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Comparison of Strut Coverage With OPTIMAX Versus SYNERGY Stents (OPTIMAX-OCT)

Primary Purpose

Acute Coronary Syndrome

Status
Unknown status
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Stent
Sponsored by
The Hospital District of Satakunta
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Coronary Syndrome focused on measuring Vascular healing of coronary stents in patients with acute coronary syndrome

Eligibility Criteria

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

Inclusion Criteria:

  1. Age >18 and <80 years
  2. STEMI or NSTEMI (assumed by investigator to be type 1 myocardial infarction, according to universal definitions of MI; EHJ 2007; 28(20):2525-38); or unstable angina (clinical symptoms of chest pain, ecg suggestive of reversible ischemia)
  3. Patient is willing to comply with specified follow-up evaluations
  4. Patient or legally authorized representative has been informed of the nature of the study, agrees to its provisions and has been provided written informed consent, approved by the appropriate Medical Ethics committee or Institutional Review Board.
  5. Single de novo or non-stented restenosis lesion
  6. Patients with two-vessel disease may have undergone successful treatment of the non-target vessel with approved devices up to and including the index procedure but must be prior to the index target vessel treatment.
  7. Target lesion (maximum 20 mm length by visual estimation) to be covered by a single stent of maximum 23mm length.
  8. Reference vessel diameter must be >2.5mm and <4.0mm by visual estimate.
  9. The vessel diameter should be measured after pre-dilation procedure and after intracoronary nitroglycerin if vasospasm is suspected.
  10. Target lesion >50% and <100% stenosed by visual estimate.

Exclusion Criteria:

  1. Impaired renal function (serum creatinine >177micromol/l) or on dialysis
  2. Platelet count < 10 e5 cells/mm3
  3. Patient has a history of bleeding diathesis or coagulopathy or patients in whom antiplatelet and and/or anticoagulation therapy is contraindicated.
  4. Patient has received organ transplant or is on a waiting list for any organ transplant.
  5. Patient has a known hypersensitivity or contraindication to aspirin, heparin/bivalirudin, clopidogrel/prasugrel/ticagrelol, cobalt chromium alloy, or contrast agent that cannot be adequately pre-medicated.
  6. Patient presents with cardiogenic shock.
  7. Any significant medical condition which in the Investigator's opinion may interfere with the patient's optimal participation in the study.
  8. Currently participating in another investigational drug or device study.
  9. Unprotected left main disease.
  10. Ostial target lesions.
  11. Chronic total occlusion.
  12. Calcified target lesions that cannot be adequately pre-dilated.
  13. Target lesion has excessive tortuosity unsuitable for stent delivery and deployment.
  14. Target lesion involving bifurcation with a side branch larger than 2.0mm in diameter.
  15. A >30% stenosis proximal or distal to the target lesion that cannot be covered with the same stent.
  16. Diffuse distal disease.
  17. Prior stent in the target vessel.

Sites / Locations

  • Cardiovascular Center Aalst, OLV-Clinic, Aalst, BelgiumRecruiting
  • Heart Center, Satakunta Central HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Active Comparator

Experimental

Active Comparator

Arm Label

OPTIMAX-BAS 1

SYNERGY-EES 1

OPTIMAX-OCT 6

SYNERGY-EES 6

Arm Description

Titanium-nitride-oxide coated cobalt-chromium OPTIMAX™ bio-active stent (BAS). Patients will have OCT follow-up 1 month after the index procedure.

SYNERGY™ everolimus eluting stent (EES). Patients will have OCT follow-up 1 month after the index procedure.

Titanium-nitride-oxide coated cobalt-chromium OPTIMAX™ bio-active stent (BAS). Patients will have OCT follow-up 6 months after the index procedure.

SYNERGY™ everolimus eluting stent (EES). Patients will have OCT follow-up 6 months after the index procedure.

Outcomes

Primary Outcome Measures

Primary endpoint is the percentage of stent struts coverage per group
In Study A, time for the OCT primary endpoint is 1month
Primary endpoint is the percentage of stent struts coverage per group
In Study B, time for the OCT primary endpoint is 6 month

Secondary Outcome Measures

Percentage of stent strut malapposition
Maximum length of segment (mm) with uncovered stent struts
Maximum length of segment (mm) with malapposed stent struts
Maximum malapposition distance
Total malapposition volume
Mean neointimal thickness
Percentage of protruding struts per stent
Stent area
NIH volume
Thrombus formation
In-stent late loss
In-segment late loss
In-stent binary restenosis
In-segment binary restenosis
Major adverse cardiac events defined as a composite of death, MI (Q wave or non-Q wave), emergent coronary artery bypass surgery (CABG), or justified target lesion revascularization (TLR)
Target vessel revascularization

