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Efficacy and Safety of New Generation Drug Eluting Stents Associated With an Ultra Short Duration of Dual Antiplatelet Therapy. Design of the Short Duration of Dual antiplatElet Therapy With SyNergy II Stent in Patients Older Than 75 Years Undergoing Percutaneous Coronary Revascularization.

Not Applicable
Completed
Conditions
Acute Coronary Syndrome
Silent Myocardial Ischemia
Stable Angina
Registration Number
NCT02099617
Lead Sponsor
Ceric Sàrl
Brief Summary

The main objective of the SENIOR study is to establish the efficacy and safety of the everolimus eluting stent with a biodegradable abluminal polymer (SYNERGY II) associated with a short dual antiplatelet therapy (DAPT) in patients ≥75 years old, suffering from stable angina, silent ischemia (1 month DAPT) or acute coronary syndromes (6 months DAPT) related to significant coronary artery disease and requiring percutaneous coronary intervention. The primary end point is to demonstrate that SYNERGY II in patients ≥75 years old is associated with a lower rate of the composite rate of major cardiovascular and cerebrovascular events (all-cause death, myocardial infarction, stroke, ischemia-driven target lesion revascularization) and a similar risk of stent thrombosis than bare metal stent at one year.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1200
Inclusion Criteria
  • 1- Patient is ≥ 75 years old
  • 2- One or more significant coronary artery stenosis is/are present (defined as ≥70% by visual assessment or ≥50% with Fractional Flow Reserve <0.80) or a left main coronary stenosis ≥50% by visual assessment) suitable for PCI with one of the following present:
  • a -Silent ischemia,
  • stress-induced myocardial ischemia ≥ 10% of myocardium in a asymptomatic patient or
  • stress-induced myocardial ischemia < 10% of myocardium AND FFR (Fractional Flow Reserve) ≤0.80 or
  • b - Stable angina, in a patient with objective ischemia despite optimal medical therapy or
  • c - acute coronary syndrome including: unstable angina, non ST- and ST elevation myocardial infarction.
  • 3- All patients must also sign informed consent as per local law and comply with all study process during follow up for at least one year.
Exclusion Criteria
  • 1- The subject is not eligible for randomization if ANY of the following is present:
  • 2- Indication for myocardial revascularization by coronary artery bypass grafting,
  • 3- Subjects unable to tolerate, obtain or comply with dual antiplatelet therapy for at least one month (stable angina or silent ischemia) or at least six month (acute coronary syndrome),
  • 4- Subjects requiring additional surgery (cardiac or non-cardiac) within one month,
  • 5- Non cardiac co-morbidities with life expectancy less than 1 year,
  • 6- Prior hemorrhagic stroke,
  • 7- Known allergy to aspirin or P2Y12 inhibitors,
  • 8- At least one contra indication to ALL the authorized P2Y12 inhibitors at the requested dose (in case of contra indication to only one of two of the P2Y12 inhibitors, the investigators are allowed to use the P2Y12 inhibitors for which no allergy is known).
  • 9- Silent ischemia <10% of the myocardium with FFR ≥0.80.
  • 10- Participation in another clinical trial

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Composite measure of MACCEs (Major Adverse Cardiac and Cerebrovascular Events)12 months

all-cause death, non fatal myocardial infarction, non fatal stroke, ischemia-driven target lesion revascularization.

Secondary Outcome Measures
NameTimeMethod
Cost effectiveness12 months
Primary endpoint30 days, 180 days, 2 years
Complete revascularizationBaseline procedure

anatomic and functional

Stent thombosis30 days, 1 year, 2 years

according to the definition of ARC symptomatic or asymptomatic (definite + probable)

All revascularizations30 days, 180 days, 1 year, 2 years

All target lesion revascularization, all target vessel revascularization, all non target vessel revascularization

Net benefit30 days, 180 daysn 1 year, 2 years

association of composite events (all cause mortality, myocardial infarction, stroke, ischemia driven target lesion revascularization, and major bleedings)

Major bleedings complications30 days, 180 days, 1 year, 2 years

type 2, 3 and 5 BARC definition)

Depression scale12 months, 24 months
QoL12 months, 24 months

Trial Locations

Locations (44)

CHU St Pierre

🇧🇪

Brussels, Belgium

Centre Hospitalier de Jolimont

🇧🇪

La Louvière, Belgium

UZ Leuven

🇧🇪

Leuven, Belgium

CHU de Liège - Domaine Universitaire du Sart Tilman

🇧🇪

Liège 1, Belgium

Oulu University Hospital

🇫🇮

Oulu, Finland

Heary Center - Satakunta Centyral Hospital

🇫🇮

Pori, Finland

Hôpital Ambroise Paré

🇫🇷

Boulogne-Billancourt, France

Hôpital Henri Mondor

🇫🇷

Créteil, France

Hôpital de la Timone

🇫🇷

Marseille, France

Hôpital Privé Jacques Cartier

🇫🇷

Massy, France

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CHU St Pierre
🇧🇪Brussels, Belgium

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