Ischemic and Bleeding Outcomes After Angiolite Stent Implantation and an Abbreviated Dual Antiplatelet Therapy
- Conditions
- Coronary Artery Disease
- Interventions
- Registration Number
- NCT05952206
- Lead Sponsor
- iVascular S.L.U.
- Brief Summary
Factorial 2x2, all-comer, multicentre, randomized controlled trial (ratio 1:1:1:1). First, the study will compare (first randomization) the non-inferiority in target lesion failure of angiolite stent versus Xience stent family. Immediately after the first randomization, the study compares (second randomization) the superiority in bleeding Bleeding Academic Research Consortium (BARC) 2, 3, or 5 of abbreviated DAPT versus standard of care. Both primary endpoints will be evaluated at 12 months of follow-up. The study will be open-label for the stent type and the antiplatelet regimen.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 2312
- Age >18 - < 95 years;
- Presence of one or more coronary artery stenosis of 50% or more in a native coronary artery or in a saphenous venous or arterial bypass conduit suitable for coronary stent implantation. The vessel should have a reference vessel diameter of at least 2.00 mm (no limitation on the number of treated lesions, vessels, or lesion length);
- Able to provide informed consent and willing to participate in the trial.
- Known intolerance to acetylsalicylic acid, P2Y12 inhibitors (clopidogrel, prasugrel, or ticagrelor), sirolimus, everolimus, or chromium-cobalt.;
- Known severe hepatic impairment Child-Pug stage C;
- Prior PCI (not related to the study) performed in the last 45 days;
- Planned non-cardiac surgery during the first month after PCI, unless dual antiplatelet therapy is maintained throughout the peri-surgical period;
- Planned coronary artery bypass graft (CABG) or any other cardiac surgery (valvular for instance) following index PCI;
- Active major bleeding or major surgery within the last 30 days;
- Known stroke (any type) within the 30 days prior to the randomization;
- Women of childbearing potential being defined as woman from the onset of menstruation (menarche) until they become postmenopausal, unless they are permanently sterile. A postmenopausal state is clarified as having no menstrual periods for 12 consecutive months without any other medical cause. Women who have undergone permanent sterilization methods, including hysterectomy, bilateral salpingectomy, and bilateral oophorectomy, can be enrolled in the study
- Currently participating in another randomized controlled trial and not yet at its primary endpoint;
- Life expectancy less than one year due to non-cardiovascular comorbidity.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description Angiolite and standard of care DAPT 12-month DAPT (Standard of care) Acute coronary syndrome patients: * Need for OAC: Recommendations of the current ESC guideline: 1M of TAT (acetylsalicylic acid + clopidogrel + OAC). Dual therapy (acetylsalicylic acid or clopidogrel + OAC) up to 12M. If ischemic concerns prevail, TAT can be extended up to 6M and dual therapy up to 12M. * No need for OAC: Recommendations of the current ESC guideline: DAPT with acetylsalicylic acid and prasugrel or ticagrelor is recommended up to 12M. Chronic coronary syndrome: * Need for OAC: Recommendations of the current ESC guidelines: 1M of TAT (acetylsalicylic acid + clopidogrel + OAC). Dual therapy (acetylsalicylic acid or clopidogrel + OAC) up to 12M. If ischemic concerns prevail, TAT can be extended up to 6M and dual therapy up to 12M. * No need for OAC: Recommendations of the current ESC guidelines: DAPT composed of acetylsalicylic acid + clopidogrel up to 6M. Then, continue with acetylsalicylic acid. Xience stent family and standard of care DAPT 12-month DAPT (Standard of care) Acute coronary syndrome patients: * Need for OAC: Recommendations of the current ESC guideline: 1M of TAT (acetylsalicylic acid + clopidogrel + OAC). Dual therapy (acetylsalicylic acid or clopidogrel + OAC) up to 12M. If ischemic concerns prevail, TAT can be extended up to 6M and dual therapy up to 12M. * No need for OAC: Recommendations of the current ESC guideline: DAPT with acetylsalicylic acid and prasugrel or ticagrelor is recommended up to 12M. Chronic coronary syndrome: * Need for OAC: Recommendations of the current ESC guidelines: 1M of TAT (acetylsalicylic acid + clopidogrel + OAC). Dual therapy (acetylsalicylic acid or clopidogrel + OAC) up to 12M. If ischemic concerns prevail, TAT can be extended up to 6M and dual therapy up to 12M. * No need for OAC: Recommendations of the current ESC guidelines: DAPT composed of acetylsalicylic acid + clopidogrel up to 6M. Then, continue with acetylsalicylic acid. Angiolite and abbreviated DAPT 1-month DAPT Acute coronary syndrome patients: * Need for OAC: TAT + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6 months. * No need for OAC: DAPT with acetylsalicylic acid + prasugrel or ticagrelor for 1M. Only the same P2Y12 inhibitor up to 12M. Chronic coronary syndrome patients: * Need for OAC: TAT + clopidogrel + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6M. * No need for OAC: DAPT with acetylsalicylic acid + clopidogrel for one month. Only clopidogrel up to 12M. Xience stent family and abbreviated DAPT 1-month DAPT Acute coronary syndrome patients: * Need for OAC: TAT + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6M. * No need for OAC: DAPT with acetylsalicylic acid + prasugrel or ticagrelor for 1 month. Only the same P2Y12 inhibitor up to 12M. Chronic coronary syndrome patients: * Need for OAC: TAT + clopidogrel + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6M. * No need for OAC: DAPT with acetylsalicylic acid + clopidogrel for one month. Only clopidogrel up to 12M. Angiolite and abbreviated DAPT 1-month DAPT Acute coronary syndrome patients: * Need for OAC: TAT + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6 months. * No need for OAC: DAPT with acetylsalicylic acid + prasugrel or ticagrelor for 1M. Only the same P2Y12 inhibitor up to 12M. Chronic coronary syndrome patients: * Need for OAC: TAT + clopidogrel + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6M. * No need for OAC: DAPT with acetylsalicylic acid + clopidogrel for one month. Only clopidogrel up to 12M. Xience stent family and abbreviated DAPT 1-month DAPT Acute coronary syndrome patients: * Need for OAC: TAT + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6M. * No need for OAC: DAPT with acetylsalicylic acid + prasugrel or ticagrelor for 1 month. Only the same P2Y12 inhibitor up to 12M. Chronic coronary syndrome patients: * Need for OAC: TAT + clopidogrel + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6M. * No need for OAC: DAPT with acetylsalicylic acid + clopidogrel for one month. Only clopidogrel up to 12M. Angiolite and standard of care DAPT 12-month DAPT (Standard of care) Acute coronary syndrome patients: * Need for OAC: Recommendations of the current ESC guideline: 1M of TAT (acetylsalicylic acid + clopidogrel + OAC). Dual therapy (acetylsalicylic acid or clopidogrel + OAC) up to 12M. If ischemic concerns prevail, TAT can be extended up to 6M and dual therapy up to 12M. * No need for OAC: Recommendations of the current ESC guideline: DAPT with acetylsalicylic acid and prasugrel or ticagrelor is recommended up to 12M. Chronic coronary syndrome: * Need for OAC: Recommendations of the current ESC guidelines: 1M of TAT (acetylsalicylic acid + clopidogrel + OAC). Dual therapy (acetylsalicylic acid or clopidogrel + OAC) up to 12M. If ischemic concerns prevail, TAT can be extended up to 6M and dual therapy up to 12M. * No need for OAC: Recommendations of the current ESC guidelines: DAPT composed of acetylsalicylic acid + clopidogrel up to 6M. Then, continue with acetylsalicylic acid. Xience stent family and standard of care DAPT 12-month DAPT (Standard of care) Acute coronary syndrome patients: * Need for OAC: Recommendations of the current ESC guideline: 1M of TAT (acetylsalicylic acid + clopidogrel + OAC). Dual therapy (acetylsalicylic acid or clopidogrel + OAC) up to 12M. If ischemic concerns prevail, TAT can be extended up to 6M and dual therapy up to 12M. * No need for OAC: Recommendations of the current ESC guideline: DAPT with acetylsalicylic acid and prasugrel or ticagrelor is recommended up to 12M. Chronic coronary syndrome: * Need for OAC: Recommendations of the current ESC guidelines: 1M of TAT (acetylsalicylic acid + clopidogrel + OAC). Dual therapy (acetylsalicylic acid or clopidogrel + OAC) up to 12M. If ischemic concerns prevail, TAT can be extended up to 6M and dual therapy up to 12M. * No need for OAC: Recommendations of the current ESC guidelines: DAPT composed of acetylsalicylic acid + clopidogrel up to 6M. Then, continue with acetylsalicylic acid.
