LDL-C <1.4 mmol/L or 1.8mmol/L, respectively, and ≥50% reduction frome baseline. The Progression of Early Subclinical Atherosclerosis (PESA) study showed that among individuals with subclinical atherosclerotic plaques, the proportion of plaque regression was highest in young and middle-aged patients, and lower LDL-C levels significantly increased the likelihood of plaque regression. However, for young and middle-aged patients with chronic coronary syndrome, there remains a lack of definitive research data on the effects of intensive lipid-lowering therapy on coronary plaque progession.

CCTA-based noninvasive methods can accurately and sensitively identify and quantify coronary plaque characteristics, providing detailed information about plaque composition, volume, and morphology. This advanced imaging technology allows for precise assessment of high-risk plaque features, such as positive remodeling, low-attenuation plaques, and spotty calcifications, which are critical for evaluating the risk of future adverse cardiovascular events. Additionally, CCTA offers the advantage of longitudinal monitoring, enabling the evaluation of plaque progression or regression in response to lipid-lowering therapy.

This prospective, randomized, open-label, blinded endpoint trial will randomize about 766 participantis aged between 18 and 60 years with with non-invasively managed chronic coronary syndrome (at least one lesion with a 50%-70% stenosis) into the intervention group (goal for LDL-C <1.0 mmol/ and ≥50% reduction frome baseline) and the control group (goal for LDL-C <1.8 mmol/L and ≥50% reduction frome baseline). The aim of this study is to assess the role of intensive lipid-lowering control in delaying plaque progression, especially non-calcified plaques identified by CCTA.

Being tested
Intensive lipid-lowering strategy, Standard lipid-lowering strategy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Intensive lipid-lowering strategyDrug

    The initial recommended therapy is 20mg atorvastatin/10mg rosuvastatin plus Ezetimibe or PCSK9i, and the type and dosage of drugs can be adjusted according to the situation. If the target LDL-C level is not achieved during the Follow-up periods, adjustment of drug type and dosage will be carried out according to procedures defined in the protocol.

  • Standard lipid-lowering strategyDrug

    The initial recommended therapy is 20mg atorvastatin/10mg rosuvastatin, and the type and dosage of drugs can be adjusted according to the situation. If the target L-DLC level is not achieved during the Follow-up periods, adjustment of drug type and dosage will be carried out according to procedures defined in the protocol.

Study groups in NCT06896708
Study groupRoleWhat they receive
Intensive lipid-lowering strategyExperimentalLDL-C reduce to <1.0mmol/L and by ≥50% relative to baseline levels.
Receives: Drug: Intensive lipid-lowering strategy
Standard lipid-lowering strategyActive comparatorLDL-C reduce to <1.8mmol/L and by ≥50% relative to baseline levels.
Receives: Drug: Standard lipid-lowering strategy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The composite events of atherosclerotic plaque progression

    A composite end-point comprised of plaque progression, nonfatal myocardial infarction, death, or unstable angina driven rehospitalization or revascularization. Plaque progression is defined as an anual progression of PAV measured by CCTA more than 1%. PAV = (total plaque volume/vessel volume) *100%.

    Measured: 12 months

Secondary outcomes (10)
  1. Major adverse cardiac events

    Composite of nonfatal myocardial infarction, death, or unstable angina driven rehospitalization or revascularization.

    Measured: 12 months

  2. Plaque progression event

    The proportion of annual change in PAV >1%

    Measured: 12 months

  3. Agatston score changes of coronary artery and aortic valve

    Evaluating intensive group compared to standard group in Agatston score changes of coronary artery and aortic valve evaluated by CCTA

    Measured: 12 months

  4. Percentage change in total coronary atheroma volume

    Evaluating intensive group compared to standard group in total atheroma volume change evaluated by CCTA. PAV = (total plaque volume/vessel volume) *100%.

    Measured: 12 months

  5. Change in non-obstructive lesion reversal rate

    Evaluating intensive group compared to standard group in anual change of rate of improvement from coronary artery obstructive lesions (stenosis rate ≥50%) to non-obstructive lesions (stenosis rate <50%)

    Measured: 12 months

  6. Change in total atheroma volume by CCTA

    Evaluating intensive group compared to standard group in total atheroma volume change evaluated by CCTA.

