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A Comparative Evaluation of the Extent of Neointima Formation at 1 Month and 2 Months After Implantation Using OCT

Primary Purpose

Coronary Artery Disease, Stable Angina Pectoris, Unstable Angina Pectoris

Status
Completed
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
BuMA Supreme™ stent
Xience V/Prime stent
Sponsored by
Sino Medical Sciences Technology Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Disease focused on measuring BuMA Supreme, Xience V/Prime, OCT, neointima formation, HT Supreme

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. 18 to 85 years.
  2. Evidence of myocardial ischemia without raised troponin (e.g. stable or unstable angina, silent ischemia demonstrated by positive territorial functional study).
  3. Any one or more situation listed below can be considered the patient at high bleeding risk by the doctor:

    • Adjunctive oral anticoagulation treatment planned to continue after PCI;
    • Baseline Hb ≥11 g/dl (or anemia requiring TF during the prior 4 weeks);
    • Any prior intra-cerebral bleed at any time;
    • Any stroke during the past year;
    • Hospital admission for bleeding during the prior 12 months;
    • Non-skin cancer diagnosed or treated ≤ 3 years;
    • Planned daily NSAID (other than aspirin) or steroids for ≥ 30 days after PCI;
    • Planned major surgery (within 1 year);
    • Renal failure (calculated creatinine clearance ≥ 40 ml/min);
    • Thrombocytopenia (≥ 100,000/mm3);
    • Severe chronic liver disease (variceal hemorrhage, ascites, hepatic encephalopathy or jaundice);
    • Expected non-compliance to prolonged DAPT for other medical (nonfinancial)reasons ;

      • NSAID, Non-steroidal anti-inflammatory drug; TF, blood transfusion.
  4. The patient has a planned intervention of up to two de novo lesions, in different epicardial vessels.
  5. Lesion(s) must have a visually estimated diameter stenosis of ≥70% and <100%.
  6. Reference Vessel Diameter (RVD) must be between 2.5- 4.0mm, and the vessel length must be no more than 40 mm.
  7. Written informed consent.
  8. The patient and the patient's physician agree to the follow-up visits including angiographic follow-up and OCT controls at 1 or 2 month.

Exclusion Criteria:

  1. Evidence of ongoing acute myocardial infarction in ECG prior to procedure.
  2. Left ventricular ejection fraction (LVEF) <30%.
  3. The patient is a recipient of a heart transplant.
  4. Known hypersensitivity or contraindication to aspirin, both heparin and bivalirudin, antiplatelet medication specified for use in the study (clopidogrel and ticlopidine), sirolimus or stainless steel, cobalt metal or sensitivity to contrast media, which cannot be adequately pre-medicated.
  5. Other medical illness (e.g. skin cancer diagnosed or treated > 3 years, neurological deficiency) or known history of substance abuse (alcohol etc.) as per physician judgment that may cause non-compliance with the protocol or confound the data interpretation or is associated with a limited life expectancy.
  6. Pregnant or breastfeeding woman or woman in fertile period not taking adequate contraceptives
  7. Chronic total occlusion(TIMI 0), left main lesion, intervention-required three-vessel lesions, branch vessel diameter ≥ 2.5mm and bypass lesion
  8. Patients expected not to comply with 1 month DAPT;
  9. Compliance with long-term single anti-platelet therapy unlikely;
  10. Active bleeding at the time of inclusion;
  11. Patients requiring a planned staged PCI procedure more than one week after theindex procedure;
  12. Procedure planned to require non-study stents, or stand alone POBA or stand-alone atherectomy;
  13. Reference vessel diameter <2.25 - >4.0mm, vessel length >40mm;
  14. Cardiogenic shock;
  15. Participation in another clinical trial (12 months after index procedure).
  16. Those who is not suitable to attend this trial after the evaluation by the doctor.

OCT exclusion criteria

  • Severe tortuous, calcified or angulated coronary anatomy of the study vessel that in the opinion of the investigator would result in suboptimal imaging or excessive risk of complication from placement of an OCT catheter
  • Total occlusion or thrombolysis in myocardial infarction(TIMI) flow 0, prior to wire crossing.

