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SPIRIT IV Clinical Trial: Clinical Evaluation of the XIENCE V® Everolimus Eluting Coronary Stent System

Primary Purpose

Coronary Artery Disease

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
XIENCE V® Everolimus Eluting Coronary Stent
TAXUS™ EXPRESS2™ Paclitaxel Eluting Coronary Stent
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 Stents, Angioplasty, Total coronary occlusion, coronary restenosis, stent thrombosis

Eligibility Criteria

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

General Inclusion Criteria: Subject must be at least 18 years of age Subject is able to verbally confirm understanding of risks, benefits and treatment alternatives of receiving XIENCE V® and he/she or his/her legally authorized representative provides written informed consent prior to any study related procedure Subject 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) Subject must be an acceptable candidate for coronary artery bypass graft (CABG) surgery Subject must agree to undergo all protocol-required follow-up procedures Subject must agree not to participate in any other clinical study for a period of one year following the index procedure Angiographic Inclusion Criteria: Target lesion(s) must be located in a native coronary artery with visually estimated diameter of ≥2.5 mm to ≤4.25 mm and treatment of up to a three de novo target lesions, maximum of two de novo target lesions per epicardical vessel. (NOTE: RVD ≥2.5 mm to ≤3.75 mm until 4.0 mm TAXUS® is commercially available) Target lesion(s) must measure ≤28 mm in length by visual estimation(≥3 mm of non-diseased tissue on either side of the target lesion should be covered by the study stent) If more than one target lesion will be treated, the RVD and lesion length of each must meet the above criteria If more than one target lesion will be treated, the RVD and lesion length of each must meet the above criteria The target lesion(s) must be in a major artery or branch with a visually estimated stenosis of ≥ 50% and < 100% with a TIMI flow of ≥ 1 Non-study, percutaneous intervention for lesions in a target vessel (including side branches) is allowed if done ≥ 9 months prior to the index procedure Non-study percutaneous intervention for lesions in a non-target vessel involving: Successful and uncomplicated (visually estimated diameter stenosis < 50%, TIMI Grade 3 flow, no ECG changes, prolonged chest pain, or angiographic complications) bare-metal stent, balloon dilatation, cutting balloon, atherectomy, thrombectomy, and laser treatments are allowed if done ≥ 24 hours prior to the index procedure or during (before randomization) the index procedure. For interventions done within 24 to 48 hours prior to the index procedure, CK and CK-MB must be assessed to be < 2 times the upper limit of normal at the time of the index procedure. NOTE: Procedures within the 24 hour period preceding the index procedure are not permitted Unsuccessful or complicated bare-metal stent, balloon dilatation, cutting balloon, atherectomy, thrombectomy, and laser treatments are allowed if done ≥ 30 days prior to the index procedure Drug-eluting stent treatment is allowed if done ≥ 90 days prior to the index procedure Non-study, percutaneous interventions for lesion(s) in a target vessel (including side branches) or non-target vessel are allowed if done ≥ 9 months after the index procedure General Exclusion Criteria: Subject has had a known diagnosis of acute myocardial infarction (AMI) preceding the index procedure (CK-MB ≥ 2 times upper limit of normal) and CK and CK-MB have not returned within normal limits at the time of procedure The subject is currently experiencing clinical symptoms consistent with AMI Subject has current unstable arrhythmias Subject has a known left ventricular ejection fraction (LVEF) < 30% Subject has received a heart transplant or any other organ transplant or is on a waiting list for any organ transplant Subject is receiving or scheduled to receive anticancer therapy for malignancy within 30 days prior to or after the procedure Subject is receiving immunosuppression therapy, or has known serious immunosuppressive disease (e.g., human immunodeficiency virus), or has severe autoimmune disease that requires chronic immunosuppressive therapy (e.g., systemic lupus erythematosus, etc.) Subject is receiving or is scheduled to receive chronic anticoagulation therapy (e.g., heparin, coumadin) Subject has a known hypersensitivity or contraindication to aspirin, both heparin and bivalirudin, both clopidogrel and ticlopidine, everolimus, cobalt, chromium, nickel, tungsten, acrylic and fluoro polymers or contrast sensitivity that cannot be adequately pre-medicated Elective surgery that will require discontinuing either aspirin or clopidogrel is planned within the first 9 months after the procedure Subject 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) Subject has known renal insufficiency (e.g., serum creatinine level of > 2.5 mg/dL or subject on dialysis) Subject has a history of bleeding diathesis or coagulopathy or will refuse blood transfusions Subject has had a cerebrovascular accident (CVA) or transient ischemic neurological attack (TIA) within the past six months Subject has had a significant GI or urinary bleed within the past six months Subject has extensive peripheral vascular disease that precludes safe 6 French sheath insertion Subject 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 protocol, confound the data interpretation or is associated with a life expectancy of less than one year Subject is already participating in another clinical study that has not yet reached its primary endpoint Pregnant or nursing subjects and those who plan pregnancy in the period up to 1 year following index procedure. (Female subjects of child-bearing potential must have a negative pregnancy test done within 7 days prior to the index procedure and effective contraception must be used up to 1 year following the index procedure) Angiographic Exclusion Criteria The target lesion(s) meets any of the following criteria: Left main coronary artery location including left main ostial location (NOTE: RCA-aorto-ostial lesions are not excluded) Located within 2 mm of the origin of the LAD or LCX Located within an arterial or saphenous vein graft or distal to a diseased (vessel irregularity per angiogram and any visually estimated diameter stenosis > 20%) arterial or saphenous vein graft Involves a bifurcation in which the side branch is ≥ 2 mm in diameter AND the ostium of the side branch is > 50% stenosed by visual estimation Involves a side branch requiring pre-dilatation Total occlusion (TIMI flow 0) prior to wire crossing Excessive tortuosity proximal to or within the lesion Extreme angulation (≥ 90º) proximal to or within the lesion Heavy calcification Restenotic from previous intervention Subject has received brachytherapy in any epicardial vessel (including side branches) The target vessel contains thrombus Another clinically significant lesion in the target vessel is present that requires or has a high probability of requiring PCI during the index procedure Another lesion in a target or non-target vessel (including all side branches) is present that requires or has a high probability of requiring PCI within 9 months after the index procedure

