The TUXEDO-India is a prospective, single blind, multi-center randomized clinical trial to assess the TAXUS Element™ in a consecutive population of diabetic patients with coronary artery disease undergoing coronary revascularization. Approximately 1,830 patients with single or multi lesion, multi vessel coronary artery or saphenous vein graft disease ranging in vessels ranging from 2.25 mm to 4.0 mm in diameter by visual estimate will be enrolled in a 1:1 randomization to TAXUS Element™ vs. XIENCE™ Prime in India at up to 50 clinical sites, to demonstrate the safety and effectiveness of TAXUS Element™ in an unrestricted population. Procedural Endpoints: * Device success, defined as attainment of \< 30% residual stenosis of the target lesion (visual assessment) using the TAXUS Element™ or XIENCE™ Prime stent. * Lesion success defined as attainment of \< 30% residual stenosis (visual assessment) using any percutaneous method. * Procedure success defined as lesion success without the occurrence of in-hospital MACE. * Procedure complication rate including composite and individual angiographic occurrence of dissection ≥B, distal embolization, no reflow, slow flow, abrupt closure, or perforation.
Primary Endpoint: Composite safety endpoint of Target Vessel Failure (TVF) rate at 12 months post-index procedure: * Cardiac Death related to target vessel * Target Vessel Myocardial Infarction (TV-MI) * Target Vessel Revascularization (TVR) Secondary Endpoint: Clinical endpoints measured at 30, 180 days, and 1 and 2 years post index procedure: * TVF rate (primary endpoint 1 year) * Target Vessel Revascularization (TVR) rate * Target Lesion Revascularization (TLR) * Composite of cardiac death or target vessel MI * Composite of all deaths, all MI, all revascularizations * Major Adverse Cardiac Events (MACE) which is the composite endpoint of cardiac death, all myocardial infarction, and TLR * MI (Q-wave and non-Q-wave) rate * Cardiac death rate * Non-cardiac death rate * All death rate * Cardiac death or MI rate * All death or MI rate * Stent thrombosis rate (definite or probable by Academic Research Consortium \[ARC\] definitions) Periprocedural endpoints: * Technical success rate * Clinical procedural success rate Anti-platelet Therapy A loading dose of either Clopidogrel (300mg, 600mg recommended), Ticlopidine (500mg), or Prasugrel (60mg) must be given to the patient prior to index procedure. Thereafter, Clopidogrel (75mg daily), Ticlopidine (250mg twice daily), Prasugrel (10mg) must be given for at least 12 months after stent implantation. If the protocol mandated (loading and or daily) dosage conflicts with local DFU, the local DFU should take precedence. Aspirin (ASA): Must be administered concomitantly with Clopidogrel, Ticlopidine or Prasugrel and then continued indefinitely Sample Size Parameters: The expected 12 month TVF rate for both groups is estimated to be 8.4% based on the data available from the SPIRIT IV trial. Given the non-inferiority margin (delta) of 4% with equal expected means and a one-sided 5% significance level, 824 patients in each group will provide at least 90% power to reject the null hypothesis if it is false. When allowance is made for 10% attrition, approximately 915 patients are required per each treatment group. Therefore, the necessary total sample size for the trial is 1,830 patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
1,830
Texus Element is the next generation Boston Scientific paclitexel-eluting coronary sten and received DCGI approval on April 13th, 2010.
The Everolimus-eluting stent manufactured and distributed by Abbott Vascular Santa Clara, CA, as Xience Prime.
Fortis Escorts Heart Institute
New Delhi, National Capital Territory of Delhi, India
Composite safety endpoint of Target Vessel Failure (TVF) rate at 12 months post-index procedure: • Cardiac Death related to target vessel • Target Vessel Myocardial Infarction (TV-MI) • Target Vessel Revascularization (TVR)
TVS is defined as any ischemia-driven revascularization of the target vessel( TVR), MI (Q-wave and non-Q-wave) related to the target vessel, or cardiac death related to the target vessel.
Time frame: 12 Months
Target Lesion Revascularization (TLR) TVF rate (primary endpoint 1 year) Target Vessel Revascularization rate Target Lesion Revascularization Composite of cardiac death or target vessel
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
Ischemia Driven Target Lesion Revascularization (TLR) Rate TVF rate (primary endpoint 1 year) Target Vessel Revascularization rate Target Lesion Revascularization Composite of cardiac death or target vessel
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
Target Vessel Failure (TVF)
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
Ischemia Driven Target Vessel Revascularization (TVR)
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
Target Lesion Failure Rate
Target Lesion Failure Rate defined as any ischemia-driven revascularization of the target lesion (TLR), MI (Q-wave and non-Q-wave) related to the target vessel, or cardiac death related to the target vessel
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
Myocardial Infarction(MI) rate
Q-wave and Non-Q-wave, cumulative and individual
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
Cardiac death rate
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
Non-Cardiac death rate
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
All death or MI rate
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
All Death / MI / TVR Rate
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
Major Adverse Cardiac Event (MACE)
MACE defined as a composite of death, MI (Q-wave and non-Q-wave), emergent coronary artery bypass surgery (CABG), or target lesion revascularization (TLR) by repeat PTCA, or CABG.
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
Stent Thrombosis Rate
Stent thrombosis(ST) rate defined using ARC definition of definite and probable stent thrombosis and categorized as early, late or very late.
Time frame: Measured at 30,180 days,and 1 and 2 years post index procedure
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.