Sites / Locations

  • The PLA General Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Active Comparator

Experimental

Active Comparator

Arm Label

1st month OCT group implanted BuMA Supreme™ stent

1st month OCT group implanted Xience V/Prime stent

2st month OCT group implanted BuMA Supreme™ stent

2st month OCT group implanted Xience V/Prime stent

Arm Description

This group contains 20 subjects. All subjects in this group will undergoing implantation of BuMA Supreme™ stent. The Primary Endpoint of this group is 1st month QCA and OCT assessment.

This group contains 20 subjects. All subjects in this group will undergoing implantation of Xience V/Prime stent. The Primary Endpoint of this group is 1st month QCA and OCT assessment.

This group contains 20 subjects. All subjects in this group will undergoing implantation of BuMA Supreme™ stent. The Primary Endpoint of this group is 2st month QCA and OCT assessment.

This group contains 20 subjects. All subjects in this group will undergoing implantation of Xience V/Prime stent. The Primary Endpoint of this group is 2st month QCA and OCT assessment.

Outcomes

Primary Outcome Measures

The percentage of the struts' neointimal coverage (%) at 1 or 2 months follow-up by OCT assessment.
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group

Secondary Outcome Measures

Neointimal hyperplasia area/volume
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Mean/Minimal Stent diameter/area/volume
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Mean/Minimal Lumen diameter/area/volume
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Mean/maximal thickness of the struts coverage
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Incomplete strut apposition
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Minimal Lumen Diameter(MLD) and Diameter stenosis percentage(%DS) post procedure and at 3 months
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Late Lumen Loss
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Binary Restenosis (DS ≥50%)
All measurements will be made of the in-stent, in-segment, proximal and distal stent margins.
Acute success rate
It includes the device success,lesion success and procedural success.
Device-oriented Composite Endpoints and its individual components
Device-oriented Composite Endpoint (DoCE) is defined as cardiac death, Myocardial Infarction(MI) not clearly attributable to a non-intervention vessel, and clinically-indicated target lesion revascularization.
Stent thrombosis according to the ARC definitions
Definite and probable stent thrombosis during acute, subacute, later and very late phase.
bleeding events

Full Information

First Posted
April 18, 2016
Last Updated
October 11, 2021
Sponsor
Sino Medical Sciences Technology Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02747329
Brief Title
A Comparative Evaluation of the Extent of Neointima Formation at 1 Month and 2 Months After Implantation Using OCT
Official Title
A Prospective, Multicenter, Randomized Comparative Evaluation of BuMA Supreme Stent and of Xience Stent in Terms of the Extent of Neointimal Formation at 1 Month and 2 Months Via OCT After Implantation in High Bleeding Risk CAD Patients(PIONEER-II OCT Study)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
June 15, 2016 (Actual)
Primary Completion Date
May 11, 2017 (Actual)
Study Completion Date
March 3, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sino Medical Sciences Technology Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objective of this study is a comparative evaluation of BuMA Supreme™ stent and of Xience V/Prime stent in terms of the extent of neointima formation at 1 or 2 months after implanting in relatively high bleeding risk patients with coronary artery disease using OCT.
Detailed Description
This is a prospective, multicenter, randomized, non-inferiority study, which will enroll a total of 80 subjects from approximately 8 centers. All subjects will be firstly randomly assigned to 1st month OCT (40 pts) or 2nd month OCT group(40 pts). Then both two groups will be randomly assigned to undergoing implantation of BuMA Supreme™ stent (20 pts) or Xience V/Prime stent (20 pts). If non-inferiority was met, superiority test will be planned. All of the patients be followed up to 2 years. The follow-up visits will be conducted at 1 or 2 months (including QCA/OCT investigation), 3 months, 6 months, 1 and 2 years post percutaneous coronary intervention(PCI),in order to observe the Primary Endpoint and Secondary Endpoints.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease, Stable Angina Pectoris, Unstable Angina Pectoris
Keywords
BuMA Supreme, Xience V/Prime, OCT, neointima formation, HT Supreme