Sites / Locations

  • Scottsdale Healthcare
  • Arkansas Heart Hospital
  • Inova Fairfax Hospital
  • San Diego Cardiovascular Associates
  • Scripps Memorial Hospital
  • Good Samaritan Hospital - LA
  • Mercy General Hospital
  • Sutter Medical Center of Santa Rosa
  • The Medical Center of Aurora
  • Poudre Valley Hospital
  • Washington Hospital Center
  • Sacred Heart Hospital
  • Sarasota Memorial Hospital
  • St. Francis Hospital and Health Centers
  • The Heart Center of Indiana
  • Iowa Heart Center P.C.
  • University of Kansas Hospital
  • Central Baptist Hospital
  • Jewish Hospital
  • Maine Medical Center
  • Union Memorial Hospital
  • Johns Hopkins Hospital
  • Washington Adventist Hospital
  • St. Joseph Medical Center
  • Brigham and Women's Hospital
  • Saint Vincent Hospital
  • UMass Memorial Medical Center
  • Bay Regional Medical Center
  • Oakwood Hospital and Medical Center
  • Spectrum Health Hospital
  • Borgess Medical Center
  • Ingham Regional Medical Center
  • Northern Michigan Hospital
  • St. Luke's Hospital
  • Research Medical Center
  • St. Patrick Hospital
  • Nebraska Heart Hospital
  • Dartmouth Hitchock Medical Center
  • Millard Fillmore Hospital
  • New York Presbyterian Hospital-Cornell
  • Columbia University Medical Center
  • The Valley Hospital
  • Stony Brook Hospital and Medical Center
  • St. Joseph's Hospital Health Center
  • Presbyterian Hospital - Charlotte
  • Pitt County Memorial Hospital
  • Wake Medical Center
  • Forsyth Medical Center
  • Wake Forest University Baptist Medical Center
  • The Christ Hospital
  • Riverside Methodist Hospital
  • EMH Regional Medical Center
  • Providence St. Vincent Medical Center
  • Geisinger Medical Center
  • UPMC Presbyterian Hospital
  • Rhode Island Hospital
  • The Miriam Hospital
  • Medical University of South Carolina (MUSC)
  • Sisters of Charity Providence Hospitals
  • St. Francis Health System
  • Vanderbilt Vniversity Medical Center
  • Plaza Medical Center of Fort Worth
  • Fletcher Allen Health Care
  • Sentara Norfolk General
  • St. Luke's Medical Center - Milwaukee

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

XIENCE V®

TAXUS™ EXPRESS2™

Arm Description

Outcomes

Primary Outcome Measures

Ischemia Driven Target Lesion Failure (TLF)
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).