- Primary Outcome Measures
Name Time Method To determine the rate of target lesion failure between angiolite stent and Xience stent family (tested for non-inferiority) in both the standard of care DAPT regimen and abbreviated antiplatelet therapy group. 1 year To determine the rate of clinically relevant bleeding events (BARC 2, 3, or 5) between an abbreviated DAPT regimen and the standard of care DAPT (tested for superiority of the experimental arm). 1 year
- Secondary Outcome Measures
Name Time Method To determine the rate of adverse ischemic events between an abbreviated dual antiplatelet therapy regimen and the standard of care dual antiplatelet therapy (tested for non-inferiority). 1 year Rate of target lesion failure between angiolite stent and Xience stent family (Skypoint or Sierra) (tested for non-inferiority) in the standard of care subgroup. 1 year
Trial Locations
- Locations (39)
Olv Aalst
š§šŖAalst, Belgium
IMELDA
š§šŖBonheiden, Belgium
CHU Marie Curie
š§šŖCharleroi, Belgium
ZOL GENK
š§šŖGenk, Belgium
CHC MontlƩgia
š§šŖLiĆØge, Belgium
Hospital de La Citadelle
š§šŖLiĆØge, Belgium
Chu Ambroise Pare
š§šŖMons, Belgium
Az Delta
š§šŖRoeselare, Belgium
Az Turnhout
š§šŖTurnhout, Belgium
Chu Lille
š«š·Lille, France
Icps Massy
š«š·Massy, France
Ipcs Quincy
š«š·Quincy-sous-SĆ©nart, France
Chu Toulouse
š«š·Toulouse, France
Complejo Hospitalario Universitario A CoruƱa
šŖšøA CoruƱa, Spain
Complejo Hospitalario TorrecƔrdenas
šŖšøAlmerĆa, Spain
Hospital ClĆnic de Barcelona
šŖšøBarcelona, Spain
Hospital de La Santa Creu I Sant Pau
šŖšøBarcelona, Spain
Hospital Germans Trias I Pujol
šŖšøBarcelona, Spain
Hospital Universitario de Bellvitge
šŖšøBarcelona, Spain
Hospital Universitario Vall D'Hebrón
šŖšøBarcelona, Spain
Hospital San Pedro de Alcantara
šŖšøCĆ”ceres, Spain
Hospital Universitario Juan Ramón Jiménez
šŖšøHuelva, Spain
Hospital Universitario Jerez de La Frontera
šŖšøJerez De La Frontera, Spain
Hospital Universitario de Gran Canaria Doctor NegrĆn
šŖšøLas Palmas de Gran Canaria, Spain
Hospital Universitario de León
šŖšøLeón, Spain
Hospital Universitario 12 de Octubre
šŖšøMadrid, Spain
Hospital Universitario Puerta de Hierro
šŖšøMadrid, Spain
Hospital ClĆnico Universitario Virgen de La Arrixaca
šŖšøMurcia, Spain
Hospital Universitario Regional de MƔlaga
šŖšøMĆ”laga, Spain
Hospital Universitario Virgen de La Victoria
šŖšøMĆ”laga, Spain
Hospital Universitari Son Espases
šŖšøPalma De Mallorca, Spain
Hospital de Navarra
šŖšøPamplona, Spain
Hospital Universitario MarquƩs de Valdecilla
šŖšøSantander, Spain
Hospital ClĆnico Universitario de Santiago
šŖšøSantiago De Compostela, Spain
Hospital ClĆnico Universitario de Valencia
šŖšøValencia, Spain
Hospital Universitario Y PolitƩcnico La Fe
šŖšøValencia, Spain
Hospital ClĆnico Universitario de Valladolid
šŖšøValladolid, Spain
Hospital Ćlvaro Cunqueiro
šŖšøVigo, Spain
Hospital Universitario Miguel Servet
šŖšøZaragoza, Spain