    Measured: 12 months

  7. Change in total volume and percentage of non-calcified plaques and calcified plaques

    Evaluating intensive group compared to standard group in total volume and percentage of non-calcified plaques and calcified plaques' change evaluated by CCTA.

    Measured: 12 months

  8. Change in the proportion of high-risk plaques

    Evaluating intensive group compared to standard group in the proportion of high-risk plaques' change evaluated by CCTA.

    Measured: 12 months

  9. Change in CT Fractional Flow Reserve (CT-FFR)

    Evaluating intensive group compared to standard group in CT-FFR change evaluated by CCTA.

    Measured: 12 months

  10. Change in perivascular fat attenuation index (FAI)

    Evaluating intensive group compared to standard group in FAI change evaluated by CCTA.

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Mar 2025
  2. Study start12 Aug 2025
  3. Primary completion1 Jul 2027 (estimated)
  4. Study completion1 Mar 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
766 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06896708
Sponsor's protocol ID
KY2025-394-02
Acronym
CAPITAL-PLAQUE
Status last verified
Mar 2025
First submitted
11 Feb 2025
Last updated
17 Dec 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Mendieta G, Pocock S, Mass V, Moreno A, Owen R, Garcia-Lunar I, Lopez-Melgar B, Fuster JJ, Andres V, Perez-Herreras C, Bueno H, Fernandez-Ortiz A, Sanchez-Gonzalez J, Garcia-Alvarez A, Ibanez B, Fuster V. Determinants of Progression and Regression of Subclinical Atherosclerosis Over 6 Years. J Am Coll Cardiol. 2023 Nov 28;82(22):2069-2083. doi: 10.1016/j.jacc.2023.09.814.

    PubMed 37993199
  • Vrints C, Andreotti F, Koskinas KC, Rossello X, Adamo M, Ainslie J, Banning AP, Budaj A, Buechel RR, Chiariello GA, Chieffo A, Christodorescu RM, Deaton C, Doenst T, Jones HW, Kunadian V, Mehilli J, Milojevic M, Piek JJ, Pugliese F, Rubboli A, Semb AG, Senior R, Ten Berg JM, Van Belle E, Van Craenenbroeck EM, Vidal-Perez R, Winther S; ESC Scientific Document Group. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024 Sep 29;45(36):3415-3537. doi: 10.1093/eurheartj/ehae177. No abstract available.

    PubMed 39210710
  • Raber L, Ueki Y, Otsuka T, Losdat S, Haner JD, Lonborg J, Fahrni G, Iglesias JF, van Geuns RJ, Ondracek AS, Radu Juul Jensen MD, Zanchin C, Stortecky S, Spirk D, Siontis GCM, Saleh L, Matter CM, Daemen J, Mach F, Heg D, Windecker S, Engstrom T, Lang IM, Koskinas KC; PACMAN-AMI collaborators. Effect of Alirocumab Added to High-Intensity Statin Therapy on Coronary Atherosclerosis in Patients With Acute Myocardial Infarction: The PACMAN-AMI Randomized Clinical Trial. JAMA. 2022 May 10;327(18):1771-1781. doi: 10.1001/jama.2022.5218.

    PubMed 35368058
  • Mensah GA, Fuster V, Murray CJL, Roth GA; Global Burden of Cardiovascular Diseases and Risks Collaborators. Global Burden of Cardiovascular Diseases and Risks, 1990-2022. J Am Coll Cardiol. 2023 Dec 19;82(25):2350-2473. doi: 10.1016/j.jacc.2023.11.007. No abstract available.

    PubMed 38092509

Questions about this trial

What is this clinical trial studying?

A study testing Intensive lipid-lowering strategy and Standard lipid-lowering strategy in people with Chronic Coronary Syndrome, run by Liu yong at 7 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 17 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The composite events of atherosclerotic plaque progression (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06896708, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Dec 2025.

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