Secondary Outcome Measures

Ischemia Driven Target Vessel Failure (TVF)
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Ischemia Driven Target Vessel Failure (TVF)
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Ischemia Driven Target Vessel Failure (TVF)
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Ischemia Driven Target Vessel Failure (TVF)
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Ischemia Driven Target Vessel Failure (TVF)
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Ischemia Driven Target Vessel Failure (TVF)
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Ischemia Driven Target Lesion Revascularization (TLR)
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Target Lesion Revascularization (TLR)
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Target Lesion Revascularization (TLR)
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Target Lesion Revascularization (TLR)
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Target Lesion Revascularization (TLR)
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Target Lesion Revascularization (TLR)
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Target Vessel Revascularization (TVR)
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Target Vessel Revascularization (TVR)
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Target Vessel Revascularization (TVR)
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Target Vessel Revascularization (TVR)
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Target Vessel Revascularization (TVR)
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Target Vessel Revascularization (TVR)
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Ischemia Driven Major Adverse Cardiac Events (MACE)
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Ischemia Driven Major Adverse Cardiac Events (MACE)
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Ischemia Driven Major Adverse Cardiac Events (MACE)
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Ischemia Driven Major Adverse Cardiac Events (MACE)
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Ischemia Driven Major Adverse Cardiac Events (MACE)
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Ischemia Driven Major Adverse Cardiac Events (MACE)
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Acute Success (Clinical Device)
Successful delivery and deployment of the first implanted study stent (in overlapping stent setting a successful delivery and deployment of the first and second study stents) at the intended target lesion and successful withdrawal of the stent delivery system with attainment of final residual stenosis of less than 50% of the target lesion by QCA (by visual estimation if QCA unavailable). Bailout subjects will be included as device success only if the above criteria for clinical device are met.
Acute Success (Clinical Procedure)
Successful delivery and deployment of the study stent or stents at the intended target lesion and successful withdrawal of the stent delivery system with attainment of final residual stenosis of less than 50% of the target lesion by QCA (by visual estimation if QCA unavailable) and/or using any adjunctive device without the occurrence of major adverse cardiac event (MACE) during the hospital stay with a maximum of first seven days following the index procedure. In multiple lesion setting all lesions must meet clinical procedure success.
All Myocardial Infarction (MI)
All MI
All MI
All MI
All MI
All MI
All Cause Mortality
All Cause Mortality
All Cause Mortality
All Cause Mortality
All Cause Mortality
All Cause Mortality
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Definite + Probable Stent Thrombosis Rate Based on Academic Research Consortium (ARC) Definition
ARC: Academic Research Consortium-defines ST as a cumulative value at the different time points and with the different seperate time points. Time 0 is defined as the time point after the guiding catheter has been removed. Acute*: 0-24 hours post implantation Subacute*: >24 hours-30 days post Late†: 30 days-1 year post Very late stent thrombosis†: >1 year post * Acute/subacute can also be replaced by early ST. Early ST (0-30 days) is currently used in the community. † Including "primary" as well as "secondary" late ST; "secondary" late ST is after a target segment revascularization.
Definite + Probable Stent Thrombosis Rate Based on ARC Definition
ARC: Academic Research Consortium-defines ST as a cumulative value at the different time points and with the different seperate time points. Time 0 is defined as the time point after the guiding catheter has been removed. Acute*: 0-24 hours post implantation Subacute*: >24 hours-30 days post Late†: 30 days-1 year post Very late stent thrombosis†: >1 year post * Acute/subacute can also be replaced by early ST. Early ST (0-30 days) is currently used in the community. † Including "primary" as well as "secondary" late ST; "secondary" late ST is after a target segment revascularization.
Definite + Probable Stent Thrombosis Rate Based on ARC Definition
ARC: Academic Research Consortium-defines ST as a cumulative value at the different time points and with the different seperate time points. Time 0 is defined as the time point after the guiding catheter has been removed. Acute*: 0-24 hours post implantation Subacute*: >24 hours-30 days post Late†: 30 days-1 year post Very late stent thrombosis†: >1 year post * Acute/subacute can also be replaced by early ST. Early ST (0-30 days) is currently used in the community. † Including "primary" as well as "secondary" late ST; "secondary" late ST is after a target segment revascularization.
Definite + Probable Stent Thrombosis Rate Based on ARC Definition
ARC: Academic Research Consortium-defines ST as a cumulative value at the different time points and with the different seperate time points. Time 0 is defined as the time point after the guiding catheter has been removed. Acute*: 0-24 hours post implantation Subacute*: >24 hours-30 days post Late†: 30 days-1 year post Very late stent thrombosis†: >1 year post * Acute/subacute can also be replaced by early ST. Early ST (0-30 days) is currently used in the community. † Including "primary" as well as "secondary" late ST; "secondary" late ST is after a target segment revascularization.
Definite + Probable Stent Thrombosis Rate Based on ARC Definition
ARC: Academic Research Consortium-defines ST as a cumulative value at the different time points and with the different seperate time points. Time 0 is defined as the time point after the guiding catheter has been removed. Acute*: 0-24 hours post implantation Subacute*: >24 hours-30 days post Late†: 30 days-1 year post Very late stent thrombosis†: >1 year post * Acute/subacute can also be replaced by early ST. Early ST (0-30 days) is currently used in the community. † Including "primary" as well as "secondary" late ST; "secondary" late ST is after a target segment revascularization.
Protocol Defined Stent Thrombosis Rate
ST will be categorized as acute (≤ 1day), subacute (>1 day to ≤ 30 days) and late (>30 days) and will be defined as any of the following: Clinical presentation of acute coronary syndrome with angiographic evidence of ST In the absence of angiography, any unexplained death, or acute MI (S-T segment elevation or new Q-wave)* in the distribution of the target lesion within 30 days *(Non-specific S-T/T changes, and cardiac enzyme elevations do not suffice) Any thromboses that occur less than 30 days after the index procedure will not be counted as restenosis.
Protocol Defined Stent Thrombosis Rate
ST will be categorized as acute (≤ 1day), subacute (>1 day to ≤ 30 days) and late (>30 days) and will be defined as any of the following: Clinical presentation of acute coronary syndrome with angiographic evidence of ST In the absence of angiography, any unexplained death, or acute MI (S-T segment elevation or new Q-wave)* in the distribution of the target lesion within 30 days *(Non-specific S-T/T changes, and cardiac enzyme elevations do not suffice) Any thromboses that occur less than 30 days after the index procedure will not be counted as restenosis.
Protocol Defined Stent Thrombosis Rate
ST will be categorized as acute (≤ 1day), subacute (>1 day to ≤ 30 days) and late (>30 days) and will be defined as any of the following: Clinical presentation of acute coronary syndrome with angiographic evidence of ST In the absence of angiography, any unexplained death, or acute MI (S-T segment elevation or new Q-wave)* in the distribution of the target lesion within 30 days *(Non-specific S-T/T changes, and cardiac enzyme elevations do not suffice) Any thromboses that occur less than 30 days after the index procedure will not be counted as restenosis.
Protocol Defined Stent Thrombosis Rate
ST will be categorized as acute (≤ 1day), subacute (>1 day to ≤ 30 days) and late (>30 days) and will be defined as any of the following: Clinical presentation of acute coronary syndrome with angiographic evidence of ST In the absence of angiography, any unexplained death, or acute MI (S-T segment elevation or new Q-wave)* in the distribution of the target lesion within 30 days *(Non-specific S-T/T changes, and cardiac enzyme elevations do not suffice) Any thromboses that occur less than 30 days after the index procedure will not be counted as restenosis.
Protocol Defined Stent Thrombosis Rate
ST will be categorized as acute (≤ 1day), subacute (>1 day to ≤ 30 days) and late (>30 days) and will be defined as any of the following: Clinical presentation of acute coronary syndrome with angiographic evidence of ST In the absence of angiography, any unexplained death, or acute MI (S-T segment elevation or new Q-wave)* in the distribution of the target lesion within 30 days *(Non-specific S-T/T changes, and cardiac enzyme elevations do not suffice) Any thromboses that occur less than 30 days after the index procedure will not be counted as restenosis.
Cardiac Death or Target Vessel MI Rate
Cardiac Death or Target Vessel MI Rate
Cardiac Death or Target Vessel MI Rate
Cardiac Death or Target Vessel MI Rate
Cardiac Death or Target Vessel MI Rate
Cardiac Death or Target Vessel MI Rate
Ischemia Driven Target Lesion Failure (TLF)
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).
Ischemia Driven Target Lesion Failure (TLF)
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).
Ischemia Driven Target Lesion Failure (TLF)
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).
Ischemia Driven Target Lesion Failure (TLF)
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).
Ischemia Driven Target Lesion Failure (TLF)
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).

