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SPIRIT FIRST Clinical Trial of the Abbott Vascular XIENCE V® Everolimus Eluting Coronary Stent System

Primary Purpose

Coronary Artery Disease, Everolimus, Vascular Disease

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Coronary artery drug eluting stent placement
Coronary artery stent placement
Sponsored by
Abbott Medical Devices
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Disease focused on measuring Cardiovascular disease, Ischemia

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria Patient must be at least 18 years of age. Patient is able to verbally acknowledge an understanding of the associated risks, benefits and treatment alternatives of receiving the XIENCE™ V Everolimus Eluting Coronary Stent System and his or her legally authorized representative provides written informed consent prior to the stent procedure, as approved by the appropriate Ethics Committee. Patient must have evidence of myocardial ischemia (e.g., stable or unstable angina, silent ischemia, positive functional study). Patient must be an acceptable candidate for coronary artery bypass graft (CABG) surgery. Patient must agree to undergo all protocol-required follow-up examinations including angiographic and IVUS follow-up at two time points (180 days and 1 year ). Female 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. Female patients of childbearing potential must also agree at time of consent to use birth control up to and including the second angiographic follow-up at 1 year. Inclusion Criteria: Angiographic Planned single, de novo, type A - B1, native coronary artery lesion treatment. Target lesion must be located in a native vessel with a diameter of 3.0 mm assessed by QCA on-line. Target lesion length ≤ 12 mm, assessed by QCA on-line. The target lesion must be in a major artery or branch with a stenosis of ≥ 50% and < 100% assessed by QCA on-line and with a TIMI flow of ≥ 1. Exclusion Criteria Patient has had a known acute myocardial infarction (greater than two times the upper limit of normal CK with presence of CK-MB) within 3 days preceding the index procedure and CK has not returned to normal limits at the time of the procedure. Patient has current or a history of unstable arrhythmias, regardless of whether cardiac rhythm management devices are used (e.g., pacemaker, Automatic Implantable Cardioverter Defibrillator). Patient has a known left ventricular ejection fraction ≥ 30%. Patient has received a heart transplant or any other organ transplant or is on a waiting list for any organ transplant. Patient is receiving or scheduled to receive chemotherapy or radiation therapy within 30 days prior to or after the procedure. Patient is receiving immunosuppression therapy or has known immunosuppressive disease. Patient is receiving chronic anticoagulation therapy (e.g., heparin, coumadin). Patient has a known hypersensitivity or contraindication to aspirin, heparin, clopidogrel, cobalt, chromium, nickel, tungsten, everolimus, acrylic and fluoro polymers or contrast sensitivity that cannot be adequately pre-medicated. Patient has a platelet count <100,000 cells/mm3 or >700,000 cells/mm3, a WBC of <3,000 cells/mm3, or documented or suspected liver disease (including laboratory evidence of hepatitis). Patient has known renal insufficiency (e.g., serum creatinine level of more than 2.5 mg/dL, patient on dialysis). Patient has a history of bleeding diathesis or coagulopathy or will refuse blood transfusions. Patient has had a cerebrovascular accident (CVA) or stroke or transient ischemic neurological attack (TIA) within the past six months. Patient has had a significant GI or urinary bleed within the past six months. Patient has extensive peripheral vascular disease that precludes safe 6 French sheath insertion or extreme anticoagulation. Patient has other medical illness (e.g., cancer or congestive heart failure) or recent history of substance abuse that may cause non-compliance with the protocol, confound the data interpretation or is associated with a limited life expectancy (i.e., less than one year). Patient is already participating in another investigational use device or drug study or has completed the follow-up phase of another trial within the last 30 days. Patient has received a drug eluting stent within the last 1 year. Exclusion Criteria: Angiographic The target lesion meets any of the following criteria: Aorto-ostial location Unprotected left main location Located within 2 mm of the origin of the LAD or LCX Located within or distal to an arterial or saphenous vein graft Located within 2 mm of a bifurcation Located distal to a previously implanted stent (same major epicardial vessel) Located in a major epicardial vessel that has been previously treated with brachytherapy Located in a major epicardial vessel that has been previously treated with any type of PCI (e.g., POBA, stent, cutting balloon, atherectomy), except if previous treatment occurred in a side branch distal to target lesion at least 180 days preceding the index procedure Involves jailing of side branches > 2.0 mm in diameter Total occlusion (TIMI flow 0) Excessive tortuosity proximal to or within the lesion Extreme angulation (≥ 90%) proximal to or within the lesion Moderate to heavy calcification Restenotic from previous intervention The target vessel contains thrombus. Another significant lesion (≥ 40 %DS) is located in the same major epicardial vessel as the target lesion. Patient has a high probability that a procedure other than pre-dilatation and stenting will be required for treatment of the target vessel (e.g. atherectomy, cutting balloon). Patient has additional lesion(s) for which an intervention within 180 days (prior to or after) of the index procedure would be required or has been performed.