Full Information

First Posted
June 1, 2015
Last Updated
June 3, 2015
Sponsor
The Hospital District of Satakunta
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1. Study Identification

Unique Protocol Identification Number
NCT02464397
Brief Title
Comparison of Strut Coverage With OPTIMAX Versus SYNERGY Stents
Acronym
OPTIMAX-OCT
Official Title
A Randomized Prospective Multicenter Trial to Examine Vascular Healing at 1 and 6 Month(s) After Deployment of TItanium-nitride-oxide-coated OPTIMAX™ Bio-active-stent (BAS) Stent and SYNERGY™ Everolimus-Eluting Stent (EES) in Patients With Acute Coronary Syndromes by Means of Optical Coherence Tomography
Study Type
Interventional

2. Study Status

Record Verification Date
June 2015
Overall Recruitment Status
Unknown status
Study Start Date
February 2015 (undefined)
Primary Completion Date
August 2016 (Anticipated)
Study Completion Date
August 2017 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The Hospital District of Satakunta

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to compare vascular healing of the stented segment after deployment of titanium-nitride-oxide coated cobalt-chromium OPTIMAX™ bio-active stent (BAS) and SYNERGY™ everolimus-eluting stent (EES) in patients with acute coronary syndromes requiring percutaneous coronary intervention. Patients treated with BAS will be treated with DAPT for at least 4 weeks after the procedure followed by aspirin alone, while patients in the EES group will be treated with DAPT, at least for 6 months post procedure. In addition, this study will collect initial information about the safety and effectiveness of the BAS in comparison with EES group at 30 days, 6 months, and 12 months.
Detailed Description
OPTIMAX-OCT is a prospective, randomized (1:1), study that will be conducted at 2-3 sites (Finland, Belgium) to evaluate OPTIMAX-BAS vascular healing patterns and thrombus formation with OCT at one (Study A) and six (Study B) month after stent implantation in comparison with SYNERGY-EES. Patients receiving BAS will receive dual antiplatelet treatment (DAPT) for at least four weeks followed by aspirin, while patients implanted with EES, will receive DAPT for at least 6 months followed by aspirin. Patients will be randomized to study A and B as follow: Study A: OPTIMAX-BAS (n=25) versus SYNERGY-EES (n=25). First 50 patients will be randomized to study A. OCT at 1 month follow up. Study B: OPTIMAX-BAS (n=30) versus SYNERGY-EES (n=30) Following 60 patients will be randomized to study B. OCT at 6 months follow up. Randomization is used at the time of recruitment with sealed envelopes. Patients will be randomized in 1:1 fashion. First 50 patients are randomized in study A and following 60 patients in study B. Patients in study A will have OCT follow up at 1 month after index procedure and patients in study B will have OCT at 6 months. OCT analyses will be performed blinded to patient's characteristics as well as the type of the stent used. Two (2-3) investigational sites: Cardiovascular Center Aalst, Aalst, Belgium Heart Center, Satakunta Central Hospital, Pori, Finland