Full Information

First Posted
March 23, 2006
Last Updated
October 8, 2012
Sponsor
Abbott Medical Devices
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1. Study Identification

Unique Protocol Identification Number
NCT00307047
Brief Title
SPIRIT IV Clinical Trial: Clinical Evaluation of the XIENCE V® Everolimus Eluting Coronary Stent System
Official Title
SPIRIT IV Clinical Trial: Clinical Evaluation of the XIENCE V® Everolimus Eluting Coronary Stent System in the Treatment of Subjects With de Novo Native Coronary Artery Lesions
Study Type
Interventional

2. Study Status

Record Verification Date
October 2012
Overall Recruitment Status
Completed
Study Start Date
August 2006 (undefined)
Primary Completion Date
August 2009 (Actual)
Study Completion Date
May 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Abbott Medical Devices

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of the SPIRIT IV Clinical Trial is to continue to evaluate the safety and efficacy of the XIENCE V® Everolimus Eluting Coronary Stent System (XIENCE V®). The XIENCE V® arm will be compared to an active control, represented by the FDA-approved TAXUS® EXPRESS2™ Paclitaxel-Eluting Coronary Stent System (TAXUS®), commercially available from Boston Scientific. TAXUS® EXPRESS2™ Paclitaxel Eluting Coronary Stent System is manufactured by Boston Scientific.
Detailed Description
The completion of the SPIRIT IV clinical trial at three years is justified by the consistent long-term clinical evidence supporting the safety and efficacy of the XIENCE V EECSS in complex, real-world patients across multiple geographies. As SPIRIT IV was designed as a continued access trial, completing the clinical follow-up at the three-year visit does not conflict with any FDA requirements. Abbott Vascular is committed to providing clinical outcomes through three years. The clinical evidence provided from across multiple geographies, in complex populations thus supports Abbott Vascular's proposal to complete the SPIRIT IV RCT at the three-year clinical follow-up. The SPIRIT IV Clinical Trial is a randomized, active-controlled, single-blinded, multicenter clinical trial in the US that will enroll approximately 3,690 subjects (2:1 randomization XIENCE V®: TAXUS®). The trial allows the treatment of up to three de novo native coronary artery lesions, maximum of two lesion per epicardial vessel, with reference vessel diameters (RVD) ≥ 2.5 mm to ≤ 4.25 mm and lesion lengths ≤ 28 mm. (NOTE: RVD ≥ 2.5 mm to ≤ 3.75 mm until 4.0 mm TAXUS® is commercially available). All subjects will be screened per the protocol inclusion and exclusion criteria and enrolled subjects will have clinical follow-up at 30, 180, and 270 days and 1, 2, and 3 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease
Keywords
Stents, Angioplasty, Total coronary occlusion, coronary restenosis, stent thrombosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
3687 (Actual)

