PIONEER IV CHINA is sought to investigate the safety and efficacy of 11-month ticagrelor monotherapy following one-month dual antiplatelet therapy (DAPT) after HT Supreme drug-eluting stent system at 12 months follow-up.
This study is a prospective, multi-center, single-arm objective performance criteria clinical trial in an all-comers patient population (including patients with high bleeding risk, HBR) undergoing PCI with unrestrictive use of the HT Supreme sirolimus-eluting stent and treated with 11-month ticagrelor monotherapy following one-month dual antiplatelet therapy (DAPT) in approximately 285 patients (including 80 coronary heart disease cases entering the OCT subgroup). All patients will be (at minimum) contacted via visit at 30 days (±7 days) and at 12 months (±30 days), and by phone contact at 6 months (±14 days), 24 months (±30 days) and 36 months (±45 days) post index procedure to assess clinical status and adverse events. The Primary Endpoint for this trial is Patient-oriented Composite Endpoint (PoCE) at 12 months post-procedure.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
HT Supreme ( R\&D by Sinomed, Tianjin, China)
Rate of Patient-oriented Composite Endpoint (PoCE) at 12 months post-procedure.
PoCE is a composite clinical endpoint of: all-cause death; any stroke, Modified Rankin scale, (MRS ≥1); any myocardial infarction (peri-procedural MI according to SCAI, spontaneous according to 4th universal definition); any clinically and physiologically driven revascularization (ARC-2)
Time frame: 12 months post-procedure
Rate of Patient oriented composite endpoint (PoCE) at 2 and 3 years;
PoCE is a composite clinical endpoint of: all-cause death; any stroke, Modified Rankin scale, (MRS ≥1); any myocardial infarction (periprocedural MI according to SCAI, spontaneous according to 4th universal definition); any clinically and physiologically driven revascularization (ARC-2)
Time frame: 2 and 3 years post-procedure
Rate of Individual components of patient-oriented composite endpoint;
PoCE is a composite clinical endpoint of: all-cause death; any stroke, Modified Rankin scale, (MRS ≥1); any myocardial infarction (periprocedural MI according to SCAI, spontaneous according to 4th universal definition); any clinically and physiologically driven revascularization (ARC-2)
Time frame: 1, 2 and 3 years post-procedure
Rate of Vessel-oriented composite endpoints (VoCE)
VoCE is a composite clinical endpoint of: Vessel-related cardiovascular Death; Target-vessel related MI; Clinically and physiologically-oriented Target vessel revascularization (ARC-2)
Time frame: 1, 2 and 3 years post-procedure
Rate of Individual components of vessel-oriented composite endpoint;
VoCE is a composite clinical endpoint of: Vessel-related cardiovascular Death; Target-vessel related MI; Clinically and physiologically-oriented Target vessel revascularization (ARC-2)
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Time frame: 1, 2 and 3 years post-procedure
Rate of Device-oriented composite endpoint (DoCE) at all timepoints;
VoCE is a composite clinical endpoint of: Cardiovascular Death;Target-vessel related MI;Clinically and physiologically-oriented Target lesion revascularization
Time frame: 30days, 6months, annually up to 3 years post procedure
Rate of Individual components of device-oriented composite endpoint;
VoCE is a composite clinical endpoint of: Cardiovascular Death;Target-vessel related MI;Clinically and physiologically-oriented Target lesion revascularization
Time frame: 30days, 6months, annually up to 3 years post procedure
Rate of Pre-procedural myocardioal infarction according to 4th universal definition;
Fourth Universal Definition of Myocardial Infarction (2018)
Time frame: 30days, 6months, annually up to 3 years post procedure
Device Success Rate
according to the statement from European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the European Society of Cardiology (ESC))
Time frame: intra-operative
Rate of Stent thrombosis
Stent thrombosis is consist of Definite stent thrombosis; Probable stent thrombosis; Definite or probable stent thrombosis
Time frame: 30days, 6months, annually up to 3 years post procedure
Rate of Target-vessel failure composite endpoint
TVF is a composite clinical endpoint of: Cardiac death; Myocardial Infarction (MI) (unless clearly attributable to a non target vessel); Target vessel revascularization
Time frame: 30days, 6months, annually up to 3 years post procedure
Rate of Individual components of Target-vessel failure composite endpoint
TVF is a composite clinical endpoint of: Cardiac death; Myocardial Infarction (MI) (unless clearly attributable to a non target vessel); Target vessel revascularization
Time frame: 30days, 6months, annually up to 3 years post procedure
Rate of Bleeding according to BARC (2, 3 and 5) classification
Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk
Time frame: 30days, 6months, annually up to 3 years post procedure
Rate of Net adverse clinical and cerebral events
NACCE is a composite clinical endpoint of: any cause, myocardial infarction (MI), cerebral vascular accident, and major bleeding (according to the modified REPLACE-2 and GUSTO criteria)
Time frame: 30days, 6months, annually up to 3 years post procedure
Cost-Effectiveness
Cost of procedure will be collected in the eCRF(e.g. diagnostic tests, procedural materials, time of the procedure, re-angiography, repeat revascularization, etc. will be quantified).
Time frame: hospitalization, 1 year post procedure