Sites / Locations

  • Skejby Sygehus
  • Herzzentrum Bad Krozingen
  • Kerckhoff-Klinik
  • Herzzentrum Bad Oeynhausen
  • Herzzentrum Siegburg GmbH
  • Academisch Medisch Centrum
  • Erasmus Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

1

2

Arm Description

Abbott Vascular XIENCE V® Everolimus Eluting Coronary Stent System

Abbott Vascular MULTI-LINK VISION® BMS

Outcomes

Primary Outcome Measures

In-stent late loss

Secondary Outcome Measures

In-stent late loss
In-segment Late Loss
In-stent and in-segment %Volume Obstruction
In-stent and in-segment %Diameter Stenosis
In-stent and in-segment Angiographic Binary Restenosis rate
Persisting incomplete apposition, late incomplete apposition, aneurysm, thrombus, persisting dissection
Major Adverse Cardiac Events
Target Vessel Failure
Acute success (device, procedure and clinical)

Full Information

First Posted
September 13, 2005
Last Updated
January 5, 2010
Sponsor
Abbott Medical Devices
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1. Study Identification

Unique Protocol Identification Number
NCT00180453
Brief Title
SPIRIT FIRST Clinical Trial of the Abbott Vascular XIENCE V® Everolimus Eluting Coronary Stent System
Official Title
SPIRIT First: A Clinical Evaluation of an Investigational Device. The Abbott XIENCE V® Everolimus Eluting Coronary Stent System in the Treatment of Patients With de Novo Native Coronary Artery Lesions
Study Type
Interventional

2. Study Status

Record Verification Date
June 2009
Overall Recruitment Status
Completed
Study Start Date
December 2003 (undefined)
Primary Completion Date
April 2005 (Actual)
Study Completion Date
June 2009 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Abbott Medical Devices

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Prospective, randomized, controlled, single-blinded, parallel two-arm, multicenter trial. Test arm: XIENCE V® Everolimus Eluting Coronary Stent System(stent length: 18mm, diameter: 3.0mm) Control arm: Metallic stent (MULTI-LINK VISION® metallic stent(stent length: 18mm, diameter: 3.0mm) Follow-up angiographic imaging and intra vascular ultra sound (IVUS) at 180 days and 1 year
Detailed Description
The SPIRIT FIRST clinical trial will enroll approximately 60 patients and will assess the feasibility and performance of the XIENCE V® Everolimus Eluting Coronary Stent System in the treatment of patients with de novo native coronary artery lesions. In this trial, the XIENCE V® Everolimus Eluting Coronary Stent System will be compared to the MULTI-LINK VISION® metallic stent which is CE marked and FDA approved and is available for commercial use in Europe and in the United States. The SPIRIT FIRST Clinical trial will enroll approximately 60 patients (30 patients in the test arm and 30 patients in the control arm) with de novo native coronary artery lesions in 4 clinical sites in The Netherlands and Germany

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease, Everolimus, Vascular Disease, Myocardial Ischemia, Coronary Artery Stenosis
Keywords
Cardiovascular disease, Ischemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Abbott Vascular XIENCE V® Everolimus Eluting Coronary Stent System
Arm Title
2
Arm Type
Active Comparator
Arm Description
Abbott Vascular MULTI-LINK VISION® BMS
Intervention Type
Device
Intervention Name(s)
Coronary artery drug eluting stent placement
Intervention Description
Coronary artery drug eluting stent placement
Intervention Type
Device
Intervention Name(s)
Coronary artery stent placement
Other Intervention Name(s)
Abbott Vascular MULTI-LINK VISION® coronary stent system
Intervention Description
Coronary artery stent placement
Primary Outcome Measure Information:
Title
In-stent late loss
Time Frame
at 180 days post procedure
Secondary Outcome Measure Information:
Title
In-stent late loss
Time Frame
at 1 year post procedure
Title
In-segment Late Loss
Time Frame
at 180 days and 1 year
Title
In-stent and in-segment %Volume Obstruction
Time Frame
at 180 days and 1 year
Title
In-stent and in-segment %Diameter Stenosis
Time Frame
at 180 days and 1 year
Title
In-stent and in-segment Angiographic Binary Restenosis rate
Time Frame
at 180 days and 1 year
Title
Persisting incomplete apposition, late incomplete apposition, aneurysm, thrombus, persisting dissection
Time Frame
at 180 days and 1 year
Title
Major Adverse Cardiac Events
Time Frame
at 30, 180, 270 days, and 1, 2, 3, 4, 5 years
Title
Target Vessel Failure
Time Frame
at 30, 180, 270 days, and 1, 2, 3, 4, 5 years
Title
Acute success (device, procedure and clinical)
Time Frame
Acute