8. Arms, Groups, and Interventions

Arm Title
XIENCE V®
Arm Type
Experimental
Arm Title
TAXUS™ EXPRESS2™
Arm Type
Active Comparator
Intervention Type
Device
Intervention Name(s)
XIENCE V® Everolimus Eluting Coronary Stent
Other Intervention Name(s)
XIENCE V® Everolimus Eluting Coronary Stent System
Intervention Description
Drug eluting stent implantation stent in the treatment of coronary artery disease.
Intervention Type
Device
Intervention Name(s)
TAXUS™ EXPRESS2™ Paclitaxel Eluting Coronary Stent
Other Intervention Name(s)
TAXUS™ EXPRESS2™ Paclitaxel Eluting Coronary Stent System
Intervention Description
Drug eluting stent implantation stent in the treatment of coronary artery disease.
Primary Outcome Measure Information:
Title
Ischemia Driven Target Lesion Failure (TLF)
Description
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Ischemia Driven Target Vessel Failure (TVF)
Description
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Time Frame
30 days
Title
Ischemia Driven Target Vessel Failure (TVF)
Description
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Time Frame
180 days
Title
Ischemia Driven Target Vessel Failure (TVF)
Description
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Time Frame
270 days
Title
Ischemia Driven Target Vessel Failure (TVF)
Description
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Time Frame
1 year
Title
Ischemia Driven Target Vessel Failure (TVF)
Description
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Time Frame
2 years
Title
Ischemia Driven Target Vessel Failure (TVF)
Description
Defined as the composite endpoint comprised of cardiac death (CD), myocardial infarction (MI), TLR, and TVR
Time Frame
3 years
Title
Ischemia Driven Target Lesion Revascularization (TLR)
Description
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
30 days
Title
Ischemia Driven Target Lesion Revascularization (TLR)
Description
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
180 days
Title
Ischemia Driven Target Lesion Revascularization (TLR)
Description
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
270 days
Title
Ischemia Driven Target Lesion Revascularization (TLR)
Description
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
1 year
Title
Ischemia Driven Target Lesion Revascularization (TLR)
Description
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
2 years
Title
Ischemia Driven Target Lesion Revascularization (TLR)
Description
Revascularization of a target lesion associated with any of the following: positive functional ischemia study ischemic symptoms and angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
3 years
Title
Ischemia Driven Target Vessel Revascularization (TVR)
Description
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
30 days
Title
Ischemia Driven Target Vessel Revascularization (TVR)
Description
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
180 days
Title
Ischemia Driven Target Vessel Revascularization (TVR)
Description
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
270 days
Title
Ischemia Driven Target Vessel Revascularization (TVR)
Description
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
1 year
Title
Ischemia Driven Target Vessel Revascularization (TVR)
Description
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
2 years
Title
Ischemia Driven Target Vessel Revascularization (TVR)
Description
Revascularization of a lesion within the target vessel associated with any of the following: positive functional ischemia study ischemic symptoms and an angiographic minimal lumen diameter stenosis ≥ 50% by core laboratory quantitative coronary angiography (QCA) angiographic diameter stenosis ≥ 70% by core laboratory QCA without either ischemic symptoms or a positive functional study
Time Frame
3 years
Title
Ischemia Driven Major Adverse Cardiac Events (MACE)
Description
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Time Frame
30 days
Title
Ischemia Driven Major Adverse Cardiac Events (MACE)
Description
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Time Frame
180 days
Title
Ischemia Driven Major Adverse Cardiac Events (MACE)
Description
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Time Frame
270 days
Title
Ischemia Driven Major Adverse Cardiac Events (MACE)
Description
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Time Frame
1 years
Title
Ischemia Driven Major Adverse Cardiac Events (MACE)
Description
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Time Frame
2 years
Title
Ischemia Driven Major Adverse Cardiac Events (MACE)
Description
Patients determined to have had a MACE event, defined as one of the following events: Cardiac death, myocardial infarction, and TLR
Time Frame
3 years
Title
Acute Success (Clinical Device)
Description
Successful delivery and deployment of the first implanted study stent (in overlapping stent setting a successful delivery and deployment of the first and second study stents) at the intended target lesion and successful withdrawal of the stent delivery system with attainment of final residual stenosis of less than 50% of the target lesion by QCA (by visual estimation if QCA unavailable). Bailout subjects will be included as device success only if the above criteria for clinical device are met.
Time Frame
Acute: At time of index procedure
Title
Acute Success (Clinical Procedure)
Description
Successful delivery and deployment of the study stent or stents at the intended target lesion and successful withdrawal of the stent delivery system with attainment of final residual stenosis of less than 50% of the target lesion by QCA (by visual estimation if QCA unavailable) and/or using any adjunctive device without the occurrence of major adverse cardiac event (MACE) during the hospital stay with a maximum of first seven days following the index procedure. In multiple lesion setting all lesions must meet clinical procedure success.
Time Frame
Acute: At time of index procedure
Title
All Myocardial Infarction (MI)
Time Frame
30 days
Title
All MI
Time Frame
180 days
Title
All MI
Time Frame
270 days
Title
All MI
Time Frame
1 year
Title
All MI
Time Frame
2 years
Title
All MI
Time Frame
3 years
Title
All Cause Mortality
Time Frame
30 days
Title
All Cause Mortality
Time Frame
180 days
Title
All Cause Mortality
Time Frame
270 days
Title
All Cause Mortality
Time Frame
1 year
Title
All Cause Mortality
Time Frame
2 years
Title
All Cause Mortality
Time Frame
3 years
Title
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Time Frame
30 days
Title
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Time Frame
180 days
Title
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Time Frame
270 days
Title
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Time Frame
1 year
Title
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Time Frame
2 years
Title
Composite Endpoint of All Deaths, All MI, All Revascularizations (DMR)
Time Frame
3 years
Title
Definite + Probable Stent Thrombosis Rate Based on Academic Research Consortium (ARC) Definition
Description
ARC: Academic Research Consortium-defines ST as a cumulative value at the different time points and with the different seperate time points. Time 0 is defined as the time point after the guiding catheter has been removed. Acute*: 0-24 hours post implantation Subacute*: >24 hours-30 days post Late†: 30 days-1 year post Very late stent thrombosis†: >1 year post * Acute/subacute can also be replaced by early ST. Early ST (0-30 days) is currently used in the community. † Including "primary" as well as "secondary" late ST; "secondary" late ST is after a target segment revascularization.