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Coronary Syndrome
Keywords
Vascular healing of coronary stents in patients with acute coronary syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
110 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
OPTIMAX-BAS 1
Arm Type
Experimental
Arm Description
Titanium-nitride-oxide coated cobalt-chromium OPTIMAX™ bio-active stent (BAS). Patients will have OCT follow-up 1 month after the index procedure.
Arm Title
SYNERGY-EES 1
Arm Type
Active Comparator
Arm Description
SYNERGY™ everolimus eluting stent (EES). Patients will have OCT follow-up 1 month after the index procedure.
Arm Title
OPTIMAX-OCT 6
Arm Type
Experimental
Arm Description
Titanium-nitride-oxide coated cobalt-chromium OPTIMAX™ bio-active stent (BAS). Patients will have OCT follow-up 6 months after the index procedure.
Arm Title
SYNERGY-EES 6
Arm Type
Active Comparator
Arm Description
SYNERGY™ everolimus eluting stent (EES). Patients will have OCT follow-up 6 months after the index procedure.
Intervention Type
Device
Intervention Name(s)
Stent
Other Intervention Name(s)
PCI
Intervention Description
In the study, either OPTIMAX or SYNERGY stent will be implanted in coronary artery lesion
Primary Outcome Measure Information:
Title
Primary endpoint is the percentage of stent struts coverage per group
Description
In Study A, time for the OCT primary endpoint is 1month
Time Frame
1 month
Title
Primary endpoint is the percentage of stent struts coverage per group
Description
In Study B, time for the OCT primary endpoint is 6 month
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Percentage of stent strut malapposition
Time Frame
1 and 6 months
Title
Maximum length of segment (mm) with uncovered stent struts
Time Frame
1 and 6 months
Title
Maximum length of segment (mm) with malapposed stent struts
Time Frame
1 and 6 months
Title
Maximum malapposition distance
Time Frame
1 and 6 months
Title
Total malapposition volume
Time Frame
1 and 6 months
Title
Mean neointimal thickness
Time Frame
1 and 6 months
Title
Percentage of protruding struts per stent
Time Frame
1 and 6 months
Title
Stent area
Time Frame
1 and 6 months
Title
NIH volume
Time Frame
1 and 6 months
Title
Thrombus formation
Time Frame
1 and 6 months
Title
In-stent late loss
Time Frame
6 months
Title
In-segment late loss
Time Frame
6 months
Title
In-stent binary restenosis
Time Frame
6 months
Title
In-segment binary restenosis
Time Frame
6 months
Title
Major adverse cardiac events defined as a composite of death, MI (Q wave or non-Q wave), emergent coronary artery bypass surgery (CABG), or justified target lesion revascularization (TLR)
Time Frame
1, 6, and 12 months
Title
Target vessel revascularization
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age >18 and <80 years STEMI or NSTEMI (assumed by investigator to be type 1 myocardial infarction, according to universal definitions of MI; EHJ 2007; 28(20):2525-38); or unstable angina (clinical symptoms of chest pain, ecg suggestive of reversible ischemia) Patient is willing to comply with specified follow-up evaluations Patient or legally authorized representative has been informed of the nature of the study, agrees to its provisions and has been provided written informed consent, approved by the appropriate Medical Ethics committee or Institutional Review Board. Single de novo or non-stented restenosis lesion Patients with two-vessel disease may have undergone successful treatment of the non-target vessel with approved devices up to and including the index procedure but must be prior to the index target vessel treatment. Target lesion (maximum 20 mm length by visual estimation) to be covered by a single stent of maximum 23mm length. Reference vessel diameter must be >2.5mm and <4.0mm by visual estimate. The vessel diameter should be measured after pre-dilation procedure and after intracoronary nitroglycerin if vasospasm is suspected. Target lesion >50% and <100% stenosed by visual estimate. Exclusion Criteria: Impaired renal function (serum creatinine >177micromol/l) or on dialysis Platelet count < 10 e5 cells/mm3 Patient has a history of bleeding diathesis or coagulopathy or patients in whom antiplatelet and and/or anticoagulation therapy is contraindicated. Patient has received organ transplant or is on a waiting list for any organ transplant. Patient has a known hypersensitivity or contraindication to aspirin, heparin/bivalirudin, clopidogrel/prasugrel/ticagrelol, cobalt chromium alloy, or contrast agent that cannot be adequately pre-medicated. Patient presents with cardiogenic shock. Any significant medical condition which in the Investigator's opinion may interfere with the patient's optimal participation in the study. Currently participating in another investigational drug or device study. Unprotected left main disease. Ostial target lesions. Chronic total occlusion. Calcified target lesions that cannot be adequately pre-dilated. Target lesion has excessive tortuosity unsuitable for stent delivery and deployment. Target lesion involving bifurcation with a side branch larger than 2.0mm in diameter. A >30% stenosis proximal or distal to the target lesion that cannot be covered with the same stent. Diffuse distal disease. Prior stent in the target vessel.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Pasi P Karjalainen, MD, PhD
Phone
+358 2 627 7500
Email
pasi.karjalainen@satshp.fi
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pasi P Karjalainen, MD, phd
Organizational Affiliation
Heart Center, Satakunta Central Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium
City
Aalst
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bernard de Bruyne, MD
First Name & Middle Initial & Last Name & Degree
Bernard de Bruyne, MD
Facility Name
Heart Center, Satakunta Central Hospital
City
Pori
ZIP/Postal Code
28500
Country
Finland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Pasi Karjalainen, MD, PhD
Phone
+358 2 627 7500
Email
pasi.karjalainen@satshp.fi
First Name & Middle Initial & Last Name & Degree
Pasi Karjalainen, MD, Phd
First Name & Middle Initial & Last Name & Degree
Jussi Mikkelsson, MD,PhD
First Name & Middle Initial & Last Name & Degree
Tuomas Paana, MD

12. IPD Sharing Statement

Citations:
PubMed Identifier
35752571
Citation
Sia J, Nammas W, Collet C, De Bruyne B, Karjalainen PP. Comparative study of neointimal coverage between titanium-nitric oxide-coated and everolimus-eluting stents in acute coronary syndromes. Rev Esp Cardiol (Engl Ed). 2023 Mar;76(3):150-156. doi: 10.1016/j.rec.2022.05.017. Epub 2022 Jun 2. English, Spanish.
Results Reference
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Comparison of Strut Coverage With OPTIMAX Versus SYNERGY Stents

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