XIENCE V: SPIRIT WOMEN Sub-study
Primary Purpose
Coronary Artery Stenosis, Coronary Arteriosclerosis, Coronary Artery Disease
Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
XIENCE V®/ XIENCE PRIME™
CYPHER SELECT
Sponsored by
About this trial
This is an interventional treatment trial for Coronary Artery Stenosis focused on measuring Stents, Angioplasty, Total coronary occlusions, Coronary restenosis, Stent thrombosis, Everolimus
Eligibility Criteria
General Inclusion Criteria:
- Patient must be female.
- Patient must be at least 18 years of age.
- Patient is able to verbally confirm understanding of risks, benefits and treatment alternatives and she or her legally authorized representative provides written informed consent prior to any study related procedure, as approved by the appropriate Medical Ethics Committee of the respective clinical site.
- Patient 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).
- Patient must be an acceptable candidate for coronary artery bypass graft (CABG) surgery.
- Patient must agree to undergo all protocol-required follow-up examinations.
- 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.
Angiographic Inclusion Criteria:
- Patients' artery morphology and disease is suitable to be optimally treated with a maximum of 4 planned study stents.
- Target lesions must be de novo lesions (no prior stent implant, no prior brachytherapy).
- Target vessel reference diameter must be between 2.5 mm and 4.0 mm by visual estimate. The diameter range will be expanded to 2.25 mm when the 2.25 mm stent is available.
- Target lesion greater than or equal to 28 mm in length by visual estimate.
General Exclusion Criteria:
- Patient 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 clinical investigation plan, confound the data interpretation or is associated with a limited life expectancy (i.e., less than one year).
- Patient has a known hypersensitivity or contraindication to aspirin, either heparin or bivalirudin, both clopidogrel and ticlopidine, everolimus, cobalt, chromium, nickel, tungsten, acrylic and fluoro polymers or contrast sensitivity that cannot be adequately pre-medicated.
- Participation in another device or drug study or has completed the follow-up phase of another study within the last 30 days.
- Patient who is judged to have a lesion that prevents complete inflation of an angioplasty balloon.
- Patient has had a previous stent implant, either Bare Metal Stent (BMS) or Drug Eluting Stent (DES) within the target vessel(s)
Sites / Locations
- Hosital Italiano de Buenos Aires - Cardiologia
- Instituto Cardiovascular de Buenos Aires-ICBA
- Allgemeines Krankenhaus der Stadt Wien - Univ.Klinik f. Innere Medizin II
- Heilig Hart Ziekenhuis Roeselare
- Instituto de Cardiologia Dante Pazzanese Unidadae II Recepcao de Angioplastia
- Rigshospitalet
- Institut Hospitalier Jacques Cartier Service d'Angiographie, Inst Cardiovasculaire Paris-Sud
- Kardiologische Klinik Herz- und Diabeteszentrum
- Segebergerkliniken
- Technische Universität Dresden, Medizinische Klinik II - Kardiologie
- Semmelweis University, Department of Cardiovascular Surgery
- Clinico S.Ambrogio, GRUPPO OSPEDALIERO SAN DONATO
- Centro Cardiologico Monzino
- Azienda Policlinico di Modena U.O. Cardiologia, Ospedale di Modena
- Ospedale Cisanello
- Istituto Clinico Humanitas
- Latvian Center of Cardiology, P. Stradina University Hospital
- AMC
- St. Antonius Ziekenhuis
- Haukeland university hospital
- Institute of Cardiology
- Hospital General de Alicante
- Hospital Universitari Germans Trias i Pujol
- Inselspital Bern, Kardiologie
- Cardiocentro Ticino
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
XIENCE V® / XIENCE PRIME™
CYPHER SELECT
Arm Description
Outcomes
Primary Outcome Measures
Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).
This measure adds together all subjects who were determined by an expert panel to have died, had MI or had TVR as a result of their procedure.
In-stent Late Loss (LL) (Main Secondary Endpoint)
In-stent Minimal Lumen Diameter (MLD)post-procedure - in-stent MLD at follow-up.
Secondary Outcome Measures
Clinical Device Success
Successful delivery and deployment of the study stent at the intended target lesion and successful withdrawal of the stent delivery system.
Clinical Procedure Success
Successful delivery and deployment of the study stent or stents at the intended target lesion and successful withdrawal of the stent delivery system without adverse cardiac events.
Adjudicated Stent Thrombosis (Definite, Probable)
Adjudicated Stent Thrombosis (Definite, Probable)
Adjudicated Stent Thrombosis (Definite, Probable)
Adjudicated Stent Thrombosis (Definite, Probable, Possible)
Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and Clinically Indicated Target Lesion Revascularization (CI-TLR).
Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and CI-TLR.
Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and CI-TLR.
Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).
Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).
Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).
Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).
Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).
Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).
Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).
Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).
In-segment Late Loss (LL)
LL = Minimal Lumen Diameter (MLD) post-procedure minus MLD at follow-up
In-stent Angiographic Binary Restenosis Rates
Only a certain number of patients were required to have angiographic follow-up. Percent of subjects with a follow-up in-stent percent diameter stenosis of ≥ 50% per quantitative coronary angiography (QCA).
In-segment Angiographic Binary Restenosis Rates
Only a certain number of patients were required to have angiographic follow-up. Percent of subjects with a follow-up in-stent percent diameter stenosis of ≥ 50% per quantitative coronary angiography (QCA).
In-stent Percent Diameter Stenosis
In-segment Percent Diameter Stenosis
Adjudicated Revascularization (TLR/TVR/All Revascularizations)
Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations
Adjudicated Revascularization (TLR/TVR/All Revascularizations)
Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations
Adjudicated Revascularization (TLR/TVR/All Revascularizations)
Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations
Aneurysm
All subjects with aneurysm of the target lesion up to the 270 day follow-up visit
Thrombus
All subjects with thrombus of the target lesion up to the 270 day follow-up visit
Persisting Dissection
All subjects with persisting dissection of the target lesion up to the 270 day follow-up visit
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01182428
Brief Title
XIENCE V: SPIRIT WOMEN Sub-study
Official Title
A Clinical Evaluation of the XIENCE Everolimus Eluting Coronary Stent System in the Treatment of Women With de Novo Coronary Artery Lesions
Study Type
Interventional
2. Study Status
Record Verification Date
July 2012
Overall Recruitment Status
Completed
Study Start Date
September 2008 (undefined)
Primary Completion Date
February 2011 (Actual)
Study Completion Date
July 2011 (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 this Clinical Evaluation is the continued assessment of the XIENCE Everolimus Eluting Coronary Stent System (XIENCE V® and XIENCE PRIME™ EECSS) with the primary focus on clinical outcomes in the treatment of female patients with de novo coronary artery lesions, and the characterization of the female population undergoing stent implantation with a XIENCE stent.
Detailed Description
SPIRIT Women Randomized Sub-study is a prospective, single-blind, double arm, randomized multi-center sub-study comparing the XIENCE V® EECSS and XIENCE PRIME™ EESS to the CYPHER SELECT™ PLUS Sirolimus-eluting Coronary Stent in the treatment of female patients with coronary artery lesions.
The long term safety and efficacy of the XIENCE V EECSS have been demonstrated in the SPIRIT FIRST trial up to 5 years, the SPIRIT II trial up to 4 years, and in the SPIRIT III Randomized Control Trial (RCT) up to 3 years. In addition, these pre-approval studies have shown low rates of Target Vessel Failure and Major Adverse Cardiac Events (MACE) that were observed to plateau or gradually decline after about 1 year and were consistently lower than the comparator arm of each study. This benefit in MACE is sustained for up to 5 years and is also independent of the first year results.
The post approval SPIRIT V study demonstrated that the use of the XIENCE EECSS in complex lesions in a real-world population resulted in 1 year MACE, Stent Thrombosis and Target Lesion Revascularization rates that are comparable to those of the previously mentioned pre-approval studies which included patients with more restricted inclusion / exclusion criteria.
Therefore, based on existing data from these trials, Abbott Vascular has decided to discontinue further follow up in the SPIRIT Women study after 2 years.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Stenosis, Coronary Arteriosclerosis, Coronary Artery Disease, Coronary Artery Restenosis, Total Coronary Occlusion, Stent Thrombosis, Vascular Disease, Myocardial Ischemia
Keywords
Stents, Angioplasty, Total coronary occlusions, Coronary restenosis, Stent thrombosis, Everolimus
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
455 (Actual)
8. Arms, Groups, and Interventions
Arm Title
XIENCE V® / XIENCE PRIME™
Arm Type
Experimental
Arm Title
CYPHER SELECT
Arm Type
Active Comparator
Intervention Type
Device
Intervention Name(s)
XIENCE V®/ XIENCE PRIME™
Intervention Description
Coronary artery placement of a XIENCE V®/ XIENCE PRIME™ Everolimus Eluting Stent System
Intervention Type
Device
Intervention Name(s)
CYPHER SELECT
Intervention Description
XIENCE V® / XIENCE PRIME™ to CYPHER SELECT in female patients with de novo coronary artery lesions
Primary Outcome Measure Information:
Title
Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).
Description
This measure adds together all subjects who were determined by an expert panel to have died, had MI or had TVR as a result of their procedure.
Time Frame
at 1 year
Title
In-stent Late Loss (LL) (Main Secondary Endpoint)
Description
In-stent Minimal Lumen Diameter (MLD)post-procedure - in-stent MLD at follow-up.