Time Frame
0-30 days
Title
Definite + Probable Stent Thrombosis Rate Based on ARC Definition
Description
ARC: Academic Research Consortium-defines ST as a cumulative value at the different time points and with the different seperate time points. Time 0 is defined as the time point after the guiding catheter has been removed. Acute*: 0-24 hours post implantation Subacute*: >24 hours-30 days post Late†: 30 days-1 year post Very late stent thrombosis†: >1 year post * Acute/subacute can also be replaced by early ST. Early ST (0-30 days) is currently used in the community. † Including "primary" as well as "secondary" late ST; "secondary" late ST is after a target segment revascularization.
Time Frame
31-393 days
Title
Definite + Probable Stent Thrombosis Rate Based on ARC Definition
Description
ARC: Academic Research Consortium-defines ST as a cumulative value at the different time points and with the different seperate time points. Time 0 is defined as the time point after the guiding catheter has been removed. Acute*: 0-24 hours post implantation Subacute*: >24 hours-30 days post Late†: 30 days-1 year post Very late stent thrombosis†: >1 year post * Acute/subacute can also be replaced by early ST. Early ST (0-30 days) is currently used in the community. † Including "primary" as well as "secondary" late ST; "secondary" late ST is after a target segment revascularization.
Time Frame
0 -393 days
Title
Definite + Probable Stent Thrombosis Rate Based on ARC Definition
Description
ARC: Academic Research Consortium-defines ST as a cumulative value at the different time points and with the different seperate time points. Time 0 is defined as the time point after the guiding catheter has been removed. Acute*: 0-24 hours post implantation Subacute*: >24 hours-30 days post Late†: 30 days-1 year post Very late stent thrombosis†: >1 year post * Acute/subacute can also be replaced by early ST. Early ST (0-30 days) is currently used in the community. † Including "primary" as well as "secondary" late ST; "secondary" late ST is after a target segment revascularization.
Time Frame
0-758 days
Title
Definite + Probable Stent Thrombosis Rate Based on ARC Definition
Description
ARC: Academic Research Consortium-defines ST as a cumulative value at the different time points and with the different seperate time points. Time 0 is defined as the time point after the guiding catheter has been removed. Acute*: 0-24 hours post implantation Subacute*: >24 hours-30 days post Late†: 30 days-1 year post Very late stent thrombosis†: >1 year post * Acute/subacute can also be replaced by early ST. Early ST (0-30 days) is currently used in the community. † Including "primary" as well as "secondary" late ST; "secondary" late ST is after a target segment revascularization.
Time Frame
0-1123 days
Title
Protocol Defined Stent Thrombosis Rate
Description
ST will be categorized as acute (≤ 1day), subacute (>1 day to ≤ 30 days) and late (>30 days) and will be defined as any of the following: Clinical presentation of acute coronary syndrome with angiographic evidence of ST In the absence of angiography, any unexplained death, or acute MI (S-T segment elevation or new Q-wave)* in the distribution of the target lesion within 30 days *(Non-specific S-T/T changes, and cardiac enzyme elevations do not suffice) Any thromboses that occur less than 30 days after the index procedure will not be counted as restenosis.
Time Frame
0-30 days
Title
Protocol Defined Stent Thrombosis Rate
Description
ST will be categorized as acute (≤ 1day), subacute (>1 day to ≤ 30 days) and late (>30 days) and will be defined as any of the following: Clinical presentation of acute coronary syndrome with angiographic evidence of ST In the absence of angiography, any unexplained death, or acute MI (S-T segment elevation or new Q-wave)* in the distribution of the target lesion within 30 days *(Non-specific S-T/T changes, and cardiac enzyme elevations do not suffice) Any thromboses that occur less than 30 days after the index procedure will not be counted as restenosis.
Time Frame
31-393 days
Title
Protocol Defined Stent Thrombosis Rate
Description
ST will be categorized as acute (≤ 1day), subacute (>1 day to ≤ 30 days) and late (>30 days) and will be defined as any of the following: Clinical presentation of acute coronary syndrome with angiographic evidence of ST In the absence of angiography, any unexplained death, or acute MI (S-T segment elevation or new Q-wave)* in the distribution of the target lesion within 30 days *(Non-specific S-T/T changes, and cardiac enzyme elevations do not suffice) Any thromboses that occur less than 30 days after the index procedure will not be counted as restenosis.
Time Frame
0-393 days
Title
Protocol Defined Stent Thrombosis Rate
Description
ST will be categorized as acute (≤ 1day), subacute (>1 day to ≤ 30 days) and late (>30 days) and will be defined as any of the following: Clinical presentation of acute coronary syndrome with angiographic evidence of ST In the absence of angiography, any unexplained death, or acute MI (S-T segment elevation or new Q-wave)* in the distribution of the target lesion within 30 days *(Non-specific S-T/T changes, and cardiac enzyme elevations do not suffice) Any thromboses that occur less than 30 days after the index procedure will not be counted as restenosis.
Time Frame
0-758 days
Title
Protocol Defined Stent Thrombosis Rate
Description
ST will be categorized as acute (≤ 1day), subacute (>1 day to ≤ 30 days) and late (>30 days) and will be defined as any of the following: Clinical presentation of acute coronary syndrome with angiographic evidence of ST In the absence of angiography, any unexplained death, or acute MI (S-T segment elevation or new Q-wave)* in the distribution of the target lesion within 30 days *(Non-specific S-T/T changes, and cardiac enzyme elevations do not suffice) Any thromboses that occur less than 30 days after the index procedure will not be counted as restenosis.
Time Frame
0-1123 days
Title
Cardiac Death or Target Vessel MI Rate
Time Frame
30 days
Title
Cardiac Death or Target Vessel MI Rate
Time Frame
180 days
Title
Cardiac Death or Target Vessel MI Rate
Time Frame
270 days
Title
Cardiac Death or Target Vessel MI Rate
Time Frame
1 year
Title
Cardiac Death or Target Vessel MI Rate
Time Frame
2 years
Title
Cardiac Death or Target Vessel MI Rate
Time Frame
3 years
Title
Ischemia Driven Target Lesion Failure (TLF)
Description
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).
Time Frame
30 days
Title
Ischemia Driven Target Lesion Failure (TLF)
Description
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).
Time Frame
180 days
Title
Ischemia Driven Target Lesion Failure (TLF)
Description
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).
Time Frame
270 days
Title
Ischemia Driven Target Lesion Failure (TLF)
Description
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).
Time Frame
2 years
Title
Ischemia Driven Target Lesion Failure (TLF)
Description
Percentage of participants with the determination of TLF. TLF is the composite of cardiac death, target vessel myocardial infarction, and ischemic driven target lesion revascularization (TLR).