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Patient must be at least 18 years of age. Patient is able to verbally acknowledge an understanding of the associated risks, benefits and treatment alternatives of receiving the XIENCE™ V Everolimus Eluting Coronary Stent System and his or her legally authorized representative provides written informed consent prior to the stent procedure, as approved by the appropriate Ethics Committee. Patient must have evidence of myocardial ischemia (e.g., stable or unstable angina, silent ischemia, positive functional study). Patient must be an acceptable candidate for coronary artery bypass graft (CABG) surgery. Patient must agree to undergo all protocol-required follow-up examinations including angiographic and IVUS follow-up at two time points (180 days and 1 year ). Female 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. Female patients of childbearing potential must also agree at time of consent to use birth control up to and including the second angiographic follow-up at 1 year. Inclusion Criteria: Angiographic Planned single, de novo, type A - B1, native coronary artery lesion treatment. Target lesion must be located in a native vessel with a diameter of 3.0 mm assessed by QCA on-line. Target lesion length ≤ 12 mm, assessed by QCA on-line. The target lesion must be in a major artery or branch with a stenosis of ≥ 50% and < 100% assessed by QCA on-line and with a TIMI flow of ≥ 1. Exclusion Criteria Patient has had a known acute myocardial infarction (greater than two times the upper limit of normal CK with presence of CK-MB) within 3 days preceding the index procedure and CK has not returned to normal limits at the time of the procedure. Patient has current or a history of unstable arrhythmias, regardless of whether cardiac rhythm management devices are used (e.g., pacemaker, Automatic Implantable Cardioverter Defibrillator). Patient has a known left ventricular ejection fraction ≥ 30%. Patient has received a heart transplant or any other organ transplant or is on a waiting list for any organ transplant. Patient is receiving or scheduled to receive chemotherapy or radiation therapy within 30 days prior to or after the procedure. Patient is receiving immunosuppression therapy or has known immunosuppressive disease. Patient is receiving chronic anticoagulation therapy (e.g., heparin, coumadin). Patient has a known hypersensitivity or contraindication to aspirin, heparin, clopidogrel, cobalt, chromium, nickel, tungsten, everolimus, acrylic and fluoro polymers or contrast sensitivity that cannot be adequately pre-medicated. Patient has a platelet count <100,000 cells/mm3 or >700,000 cells/mm3, a WBC of <3,000 cells/mm3, or documented or suspected liver disease (including laboratory evidence of hepatitis). Patient has known renal insufficiency (e.g., serum creatinine level of more than 2.5 mg/dL, patient on dialysis). Patient has a history of bleeding diathesis or coagulopathy or will refuse blood transfusions. Patient has had a cerebrovascular accident (CVA) or stroke or transient ischemic neurological attack (TIA) within the past six months. Patient has had a significant GI or urinary bleed within the past six months. Patient has extensive peripheral vascular disease that precludes safe 6 French sheath insertion or extreme anticoagulation. Patient has other medical illness (e.g., cancer or congestive heart failure) or recent history of substance abuse that may cause non-compliance with the protocol, confound the data interpretation or is associated with a limited life expectancy (i.e., less than one year). Patient is already participating in another investigational use device or drug study or has completed the follow-up phase of another trial within the last 30 days. Patient has received a drug eluting stent within the last 1 year. Exclusion Criteria: Angiographic The target lesion meets any of the following criteria: Aorto-ostial location Unprotected left main location Located within 2 mm of the origin of the LAD or LCX Located within or distal to an arterial or saphenous vein graft Located within 2 mm of a bifurcation Located distal to a previously implanted stent (same major epicardial vessel) Located in a major epicardial vessel that has been previously treated with brachytherapy Located in a major epicardial vessel that has been previously treated with any type of PCI (e.g., POBA, stent, cutting balloon, atherectomy), except if previous treatment occurred in a side branch distal to target lesion at least 180 days preceding the index procedure Involves jailing of side branches > 2.0 mm in diameter Total occlusion (TIMI flow 0) Excessive tortuosity proximal to or within the lesion Extreme angulation (≥ 90%) proximal to or within the lesion Moderate to heavy calcification Restenotic from previous intervention The target vessel contains thrombus. Another significant lesion (≥ 40 %DS) is located in the same major epicardial vessel as the target lesion. Patient has a high probability that a procedure other than pre-dilatation and stenting will be required for treatment of the target vessel (e.g. atherectomy, cutting balloon). Patient has additional lesion(s) for which an intervention within 180 days (prior to or after) of the index procedure would be required or has been performed.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrick Serruys, MD
Organizational Affiliation
Erasmus Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Skejby Sygehus
City
Aarhus
Country
Denmark
Facility Name
Herzzentrum Bad Krozingen
City
Bad Krozingen
ZIP/Postal Code
79189
Country
Germany
Facility Name
Kerckhoff-Klinik
City
Bad Nauheim
ZIP/Postal Code
61231
Country
Germany
Facility Name
Herzzentrum Bad Oeynhausen
City
Bad Oeynhausen
ZIP/Postal Code
32545
Country
Germany
Facility Name
Herzzentrum Siegburg GmbH
City
Siegburg
Country
Germany
Facility Name
Academisch Medisch Centrum
City
Amsterdam
ZIP/Postal Code
1105 AZ
Country
Netherlands
Facility Name
Erasmus Medical Center
City
Rotterdam
Country
Netherlands