Time Frame
at 270 days
Secondary Outcome Measure Information:
Title
Clinical Device Success
Description
Successful delivery and deployment of the study stent at the intended target lesion and successful withdrawal of the stent delivery system.
Time Frame
Intra-operative
Title
Clinical Procedure Success
Description
Successful delivery and deployment of the study stent or stents at the intended target lesion and successful withdrawal of the stent delivery system without adverse cardiac events.
Time Frame
Intra-operative
Title
Adjudicated Stent Thrombosis (Definite, Probable)
Time Frame
< 1 day (Acute)
Title
Adjudicated Stent Thrombosis (Definite, Probable)
Time Frame
1 to 30 days (Sub-Acute)
Title
Adjudicated Stent Thrombosis (Definite, Probable)
Time Frame
30 days to 1 year (Late)
Title
Adjudicated Stent Thrombosis (Definite, Probable, Possible)
Time Frame
30 days to 1 year (Late)
Title
Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and Clinically Indicated Target Lesion Revascularization (CI-TLR).
Time Frame
at 30 days
Title
Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and CI-TLR.
Time Frame
at 240 days
Title
Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and CI-TLR.
Time Frame
at 1 year
Title
Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).
Time Frame
at 30 days
Title
Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).
Time Frame
at 240 days
Title
Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).
Time Frame
at 30 days
Title
Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).
Time Frame
at 240 days
Title
Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).
Time Frame
at 1 year
Title
Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).
Time Frame
at 30 days
Title
Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).
Time Frame
at 240 days
Title
Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).
Time Frame
at 1 year
Title
In-segment Late Loss (LL)
Description
LL = Minimal Lumen Diameter (MLD) post-procedure minus MLD at follow-up
Time Frame
at 270 days
Title
In-stent Angiographic Binary Restenosis Rates
Description
Only a certain number of patients were required to have angiographic follow-up. Percent of subjects with a follow-up in-stent percent diameter stenosis of ≥ 50% per quantitative coronary angiography (QCA).
Time Frame
at 270 days
Title
In-segment Angiographic Binary Restenosis Rates
Description
Only a certain number of patients were required to have angiographic follow-up. Percent of subjects with a follow-up in-stent percent diameter stenosis of ≥ 50% per quantitative coronary angiography (QCA).
Time Frame
at 270 days
Title
In-stent Percent Diameter Stenosis
Time Frame
at 270 days
Title
In-segment Percent Diameter Stenosis
Time Frame
at 270 days
Title
Adjudicated Revascularization (TLR/TVR/All Revascularizations)
Description
Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations
Time Frame
at 30 days
Title
Adjudicated Revascularization (TLR/TVR/All Revascularizations)
Description
Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations
Time Frame
at 240 days
Title
Adjudicated Revascularization (TLR/TVR/All Revascularizations)
Description
Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations
Time Frame
at 1 year
Title
Aneurysm
Description
All subjects with aneurysm of the target lesion up to the 270 day follow-up visit
Time Frame
at 270 days
Title
Thrombus
Description
All subjects with thrombus of the target lesion up to the 270 day follow-up visit
Time Frame
at 270 days
Title
Persisting Dissection
Description
All subjects with persisting dissection of the target lesion up to the 270 day follow-up visit
Time Frame
at 270 days
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
General Inclusion Criteria:
Patient must be female.
Patient must be at least 18 years of age.
Patient is able to verbally confirm understanding of risks, benefits and treatment alternatives and she or her legally authorized representative provides written informed consent prior to any study related procedure, as approved by the appropriate Medical Ethics Committee of the respective clinical site.
Patient 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).
Patient must be an acceptable candidate for coronary artery bypass graft (CABG) surgery.
Patient must agree to undergo all protocol-required follow-up examinations.
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.
Angiographic Inclusion Criteria:
Patients' artery morphology and disease is suitable to be optimally treated with a maximum of 4 planned study stents.
Target lesions must be de novo lesions (no prior stent implant, no prior brachytherapy).
Target vessel reference diameter must be between 2.5 mm and 4.0 mm by visual estimate. The diameter range will be expanded to 2.25 mm when the 2.25 mm stent is available.
Target lesion greater than or equal to 28 mm in length by visual estimate.
General Exclusion Criteria:
Patient 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 clinical investigation plan, confound the data interpretation or is associated with a limited life expectancy (i.e., less than one year).
Patient has a known hypersensitivity or contraindication to aspirin, either heparin or bivalirudin, both clopidogrel and ticlopidine, everolimus, cobalt, chromium, nickel, tungsten, acrylic and fluoro polymers or contrast sensitivity that cannot be adequately pre-medicated.
Participation in another device or drug study or has completed the follow-up phase of another study within the last 30 days.
Patient who is judged to have a lesion that prevents complete inflation of an angioplasty balloon.