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
General Inclusion Criteria: Subject must be at least 18 years of age Subject is able to verbally confirm understanding of risks, benefits and treatment alternatives of receiving XIENCE V® and he/she or his/her legally authorized representative provides written informed consent prior to any study related procedure Subject 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) Subject must be an acceptable candidate for coronary artery bypass graft (CABG) surgery Subject must agree to undergo all protocol-required follow-up procedures Subject must agree not to participate in any other clinical study for a period of one year following the index procedure Angiographic Inclusion Criteria: Target lesion(s) must be located in a native coronary artery with visually estimated diameter of ≥2.5 mm to ≤4.25 mm and treatment of up to a three de novo target lesions, maximum of two de novo target lesions per epicardical vessel. (NOTE: RVD ≥2.5 mm to ≤3.75 mm until 4.0 mm TAXUS® is commercially available) Target lesion(s) must measure ≤28 mm in length by visual estimation(≥3 mm of non-diseased tissue on either side of the target lesion should be covered by the study stent) If more than one target lesion will be treated, the RVD and lesion length of each must meet the above criteria If more than one target lesion will be treated, the RVD and lesion length of each must meet the above criteria The target lesion(s) must be in a major artery or branch with a visually estimated stenosis of ≥ 50% and < 100% with a TIMI flow of ≥ 1 Non-study, percutaneous intervention for lesions in a target vessel (including side branches) is allowed if done ≥ 9 months prior to the index procedure Non-study percutaneous intervention for lesions in a non-target vessel involving: Successful and uncomplicated (visually estimated diameter stenosis < 50%, TIMI Grade 3 flow, no ECG changes, prolonged chest pain, or angiographic complications) bare-metal stent, balloon dilatation, cutting balloon, atherectomy, thrombectomy, and laser treatments are allowed if done ≥ 24 hours prior to the index procedure or during (before randomization) the index procedure. For interventions done within 24 to 48 hours prior to the index procedure, CK and CK-MB must be assessed to be < 2 times the upper limit of normal at the time of the index procedure. NOTE: Procedures within the 24 hour period preceding the index procedure are not permitted Unsuccessful or complicated bare-metal stent, balloon dilatation, cutting balloon, atherectomy, thrombectomy, and laser treatments are allowed if done ≥ 30 days prior to the index procedure Drug-eluting stent treatment is allowed if done ≥ 90 days prior to the index procedure Non-study, percutaneous interventions for lesion(s) in a target vessel (including side branches) or non-target vessel are allowed if done ≥ 9 months after the index procedure General Exclusion Criteria: Subject has had a known diagnosis of acute myocardial infarction (AMI) preceding the index procedure (CK-MB ≥ 2 times upper limit of normal) and CK and CK-MB have not returned within normal limits at the time of procedure The subject is currently experiencing clinical symptoms consistent with AMI Subject has current unstable arrhythmias Subject has a known left ventricular ejection fraction (LVEF) < 30% Subject has received a heart transplant or any other organ transplant or is on a waiting list for any organ transplant Subject is receiving or scheduled to receive anticancer therapy for malignancy within 30 days prior to or after the procedure Subject is receiving immunosuppression therapy, or has known serious immunosuppressive disease (e.g., human immunodeficiency virus), or has severe autoimmune disease that requires chronic immunosuppressive therapy (e.g., systemic lupus erythematosus, etc.) Subject is receiving or is scheduled to receive chronic anticoagulation therapy (e.g., heparin, coumadin) Subject has a known hypersensitivity or contraindication to aspirin, both heparin and bivalirudin, both clopidogrel and ticlopidine, everolimus, cobalt, chromium, nickel, tungsten, acrylic and fluoro polymers or contrast sensitivity that cannot be adequately pre-medicated Elective surgery that will require discontinuing either aspirin or clopidogrel is planned within the first 9 months after the procedure Subject 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) Subject has known renal insufficiency (e.g., serum creatinine level of > 2.5 mg/dL or subject on dialysis) Subject has a history of bleeding diathesis or coagulopathy or will refuse blood transfusions Subject has had a cerebrovascular accident (CVA) or transient ischemic neurological attack (TIA) within the past six months Subject has had a significant GI or urinary bleed within the past six months Subject has extensive peripheral vascular disease that precludes safe 6 French sheath insertion Subject 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 protocol, confound the data interpretation or is associated with a life expectancy of less than one year Subject is already participating in another clinical study that has not yet reached its primary endpoint Pregnant or nursing subjects and those who plan pregnancy in the period up to 1 year following index procedure. (Female subjects of child-bearing potential must have a negative pregnancy test done within 7 days prior to the index procedure and effective contraception must be used up to 1 year following the index procedure) Angiographic Exclusion Criteria The target lesion(s) meets any of the following criteria: Left main coronary artery location including left main ostial location (NOTE: RCA-aorto-ostial lesions are not excluded) Located within 2 mm of the origin of the LAD or LCX Located within an arterial or saphenous vein graft or distal to a diseased (vessel irregularity per angiogram and any visually estimated diameter stenosis > 20%) arterial or saphenous vein graft Involves a bifurcation in which the side branch is ≥ 2 mm in diameter AND the ostium of the side branch is > 50% stenosed by visual estimation Involves a side branch requiring pre-dilatation Total occlusion (TIMI flow 0) prior to wire crossing Excessive tortuosity proximal to or within the lesion Extreme angulation (≥ 90º) proximal to or within the lesion Heavy calcification Restenotic from previous intervention Subject has received brachytherapy in any epicardial vessel (including side branches) The target vessel contains thrombus Another clinically significant lesion in the target vessel is present that requires or has a high probability of requiring PCI during the index procedure Another lesion in a target or non-target vessel (including all side branches) is present that requires or has a high probability of requiring PCI within 9 months after the index procedure
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gregg W Stone
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Scottsdale Healthcare
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85260
Country
United States
Facility Name
Arkansas Heart Hospital
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72211
Country
United States
Facility Name
Inova Fairfax Hospital
City
Fairfax
State/Province
California
