LEADERS FREE II: BioFreedom™ Pivotal Study
Acute Coronary Syndrome, High Bleeding Risk
About this trial
This is an interventional treatment trial for Acute Coronary Syndrome focused on measuring Acute Coronary Syndrome, Percutaneous Coronary Intervention, Drug Coated Stent, Drug Eluting Stent
Eligibility Criteria
Inclusion Criteria:
Any indication for percutaneous coronary intervention with stent placement (PCI-S) in patients deemed at high risk for bleeding and candidates for 1 month dual anti-platelet therapy (DAPT). This includes candidates with stable angina, silent ischemia, acute coronary syndrome (STEMI and non-STEMI), non-native lesions and in-stent restenosis. Patients must provide written informed consent.
Reasons of unsuitability for > 1 month dual antiplatelet treatment must include one or more of the following:
- Adjunctive oral anticoagulation treatment planned to continue after PCI
- Age ≥ 75 years old
- Baseline Hgb <11 g/dl (or anemia requiring transfusion during the 4 weeks prior to the index procedure)
- Any prior intracerebral bleed
- Any stroke in the last 12 months
- Hospital admission for bleeding during the prior 12 months
- Non skin cancer diagnosed or treated < 3 years, with a perceived increased risk for bleeding
- Planned daily Nonsteroidal anti-inflammatory drugs (NSAID) (other than aspirin) or steroids for >30 days after PCI
- Planned surgery that would require interruption of DAPT (within next 6 months)
- Renal failure defined as: Creatinine clearance <40 ml/min
- Thrombocytopenia (PLT <100,000/mm3)
- Severe chronic liver disease defined as: patients who have developed any of the following: variceal hemorrhage, ascites, hepatic encephalopathy or jaundice
- Expected non-compliance to prolonged DAPT for other medical reasons
Exclusion Criteria:
- Pregnant and breastfeeding women
- Patients expected not to comply with 1 month DAPT
- Patients requiring a planned staged PCI procedure more than one week after the index procedure
- Procedure planned to require non-study stents, or stand-alone plain old balloon angioplasty (POBA) or stand-alone atherectomy
- Active bleeding at the time of inclusion
- Reference vessel diameter <2.25 - >4.0mm
- Cardiogenic shock
- Compliance with long-term single anti-platelet therapy unlikely
- A known hypersensitivity or contraindication to aspirin, clopidogrel (or prasugrel, or ticagrelor if applicable), stainless steel, zinc, Biolimus A9™ or a sensitivity to contrast media, which cannot be adequately pre-medicated
- PCI during the previous 12 months for a lesion other than the target lesion of the index procedure
- Participation in another clinical trial (12 months after index procedure)
- Patients with a life expectancy of < 12 months
- Patients under judicial protection, tutorship or curatorship (for France only)
Sites / Locations
- Heart Center Research, LLC
- Tri-Lakes Research
- Scripps Health
- University of California San Diego
- Santa Barbara Cottage Hospital
- MedStar Washington Hospital Center
- University of Florida Jacksonville
- Velella Research
- Tallahassee Research Institute, Inc.
- North Georgia Heart Foundation
- St. Luke's Idaho Cardiology Associates
- Jesse Brown VA Medical Center
- St. Vincent Heart Center
- Jewish and St. Mary's Hospital
- Lahey Clinic
- McLaren Bay Region
- MidMichigan Medical Center Midland
- William Beaumont Hospital
- Missouri Cardiovascular Specialists, LLP
- Saint Luke's Hospital of Kansas City
- University of Buffalo
- Weill Cornell Medical College-New York Presbyterian
- Columbia University Medical Center/New York Presbyterian Hospital
- Novant Health Heart and Vascular Institute
- LeBauer Cardiovascular Research Foundation
- NC Heart and Vascular Research
- Genesis Healthcare System
- Penn State - Milton S. Hershey Medical Center
- Penn Presbyterian Medical Center
- Berks Cardiologists, Ltd.
- Pinnacle Health Cardiovascular Institute
- Rhode Island Hospital
- AnMed Health
- Black Hills Cardiovascular Research
- Chattanooga Heart Institute
- Tennova Healthcare-Turkey Creek Medical Center
- Houston Methodist Hospital
- Providence Health Center
- Carilion Clinic
- Mazankowski Alberta Heart Institute
- Fraser Clinical Trials Inc.
- St. Paul's Hospital
- Victoria Heart Institute Foundation
- Hamilton Health Sciences
- The University of Ottawa Heart Institute
- Montreal Heart Institute
- Hôpital Maisonneuve-Rosemont
- Centre Hospitalier de l'université de Montréal
- Institut universitaire de cardiologie et de pneumologie de Québec
- CIUSSS de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke
- Rigshospitalet Copenhagen University Hospital
- Clinique Axium
- Service de Cardiologie Interventionnelle - Pôle Santé République
- Clinique de Fontaine
- Groupe Hospitalier Mutualiste de Grenoble
- Hôpital Privé Jacques Cartier ICPS
- Hôpital Privé Claude Galien
- Clinique Saint Hilaire
- CHU Toulouse Rangeuil
- Segeberger Kliniken GmbH
- Herzzentrum Leipzig GmbH
- Grande Ospedale Metropolitano Niguarda
- Azienda Ospedaliera San Camillo Forlanini
- Royal Bournemouth Hospital, Dorset Heart Centre
- Craigavon Cardiac Centre
- Golden Jubilee National Hospital
Arms of the Study
Arm 1
Experimental
BioFreedom™ Drug Coated Stent