Patient has had a previous stent implant, either Bare Metal Stent (BMS) or Drug Eluting Stent (DES) within the target vessel(s)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marie-Claude Morice
Organizational Affiliation
Institut Cardiovasculaire Paris Sud (ICPS), Paris, France
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Stephan Windecker
Organizational Affiliation
University Hospital Bern, Bern, Switzerland
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hosital Italiano de Buenos Aires - Cardiologia
City
Buenos Aires
ZIP/Postal Code
1181
Country
Argentina
Facility Name
Instituto Cardiovascular de Buenos Aires-ICBA
City
Buenos Aires
ZIP/Postal Code
1428
Country
Argentina
Facility Name
Allgemeines Krankenhaus der Stadt Wien - Univ.Klinik f. Innere Medizin II
City
Wien
ZIP/Postal Code
1090
Country
Austria
Facility Name
Heilig Hart Ziekenhuis Roeselare
City
Roeselare
ZIP/Postal Code
8800
Country
Belgium
Facility Name
Instituto de Cardiologia Dante Pazzanese Unidadae II Recepcao de Angioplastia
City
Sao Paulo
ZIP/Postal Code
04012-180
Country
Brazil
Facility Name
Rigshospitalet
City
Copenhagen
Country
Denmark
Facility Name
Institut Hospitalier Jacques Cartier Service d'Angiographie, Inst Cardiovasculaire Paris-Sud
City
Massy
ZIP/Postal Code
91300
Country
France
Facility Name
Kardiologische Klinik Herz- und Diabeteszentrum
City
Bad Oeynhausen
ZIP/Postal Code
32545
Country
Germany
Facility Name
Segebergerkliniken
City
Bad Segeberg
ZIP/Postal Code
23795
Country
Germany
Facility Name
Technische Universität Dresden, Medizinische Klinik II - Kardiologie
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Semmelweis University, Department of Cardiovascular Surgery
City
Budapest
Country
Hungary
Facility Name
Clinico S.Ambrogio, GRUPPO OSPEDALIERO SAN DONATO
City
Milano
ZIP/Postal Code
20149
Country
Italy
Facility Name
Centro Cardiologico Monzino
City
Milan
ZIP/Postal Code
20138
Country
Italy
Facility Name
Azienda Policlinico di Modena U.O. Cardiologia, Ospedale di Modena
City
Modena
ZIP/Postal Code
41100
Country
Italy
Facility Name
Ospedale Cisanello
City
Pisa
ZIP/Postal Code
56127
Country
Italy
Facility Name
Istituto Clinico Humanitas
City
Rozzano
ZIP/Postal Code
20089
Country
Italy
Facility Name
Latvian Center of Cardiology, P. Stradina University Hospital
City
Riga
ZIP/Postal Code
1002
Country
Latvia
Facility Name
AMC
City
Amsterdam
ZIP/Postal Code
1105
Country
Netherlands
Facility Name
St. Antonius Ziekenhuis
City
Nieuwegein
ZIP/Postal Code
3430
Country
Netherlands
Facility Name
Haukeland university hospital
City
Bergen
ZIP/Postal Code
5021
Country
Norway
Facility Name
Institute of Cardiology
City
Warsaw
ZIP/Postal Code
04-628
Country
Poland
Facility Name
Hospital General de Alicante
City
Alicante
ZIP/Postal Code
3010
Country
Spain
Facility Name
Hospital Universitari Germans Trias i Pujol
City
Barcelona
ZIP/Postal Code
08916
Country
Spain
Facility Name
Inselspital Bern, Kardiologie
City
Bern
ZIP/Postal Code
3010
Country
Switzerland
Facility Name
Cardiocentro Ticino
City
Lugano
ZIP/Postal Code
6900
Country
Switzerland
12. IPD Sharing Statement
Citations:
PubMed Identifier
19072483
Citation
Morice MC. XIENCE V SPIRIT WOMEN clinical trial: characterization of the female population undergoing stent implantation. Womens Health (Lond). 2008 Sep;4(5):439-43. doi: 10.2217/17455057.4.5.439.
Results Reference
background
PubMed Identifier
28796809
Citation
Franzone A, Zaugg S, Piccolo R, Modena MG, Mikhail GW, Ferre JM, Strasser R, Grinfeld L, Heg D, Juni P, Windecker S, Morice MC. A randomized multicenter trial comparing the XIENCE everolimus eluting stent with the CYPHER sirolimus eluting stent in the treatment of female patients with de novo coronary artery lesions: The SPIRIT WOMEN study. PLoS One. 2017 Aug 10;12(8):e0182632. doi: 10.1371/journal.pone.0182632. eCollection 2017.
Results Reference
derived
Learn more about this trial
XIENCE V: SPIRIT WOMEN Sub-study
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