12. IPD Sharing Statement

Citations:
PubMed Identifier
16400664
Citation
Tsuchida K, Garcia-Garcia HM, Ong AT, Valgimigli M, Aoki J, Rademaker TA, Morel MA, van Es GA, Bruining N, Serruys PW. Revisiting late loss and neointimal volumetric measurements in a drug-eluting stent trial: analysis from the SPIRIT FIRST trial. Catheter Cardiovasc Interv. 2006 Feb;67(2):188-97. doi: 10.1002/ccd.20581.
Results Reference
background
PubMed Identifier
19758913
Citation
Popma JJ, Tulli M. Spirit First - Another hurdle is cleared. EuroIntervention. 2005 Nov;1(3):260-3. No abstract available.
Results Reference
result
PubMed Identifier
19758878
Citation
Serruys PW, Ong AT, Piek JJ, Neumann FJ, van der Giessen WJ, Wiemer M, Zeiher A, Grube E, Haase J, Thuesen L, Hamm C, Otto-Terlouw PC. A randomized comparison of a durable polymer Everolimus-eluting stent with a bare metal coronary stent: The SPIRIT first trial. EuroIntervention. 2005 May;1(1):58-65.
Results Reference
result
PubMed Identifier
19758915
Citation
Tsuchida K, Piek JJ, Neumann FJ, van der Giessen WJ, Wiemer M, Zeiher AM, Grube E, Haase J, Thuesen L, Hamm CW, Veldhof S, Dorange C, Serruys PW. One-year results of a durable polymer everolimus-eluting stent in de novo coronary narrowings (The SPIRIT FIRST Trial). EuroIntervention. 2005 Nov;1(3):266-72.
Results Reference
result
Citation
SPRITI FIRST: 2-Jahres-ergebnisse. A durable polymer everolimus-eluting stent in de novo coronary narrowings. Richartz B.; Silber S. Herz ( Germany ) June 1, 2006 , 31/4 (359). ISSN: 0340-9937. Language: German
Results Reference
result
PubMed Identifier
24746650
Citation
Muramatsu T, Onuma Y, van Geuns RJ, Chevalier B, Patel TM, Seth A, Diletti R, Garcia-Garcia HM, Dorange CC, Veldhof S, Cheong WF, Ozaki Y, Whitbourn R, Bartorelli A, Stone GW, Abizaid A, Serruys PW; ABSORB Cohort B Investigators; ABSORB EXTEND Investigators; SPIRIT FIRST Investigators; SPIRIT II Investigators; SPIRIT III Investigators; SPIRIT IV Investigators. 1-year clinical outcomes of diabetic patients treated with everolimus-eluting bioresorbable vascular scaffolds: a pooled analysis of the ABSORB and the SPIRIT trials. JACC Cardiovasc Interv. 2014 May;7(5):482-93. doi: 10.1016/j.jcin.2014.01.155. Epub 2014 Apr 16.
Results Reference
derived
Links:
URL
http://eurheartj.oxfordjournals.org/cgi/content/abstract/28/13/1583
Description
Clinical impact of in-stent late loss after drug-eluting coronary stent implantation

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SPIRIT FIRST Clinical Trial of the Abbott Vascular XIENCE V® Everolimus Eluting Coronary Stent System

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