Philips announces DEFINE GPS global multicenter study to assess outcomes of PCI procedures guided by integrated iFR and interventional X-ray images

“PCI has made a major positive impact on many coronary artery disease patients’ lives,” said Allen Jeremias, MD of St. Francis Hospital, Roslyn, NY, and Cardiovascular Research Foundation, New York, NY, U.S. and principal investigator of the DEFINE GPS study. “However, when we look back at all the major, high-quality stent trials over the past 20 years we see that around 20-30% of patients continue to have recurring chest pain at one year after receiving treatment. With the DEFINE PCI study we observed that the current approach to PCI has limitations for identifying the locations of physiologically significant arterial lesions. With DEFINE GPS we will be able to determine if a physiology-based PCI approach results in superior patient outcomes when compared with standard angioplasty.”

“As coronary stenting is applied to increasingly complex patients, it is essential that we ensure that all segments of coronary artery disease that need treatment are treated, a process that we believe can be facilitated by iFR assessment of the entire coronary artery, co-registered to the angiogram.” said Dr. Gregg W. Stone, chairman of the DEFINE GPS trial, Director of Academic Affairs for the for the Mount Sinai Heart Health System, Professor of Medicine (Cardiology) and Professor of Population Health Sciences and Policy at the Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY. “We are thrilled to be able to examine the extent to which this technique improves patient outcomes in the large-scale DEFINE GPS trial.”

The global multicentre, prospective, randomized controlled DEFINE GPS study will investigate the impact of iFR Co-registration on both outcomes and cost effectiveness. The primary endpoint is target vessel failure (a composite of cardiac death, target vessel Myocardial Infarction and ischemia-driven target vessel revascularization) or rehospitalization for progressive or unstable ischemia at two years. 

“iFR continues to be adopted into clinical practice, with mounting evidence that this innovative technology contributes to improving outcomes, reducing costs [1, 2, 3] and enhancing the patient experience,” said Chris Landon, Senior Vice President and General Manager Image Guided Therapy Devices, Philips. “This major study will provide a definitive answer to the question of the overall improvement resulting from the use of a functional guidance strategy on patient outcomes and cost.”

The Philips Image-Guided Co-registration System (SyncVision) is part of Philips’ unique portfolio of systems, smart devices, software and services in image-guided therapy, which combine to provide healthcare providers with sophisticated, procedure-oriented solutions. 

The DEFINE GPS study is sponsored by Philips with the Cardiovascular Research Foundation overseeing core lab and clinical event committee activities. The first patients will be recruited in the second half of 2020.

[1] Davies JE, et al. Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI. N Engl J Med. 2017 May 11;376(19):1824-1834.

[2] Gotberg M, et al. iFR Swedeheart Investigators. Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI. N Engl J Med. 2017 May 11;376(19):1813-1823.

[3] Tonino, et al. Fractional Flow Reserve Versus Angiography for Guiding Percutaneous Coronary Intervention. N Engl J Med. 2009;360(3):213-224.