ZIP/Postal Code
22031
Country
United States
Facility Name
San Diego Cardiovascular Associates
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
Scripps Memorial Hospital
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
Good Samaritan Hospital - LA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90017
Country
United States
Facility Name
Mercy General Hospital
City
Sacramento
State/Province
California
ZIP/Postal Code
95819
Country
United States
Facility Name
Sutter Medical Center of Santa Rosa
City
Santa Rosa
State/Province
California
ZIP/Postal Code
95404-1797
Country
United States
Facility Name
The Medical Center of Aurora
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80012
Country
United States
Facility Name
Poudre Valley Hospital
City
Fort Collins
State/Province
Colorado
ZIP/Postal Code
80528
Country
United States
Facility Name
Washington Hospital Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
Sacred Heart Hospital
City
Pensacola
State/Province
Florida
ZIP/Postal Code
32504-8721
Country
United States
Facility Name
Sarasota Memorial Hospital
City
Sarasota
State/Province
Florida
ZIP/Postal Code
34239
Country
United States
Facility Name
St. Francis Hospital and Health Centers
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46237
Country
United States
Facility Name
The Heart Center of Indiana
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46290
Country
United States
Facility Name
Iowa Heart Center P.C.
City
Des Moines
State/Province
Iowa
ZIP/Postal Code
50266
Country
United States
Facility Name
University of Kansas Hospital
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Central Baptist Hospital
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40503
Country
United States
Facility Name
Jewish Hospital
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
Maine Medical Center
City
Portland
State/Province
Maine
ZIP/Postal Code
04102
Country
United States
Facility Name
Union Memorial Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21218
Country
United States
Facility Name
Johns Hopkins Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Washington Adventist Hospital
City
Takoma Park
State/Province
Maryland
ZIP/Postal Code
20912
Country
United States
Facility Name
St. Joseph Medical Center
City
Towson
State/Province
Maryland
ZIP/Postal Code
21204
Country
United States
Facility Name
Brigham and Women's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Saint Vincent Hospital
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01608
Country
United States
Facility Name
UMass Memorial Medical Center
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01655
Country
United States
Facility Name
Bay Regional Medical Center
City
Bay City
State/Province
Michigan
ZIP/Postal Code
48706
Country
United States
Facility Name
Oakwood Hospital and Medical Center
City
Dearborn
State/Province
Michigan
ZIP/Postal Code
48124
Country
United States
Facility Name
Spectrum Health Hospital
City
Grand Rapids
State/Province
Michigan
ZIP/Postal Code
49503
Country
United States
Facility Name
Borgess Medical Center
City
Kalamazoo
State/Province
Michigan
ZIP/Postal Code
49048
Country
United States
Facility Name
Ingham Regional Medical Center
City
Lansing
State/Province
Michigan
ZIP/Postal Code
48910
Country
United States
Facility Name
Northern Michigan Hospital
City
Petoskey
State/Province
Michigan
ZIP/Postal Code
49770
Country
United States
Facility Name
St. Luke's Hospital
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Facility Name
Research Medical Center
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64132
Country
United States
Facility Name
St. Patrick Hospital
City
Missoula
State/Province
Montana
ZIP/Postal Code
59802
Country
United States
Facility Name
Nebraska Heart Hospital
City
Lincoln
State/Province
Nebraska
ZIP/Postal Code
68526
Country
United States
Facility Name
Dartmouth Hitchock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States
Facility Name
Millard Fillmore Hospital
City
Buffalo
State/Province
New York
ZIP/Postal Code
14209
Country
United States
Facility Name
New York Presbyterian Hospital-Cornell
City
New York City
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
The Valley Hospital
City
Pomona
State/Province
New York
ZIP/Postal Code
10970
Country
United States
Facility Name
Stony Brook Hospital and Medical Center
City
Stony Brook
State/Province
New York
ZIP/Postal Code
11794
Country
United States
Facility Name
St. Joseph's Hospital Health Center
City
Syracuse
State/Province
New York
ZIP/Postal Code
13203
Country
United States
Facility Name
Presbyterian Hospital - Charlotte
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28233
Country
United States
Facility Name
Pitt County Memorial Hospital
City
Greenville
State/Province
North Carolina
ZIP/Postal Code
27834
Country
United States
Facility Name
Wake Medical Center
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27610
Country
United States
Facility Name
Forsyth Medical Center
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
Wake Forest University Baptist Medical Center
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
The Christ Hospital
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
Riverside Methodist Hospital
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43214
Country
United States
Facility Name
EMH Regional Medical Center
City
Elyria
State/Province
Ohio
ZIP/Postal Code
44035
Country
United States
Facility Name
Providence St. Vincent Medical Center
City
Portland
State/Province
Oregon
ZIP/Postal Code
97225
Country
United States
Facility Name
Geisinger Medical Center
City
Danville
State/Province
Pennsylvania
ZIP/Postal Code
17822
Country
United States
Facility Name
UPMC Presbyterian Hospital
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
Rhode Island Hospital
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02903
Country
United States
Facility Name
The Miriam Hospital
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02906
Country
United States
Facility Name
Medical University of South Carolina (MUSC)
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Sisters of Charity Providence Hospitals
City
Columbia
State/Province
South Carolina
ZIP/Postal Code
29204
Country
United States
Facility Name
St. Francis Health System
City
Greenville
State/Province
South Carolina
ZIP/Postal Code
29605
Country
United States
Facility Name
Vanderbilt Vniversity Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37205
Country
United States
Facility Name
Plaza Medical Center of Fort Worth
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76104
Country
United States
Facility Name
Fletcher Allen Health Care
City
Burlington
State/Province
Vermont
ZIP/Postal Code
05401
Country
United States
Facility Name
Sentara Norfolk General
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23507
Country
United States
Facility Name
St. Luke's Medical Center - Milwaukee
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53215
Country
United States

12. IPD Sharing Statement

Citations:
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Citation
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Results Reference
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SPIRIT IV Clinical Trial: Clinical Evaluation of the XIENCE V® Everolimus Eluting Coronary Stent System

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