A Clinical Evaluation of the XIENCE Everolimus Eluting Coronary Stent System in the Treatment of Women With de Novo Coronary Artery Lesions
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 455
- 试验地点
- 48
- 主要终点
- Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).
研究概览
简要总结
The purpose of this Clinical Evaluation is the continued assessment of the XIENCE Everolimus Eluting Coronary Stent System (XIENCE V® and XIENCE PRIME™ EECSS) with the primary focus on clinical outcomes in the treatment of female patients with de novo coronary artery lesions, and the characterization of the female population undergoing stent implantation with a XIENCE stent.
详细描述
SPIRIT Women Randomized Sub-study is a prospective, single-blind, double arm, randomized multi-center sub-study comparing the XIENCE V® EECSS and XIENCE PRIME™ EESS to the CYPHER SELECT™ PLUS Sirolimus-eluting Coronary Stent in the treatment of female patients with coronary artery lesions.
The long term safety and efficacy of the XIENCE V EECSS have been demonstrated in the SPIRIT FIRST trial up to 5 years, the SPIRIT II trial up to 4 years, and in the SPIRIT III Randomized Control Trial (RCT) up to 3 years. In addition, these pre-approval studies have shown low rates of Target Vessel Failure and Major Adverse Cardiac Events (MACE) that were observed to plateau or gradually decline after about 1 year and were consistently lower than the comparator arm of each study. This benefit in MACE is sustained for up to 5 years and is also independent of the first year results.
The post approval SPIRIT V study demonstrated that the use of the XIENCE EECSS in complex lesions in a real-world population resulted in 1 year MACE, Stent Thrombosis and Target Lesion Revascularization rates that are comparable to those of the previously mentioned pre-approval studies which included patients with more restricted inclusion / exclusion criteria.
Therefore, based on existing data from these trials, Abbott Vascular has decided to discontinue further follow up in the SPIRIT Women study after 2 years.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Patient must be female.
- •Patient must be at least 18 years of age.
- •Patient is able to verbally confirm understanding of risks, benefits and treatment alternatives and she or her legally authorized representative provides written informed consent prior to any study related procedure, as approved by the appropriate Medical Ethics Committee of the respective clinical site.
- •Patient must have evidence of myocardial ischemia (e.g., stable or unstable angina, silent ischemia, positive functional study or a reversible change in the electrocardiogram (ECG) consistent with ischemia).
- •Patient must be an acceptable candidate for coronary artery bypass graft (CABG) surgery.
- •Patient must agree to undergo all protocol-required follow-up examinations.
- •Patients of childbearing potential must have had a negative pregnancy test within 7 days before treatment, and must not be nursing at the time of treatment.
- •Angiographic Inclusion Criteria:
- •Patients' artery morphology and disease is suitable to be optimally treated with a maximum of 4 planned study stents.
- •Target lesions must be de novo lesions (no prior stent implant, no prior brachytherapy).
- •Target vessel reference diameter must be between 2.5 mm and 4.0 mm by visual estimate. The diameter range will be expanded to 2.25 mm when the 2.25 mm stent is available.
- •Target lesion greater than or equal to 28 mm in length by visual estimate.
排除标准
- •Patient has other medical illness (e.g., cancer or congestive heart failure) or known history of substance abuse (alcohol, cocaine, heroin etc.) that may cause non-compliance with the clinical investigation plan, confound the data interpretation or is associated with a limited life expectancy (i.e., less than one year).
- •Patient has a known hypersensitivity or contraindication to aspirin, either heparin or bivalirudin, both clopidogrel and ticlopidine, everolimus, cobalt, chromium, nickel, tungsten, acrylic and fluoro polymers or contrast sensitivity that cannot be adequately pre-medicated.
- •Participation in another device or drug study or has completed the follow-up phase of another study within the last 30 days.
- •Patient who is judged to have a lesion that prevents complete inflation of an angioplasty balloon.
- •Patient has had a previous stent implant, either Bare Metal Stent (BMS) or Drug Eluting Stent (DES) within the target vessel(s)
结局指标
主要结局
Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).
时间窗: at 1 year
This measure adds together all subjects who were determined by an expert panel to have died, had MI or had TVR as a result of their procedure.
In-stent Late Loss (LL) (Main Secondary Endpoint)
时间窗: at 270 days
In-stent Minimal Lumen Diameter (MLD)post-procedure - in-stent MLD at follow-up.
次要结局
- Adjudicated Stent Thrombosis (Definite, Probable, Possible)(30 days to 1 year (Late))
- Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).(at 1 year)
- Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and Clinically Indicated Target Lesion Revascularization (CI-TLR).(at 30 days)
- Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and CI-TLR.(at 1 year)
- Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).(at 240 days)
- Clinical Device Success(Intra-operative)
- Clinical Procedure Success(Intra-operative)
- Adjudicated Stent Thrombosis (Definite, Probable)(30 days to 1 year (Late))
- Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).(at 1 year)
- In-segment Late Loss (LL)(at 270 days)
- In-stent Angiographic Binary Restenosis Rates(at 270 days)
- In-segment Angiographic Binary Restenosis Rates(at 270 days)
- In-stent Percent Diameter Stenosis(at 270 days)
- In-segment Percent Diameter Stenosis(at 270 days)
- Adjudicated Revascularization (TLR/TVR/All Revascularizations)(at 1 year)
- Aneurysm(at 270 days)
- Thrombus(at 270 days)
- Persisting Dissection(at 270 days)