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A Trial of Bare Metal Stent - Cobalt Chromium Versus Stent Coating With Sirolimus (INSPIRON)

Primary Purpose

Coronary Artery Disease

Status
Completed
Phase
Phase 3
Locations
Brazil
Study Type
Interventional
Intervention
DRUG ELUTING STENT
BARE METAL STENT
Sponsored by
Scitech Produtos Medicos Ltda
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Disease focused on measuring coronary artery, thrombosis, stent

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Age ≥18 years and ≤75 years;
  2. Symptomatic cardiac ischemic disease and/or documented evidence of myocardial ischemia;
  3. Types B1 and B2 coronary lesions (according to the ACC/AHA classification modified by Ellis);
  4. Target lesion located in a native coronary artery;
  5. Target lesion in vessel with diameter ranging from 2.5 to 3.5 mm (by visual estimate) amenable to treatment (coverage) with a 16- 19mm-long stent;
  6. Target lesion with >50% diameter stenosis (by visual estimate);
  7. Acceptable candidate to myocardial revascularization surgery (coronary artery bypass graft surgery);
  8. The subject has been fully informed of the nature of the study, is willing to comply with all study requirements and will provide written informed consent as approved by the Ethics Committee of the respective clinical site.

Exclusion Criteria:

  1. Female patients of childbearing potential;
  2. Recent Q-wave myocardial infarction occurred within 48 hours prior to the index procedure. Recent Q-wave or non-Q-wave myocardial infarction with still elevated levels of cardiac markers;
  3. Documented left ventricular ejection fraction <30%;
  4. Renal dysfunction (creatinine > 2.0 mg/dL or 177 µmol/L);
  5. Platelet count <100,000 cells/mm³ or >700,000 cells/mm³.;
  6. White blood cell count <3,000 cells/mm3;
  7. Suspected or documented hepatic disease (including laboratorial evidence of hepatitis);
  8. Heart transplant receptor;
  9. Known hypersensitivity to cobalt-chromium or to medications such as aspirin, clopidogrel bisulfate (Plavix or ISCOVER), ticlopidine (Ticlid) or heparin.
  10. Concurrent medical condition with a life expectancy of less than 12 months;
  11. Any major medical condition that, in the Investigator's opinion, may interfere with the optimal participation of the patient in this study;
  12. Subject is currently participating in an investigational drug or another device study, including planned participation in an investigational drug or another device study during the course of the present investigation;
  13. Coronary angioplasty (with or without stenting) less than 9 months before the index procedure at any site of the target vessel;
  14. Previous coronary angioplasty (with or without stenting) at any time (>9 months) in a vessel segment less than 5 mm proximal or distal to the target lesion.
  15. Planned coronary angioplasty (with or without stenting) in the first 12 months after the index procedure in any segment of the target vessel;

4.3. ANGIOGRAPHIC EXCLUSION CRITERIA

  1. Restenotic target lesion;
  2. More than one lesion requiring treatment in the same vessel;
  3. Target vessel diameter <2.5 mm or >3.5 mm (by visual estimation);
  4. Long target lesion not amenable to treatment (coverage) with a 16-19mm long stent;
  5. Unprotected coronary artery branch lesion (≥50% diameter stenosis)
  6. Target lesion is located in a surgical bypass graft;
  7. Total vessel occlusion (TIMI flow grade 0-1);
  8. Target lesion with ostial location;
  9. Target lesion located in a lateral branch bifurcation >2.5mm or requiring lateral branch stenting;
  10. Calcified target lesion that anticipates unsuccessful/impracticable predilation;
  11. Target vessel with excessive tortuosity

Sites / Locations

  • Hospital Ibiapaba de Barbacena
  • Instituto de Assistêcia Médica ao Servidor Publico Estadual
  • Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da USP
  • Hospital Santa Marcelina

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

BARE METAL STENT

DRUG ELUTING STENT

Arm Description

BARE METAL STENT - STENT CRONUS

STENT INSPIRON WITH SIROLIMUS

Outcomes

Primary Outcome Measures

Lumen Loss
For an accurate assessment of the stent conditions 6 months after implantation, a follow-up catheterization will be performed at the 6-month visit in order to measure the diameter of the artery at the stented site. The objective is the lumen loss in-segment (including the portion in-stent and edges of 5 mm proximal and distal) at 6 months.

Secondary Outcome Measures

Adverse Cardiac Events
The clinical follow-up should be performed during the index procedure at 30 days, 6, 12 and 60 months post-procedure, and should consist of an assessment of the angina status (according to the Canadian Cardiovascular Society Classification and the Braunwald Classification for unstable angina) and major adverse cardiac events and any interventional treatment (e.g.: repeated target lesion revascularization or recurrent ischemia).

