XIENCE V: SPIRIT WOMEN Sub-study

Abbott Medical Devices455 enrolled

Overview

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.

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Eligibility

Sex: FEMALEMin age: 18 Years

Medical Language ↔ Plain English

General Inclusion Criteria: * 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. General Exclusion Criteria: * 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)

Locations (25)

Hosital Italiano de Buenos Aires - Cardiologia

Buenos Aires, Buenos Aires, Argentina

Instituto Cardiovascular de Buenos Aires-ICBA

Buenos Aires, Argentina

Allgemeines Krankenhaus der Stadt Wien - Univ.Klinik f. Innere Medizin II

Vienna, Austria

Heilig Hart Ziekenhuis Roeselare

Roeselare, Belgium

Instituto de Cardiologia Dante Pazzanese Unidadae II Recepcao de Angioplastia

São Paulo, Brazil

Rigshospitalet

Copenhagen, Denmark

Institut Hospitalier Jacques Cartier Service d'Angiographie, Inst Cardiovasculaire Paris-Sud

Massy, France

Kardiologische Klinik Herz- und Diabeteszentrum

Bad Oeynhausen, Germany

Segebergerkliniken

Bad Segeberg, Germany

Technische Universität Dresden, Medizinische Klinik II - Kardiologie

Dresden, Germany

...and 15 more locations

Outcomes

Primary Outcomes

Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).

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.

Time frame: at 1 year

In-stent Late Loss (LL) (Main Secondary Endpoint)

In-stent Minimal Lumen Diameter (MLD)post-procedure - in-stent MLD at follow-up.

Time frame: at 270 days

Secondary Outcomes

Clinical Device Success

Successful delivery and deployment of the study stent at the intended target lesion and successful withdrawal of the stent delivery system.

Time frame: Intra-operative

Clinical Procedure Success

Successful delivery and deployment of the study stent or stents at the intended target lesion and successful withdrawal of the stent delivery system without adverse cardiac events.

Time frame: Intra-operative

Adjudicated Stent Thrombosis (Definite, Probable)

Time frame: < 1 day (Acute)

Adjudicated Stent Thrombosis (Definite, Probable)

Time frame: 1 to 30 days (Sub-Acute)

Adjudicated Stent Thrombosis (Definite, Probable)

Time frame: 30 days to 1 year (Late)

Adjudicated Stent Thrombosis (Definite, Probable, Possible)

Time frame: 30 days to 1 year (Late)

Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and Clinically Indicated Target Lesion Revascularization (CI-TLR).

Time frame: at 30 days

Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and CI-TLR.

Time frame: at 240 days

Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and CI-TLR.

Time frame: at 1 year

Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).

Time frame: at 30 days

Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).

Time frame: at 240 days

Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).

Time frame: at 30 days

Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).

Time frame: at 240 days

Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).

Time frame: at 1 year

Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).

Time frame: at 30 days

Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).

Time frame: at 240 days

Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).

Time frame: at 1 year

In-segment Late Loss (LL)

LL = Minimal Lumen Diameter (MLD) post-procedure minus MLD at follow-up

Time frame: at 270 days

In-stent Angiographic Binary Restenosis Rates

Only a certain number of patients were required to have angiographic follow-up. Percent of subjects with a follow-up in-stent percent diameter stenosis of ≥ 50% per quantitative coronary angiography (QCA).

Time frame: at 270 days

In-segment Angiographic Binary Restenosis Rates

Time frame: at 270 days

In-stent Percent Diameter Stenosis

Time frame: at 270 days

In-segment Percent Diameter Stenosis

Time frame: at 270 days

Adjudicated Revascularization (TLR/TVR/All Revascularizations)

Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations

Time frame: at 30 days

Adjudicated Revascularization (TLR/TVR/All Revascularizations)

Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations

Time frame: at 240 days

Adjudicated Revascularization (TLR/TVR/All Revascularizations)

Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations

Time frame: at 1 year

Aneurysm

All subjects with aneurysm of the target lesion up to the 270 day follow-up visit

Time frame: at 270 days

Thrombus

All subjects with thrombus of the target lesion up to the 270 day follow-up visit

Time frame: at 270 days

Persisting Dissection

All subjects with persisting dissection of the target lesion up to the 270 day follow-up visit

Time frame: at 270 days

XIENCE V: SPIRIT WOMEN Sub-study

Overview

Conditions

Interventions

Eligibility

Locations (25)

Outcomes

Primary Outcomes

Secondary Outcomes