Outcome of CHAllenging lesioNs and Patients Treated With Polymer Free Drug-CoatEd Stent ("Biofreedom"): the CHANCE a Multicenter Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 1,000
- 主要终点
- Incidence of POCE (primary patient-oriented endpoint)
研究概览
简要总结
Length of DAT (Dual Antiplatelet therapy) represents one of the most challenging choices for interventional cardiologist.
Prolonged DAT reduces risk of subsequent MI (Myocardial Infarction) with an increase in major bleedings, consequently with a neutral effect on survival [1].
Recently a Polymer-free Drug-Coated coronary stent has been tested in a randomized controlled trial with only one month of DAT due to its peculiar features, with an increased efficacy compared to BMS (Bare Metal Stent) and with a not negligible risk of ST at one year (about 2%)[2,3].
The RCT despite its promising design (inclusion of high risk patients like those with previous bleeding or with severe renal disease) showed a major limitation, that is:
- patients who are often offered a Biofreedom in real life, that is those with active cancer or needing major surgery or on OAT (Oral Anticoagulation)
- and patients with bifurcation and multivessel disease, that is those with an increased risk of ST [4]
- STEMI patients [5] were underrepresented (less than 30%). Consequently we performed this multicenter study to evaluate safety and efficacy of Biofreedom in real life patients.
POCE (a composite end point of death, myocardial infarction, target lesion revascularization) and DOCE (cardiac death, MI-TLR and TLR) will be the primary end points, while its single components will be the secondary ones along stent thrombosis and with bleedings (Barc classification).
At least 12 months The Leaders FREE (2) reported an incidence of MACE of 9.4% at one year in overall patients. If there is a true difference in favour of the experimental treatment of 1.2%, then 870 patients are required to be 80% sure that the upper limit of a one-sided 95% confidence interval (or equivalently a 90% two-sided confidence interval) will exclude a difference when compared to non selected patients of more than 2% [5]
All patients implanting Biofreedom with these prespecified analysis:
- Clinical
- Diabetic patients (both insulin and not insulin depenent)
- Requiring oral anticoagulation
- On active cancer (that is requiring chemio or radio-therapy and or surgery)
- Requiring surgery
- STEMI
- Interventional
- Bifurcation (both provisional both 2 stents)
- Multivessel
- Ostial
详细描述
Our interest is to test the performance of these stents in real life patients
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diabetic patients (both insulin and not insulin depenent)
- •Requiring oral anticoagulation
- •On active cancer (that is requiring chemio or radio-therapy and or surgery)
- •Requiring surgery
- •Interventional
- •Bifurcation (both provisional both 2 stents)
- •Multivessel
- •clinical less than 18 years old or more than 80
- •interventional last remaing vessel
排除标准
- 未提供
结局指标
主要结局
Incidence of POCE (primary patient-oriented endpoint)
时间窗: At least 6 months
Incidence of POCE (a composite and mutual exclusive end point of death, myocardial infarction, target lesion revascularization)
次要结局
- Incidence of TLR(At least 6 months)
- Incidence of Myocardial Infarction(At least 6 months)
- Incidence of MI-TLR(At least 6 months)
- Incidence of Death(At least 6 months)
- Incidence of Cardiac Death(At least 6 months)
研究者
Fabrizio D'Ascenzo
Principal Investigator
A.O.U. Città della Salute e della Scienza