Full Information

First Posted
March 18, 2010
Last Updated
July 20, 2015
Sponsor
Scitech Produtos Medicos Ltda
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1. Study Identification

Unique Protocol Identification Number
NCT01093391
Brief Title
A Trial of Bare Metal Stent - Cobalt Chromium Versus Stent Coating With Sirolimus
Acronym
INSPIRON
Official Title
A Randomized Trial of Bare Metal Stent (Cronus®) - Cobalt Chromium Versus Stent Coating With Sirolimus (DES)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2015
Overall Recruitment Status
Completed
Study Start Date
November 2010 (undefined)
Primary Completion Date
July 2015 (Actual)
Study Completion Date
July 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Scitech Produtos Medicos Ltda

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objective of this study is to evaluate the security issues and efficacy of coronary stenting Cobalt Chrome covered with sirolimus-eluting Cobalt Chrome platform in patients with coronary artery lesion.
Detailed Description
Patients will be treated in compliance with the eligibility criteria, with stent study of 16-19mm. All patients are clinically followed for 60 months after the procedure and will undergo a control angiography 6 months. Can be treated multiple lesions, measuring between 2.5-3.5mm (by visual estimate). Patients enrolled will be randomized in a 1:2 propose in one of the groups with or without stent coating, respectively. And a randomized clinical trial, prospective study in 5 centers including 60 patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease
Keywords
coronary artery, thrombosis, stent

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
63 (Actual)

8. Arms, Groups, and Interventions

Arm Title
BARE METAL STENT
Arm Type
Placebo Comparator
Arm Description
BARE METAL STENT - STENT CRONUS
Arm Title
DRUG ELUTING STENT
Arm Type
Experimental
Arm Description
STENT INSPIRON WITH SIROLIMUS
Intervention Type
Device
Intervention Name(s)
DRUG ELUTING STENT
Other Intervention Name(s)
Angiography, Stenting
Intervention Description
Site preparation and percutaneous access should be performed as per standard hospital procedures.It is recommended to cross the target lesion with 0.014-inch exchange-length guide wire. The involved lesion should be predilated with appropriately sized balloons using standard techniques. It is strongly encouraged that the Investigators use similar materials and techniques throughout the study to maintain consistency and standardization of care.A stent consists of an endovascular prosthesis with a metallic mesh structure that is implanted at the site of the artery blockage via catheterization procedure. The objective of stenting is to obtain an angiographic appearance of the expanded stent only outside the limits of the target vessel filled with contrast medium.
Intervention Type
Device
Intervention Name(s)
BARE METAL STENT
Intervention Description
Site preparation and percutaneous access should be performed as per standard hospital procedures.It is recommended to cross the target lesion with 0.014-inch exchange-length guide wire. The involved lesion should be predilated with appropriately sized balloons using standard techniques. It is strongly encouraged that the Investigators use similar materials and techniques throughout the study to maintain consistency and standardization of care.A stent consists of an endovascular prosthesis with a metallic mesh structure that is implanted at the site of the artery blockage via catheterization procedure. The objective of stenting is to obtain an angiographic appearance of the expanded stent only outside the limits of the target vessel filled with contrast medium.
Primary Outcome Measure Information:
Title
Lumen Loss
Description
For an accurate assessment of the stent conditions 6 months after implantation, a follow-up catheterization will be performed at the 6-month visit in order to measure the diameter of the artery at the stented site. The objective is the lumen loss in-segment (including the portion in-stent and edges of 5 mm proximal and distal) at 6 months.
Time Frame
6 months after the procedure
Secondary Outcome Measure Information:
Title
Adverse Cardiac Events
Description
The clinical follow-up should be performed during the index procedure at 30 days, 6, 12 and 60 months post-procedure, and should consist of an assessment of the angina status (according to the Canadian Cardiovascular Society Classification and the Braunwald Classification for unstable angina) and major adverse cardiac events and any interventional treatment (e.g.: repeated target lesion revascularization or recurrent ischemia).
Time Frame
30 days, 6, 12 and 60 months after the procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age ≥18 years and ≤75 years; Symptomatic cardiac ischemic disease and/or documented evidence of myocardial ischemia; Types B1 and B2 coronary lesions (according to the ACC/AHA classification modified by Ellis); Target lesion located in a native coronary artery; Target lesion in vessel with diameter ranging from 2.5 to 3.5 mm (by visual estimate) amenable to treatment (coverage) with a 16- 19mm-long stent; Target lesion with >50% diameter stenosis (by visual estimate); Acceptable candidate to myocardial revascularization surgery (coronary artery bypass graft surgery); The subject has been fully informed of the nature of the study, is willing to comply with all study requirements and will provide written informed consent as approved by the Ethics Committee of the respective clinical site. Exclusion Criteria: Female patients of childbearing potential; Recent Q-wave myocardial infarction occurred within 48 hours prior to the index procedure. Recent Q-wave or non-Q-wave myocardial infarction with still elevated levels of cardiac markers; Documented left ventricular ejection fraction <30%; Renal dysfunction (creatinine > 2.0 mg/dL or 177 µmol/L); Platelet count <100,000 cells/mm³ or >700,000 cells/mm³.; White blood cell count <3,000 cells/mm3; Suspected or documented hepatic disease (including laboratorial evidence of hepatitis); Heart transplant receptor; Known hypersensitivity to cobalt-chromium or to medications such as aspirin, clopidogrel bisulfate (Plavix or ISCOVER), ticlopidine (Ticlid) or heparin. Concurrent medical condition with a life expectancy of less than 12 months; Any major medical condition that, in the Investigator's opinion, may interfere with the optimal participation of the patient in this study; Subject is currently participating in an investigational drug or another device study, including planned participation in an investigational drug or another device study during the course of the present investigation; Coronary angioplasty (with or without stenting) less than 9 months before the index procedure at any site of the target vessel; Previous coronary angioplasty (with or without stenting) at any time (>9 months) in a vessel segment less than 5 mm proximal or distal to the target lesion. Planned coronary angioplasty (with or without stenting) in the first 12 months after the index procedure in any segment of the target vessel; 4.3. ANGIOGRAPHIC EXCLUSION CRITERIA Restenotic target lesion; More than one lesion requiring treatment in the same vessel; Target vessel diameter <2.5 mm or >3.5 mm (by visual estimation); Long target lesion not amenable to treatment (coverage) with a 16-19mm long stent; Unprotected coronary artery branch lesion (≥50% diameter stenosis) Target lesion is located in a surgical bypass graft; Total vessel occlusion (TIMI flow grade 0-1); Target lesion with ostial location; Target lesion located in a lateral branch bifurcation >2.5mm or requiring lateral branch stenting; Calcified target lesion that anticipates unsuccessful/impracticable predilation; Target vessel with excessive tortuosity
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Expedito E. Ribeiro da Silva, Medicine
Organizational Affiliation
Instituto do Coração do Hospital das Clínicas da Fac. de Medicina da USP
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital Ibiapaba de Barbacena
City
Barbacena
State/Province
MG
ZIP/Postal Code
36201-356
Country
Brazil
Facility Name
Instituto de Assistêcia Médica ao Servidor Publico Estadual
City
São Paulo
State/Province
SP
ZIP/Postal Code
04029-000
Country
Brazil
Facility Name
Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da USP
City
São Paulo
State/Province
SP
ZIP/Postal Code
05403-000
Country
Brazil
Facility Name
Hospital Santa Marcelina
City
São Paulo
State/Province
SP
ZIP/Postal Code
08270-070
Country
Brazil

12. IPD Sharing Statement

Citations:
Citation
Carlos Augusto Homem de Magalhães Campos; Celso K. Takimura; Guilherme B. Gregores; Carlos A. Sarmento; Emerson T. Fioretto; Fracisco R. M. Laurindo; Expedito E. Ribeiro; Eulógio E. Martinez; Thiago F.C.C. Borges; Pedro A. Lemos. Redução neointimal com Stent com polímero biodegradável e Sirolimus desenvolvido no Brasil: Resultados preliminares em Suínos. Rev. Soc. Cardiol. Estado de São Paulo - Supl. B - Vol. 19
Results Reference
result
PubMed Identifier
26331110
Citation
Oliveira MD, Ribeiro EE, Campos CM, Ribeiro HB, Faillace BL, Lopes AC, Esper RB, Meirelles GX, Perin MA, Abizaid A, Lemos PA. Four-year clinical follow-up of the first-in-man randomized comparison of a novel sirolimus eluting stent with abluminal biodegradable polymer and ultra-thin strut cobalt-chromium alloy: the INSPIRON-I trial. Cardiovasc Diagn Ther. 2015 Aug;5(4):264-70. doi: 10.3978/j.issn.2223-3652.2015.07.05.
Results Reference
derived
PubMed Identifier
24755382
Citation
Ribeiro EE, Campos CM, Ribeiro HB, Lopes AC, Esper RB, Meirelles GX, Perin MA, Abizaid A, Lemos PA. First-in-man randomised comparison of a novel sirolimus-eluting stent with abluminal biodegradable polymer and thin-strut cobalt-chromium alloy: INSPIRON-I trial. EuroIntervention. 2014;9(12):1380-4. doi: 10.4244/EIJV9I12A234.
Results Reference
derived
Links:
URL
http://www.scitechmed.com
Description
Sponsor site
URL
http://www.incor.usp.br
Description
Site about the location that will be done the study. Location where the principal investigator works.
URL
http://portal2.saude.gov.br/sisnep/
Description
National Information System on Ethics in Research involving Human

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A Trial of Bare Metal Stent - Cobalt Chromium Versus Stent Coating With Sirolimus

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