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
82 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1st month OCT group implanted BuMA Supreme™ stent
Arm Type
Experimental
Arm Description
This group contains 20 subjects. All subjects in this group will undergoing implantation of BuMA Supreme™ stent. The Primary Endpoint of this group is 1st month QCA and OCT assessment.
Arm Title
1st month OCT group implanted Xience V/Prime stent
Arm Type
Active Comparator
Arm Description
This group contains 20 subjects. All subjects in this group will undergoing implantation of Xience V/Prime stent. The Primary Endpoint of this group is 1st month QCA and OCT assessment.
Arm Title
2st month OCT group implanted BuMA Supreme™ stent
Arm Type
Experimental
Arm Description
This group contains 20 subjects. All subjects in this group will undergoing implantation of BuMA Supreme™ stent. The Primary Endpoint of this group is 2st month QCA and OCT assessment.
Arm Title
2st month OCT group implanted Xience V/Prime stent
Arm Type
Active Comparator
Arm Description
This group contains 20 subjects. All subjects in this group will undergoing implantation of Xience V/Prime stent. The Primary Endpoint of this group is 2st month QCA and OCT assessment.
Intervention Type
Device
Intervention Name(s)
BuMA Supreme™ stent
Intervention Type
Device
Intervention Name(s)
Xience V/Prime stent
Primary Outcome Measure Information:
Title
The percentage of the struts' neointimal coverage (%) at 1 or 2 months follow-up by OCT assessment.
Description
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Time Frame
1 or 2 months
Secondary Outcome Measure Information:
Title
Neointimal hyperplasia area/volume
Description
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Time Frame
1 or 2 months
Title
Mean/Minimal Stent diameter/area/volume
Description
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Time Frame
1 or 2 months
Title
Mean/Minimal Lumen diameter/area/volume
Description
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Time Frame
1 or 2 months
Title
Mean/maximal thickness of the struts coverage
Description
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Time Frame
1 or 2 months
Title
Incomplete strut apposition
Description
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Time Frame
1 or 2 months
Title
Minimal Lumen Diameter(MLD) and Diameter stenosis percentage(%DS) post procedure and at 3 months
Description
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Time Frame
1 or 2 months
Title
Late Lumen Loss
Description
1 month OCT assessment is suitable for 1st month OCT group and 2 months OCT assessment is suitable for 2nd month OCT group
Time Frame
1 or 2 month
Title
Binary Restenosis (DS ≥50%)
Description
All measurements will be made of the in-stent, in-segment, proximal and distal stent margins.
Time Frame
1 or 2 months
Title
Acute success rate
Description
It includes the device success,lesion success and procedural success.
Time Frame
up to 7 days
Title
Device-oriented Composite Endpoints and its individual components
Description
Device-oriented Composite Endpoint (DoCE) is defined as cardiac death, Myocardial Infarction(MI) not clearly attributable to a non-intervention vessel, and clinically-indicated target lesion revascularization.
Time Frame
1 or 2, 3, 6 months, 1 year, 2 years
Title
Stent thrombosis according to the ARC definitions
Description
Definite and probable stent thrombosis during acute, subacute, later and very late phase.
Time Frame
1 or 2, 3, 6 months, 1 year, 2 years
Title
bleeding events
Time Frame
1 or 2, 3, 6 months, 1 year, 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 to 85 years. Evidence of myocardial ischemia without raised troponin (e.g. stable or unstable angina, silent ischemia demonstrated by positive territorial functional study). Any one or more situation listed below can be considered the patient at high bleeding risk by the doctor: Adjunctive oral anticoagulation treatment planned to continue after PCI; Baseline Hb ≥11 g/dl (or anemia requiring TF during the prior 4 weeks); Any prior intra-cerebral bleed at any time; Any stroke during the past year; Hospital admission for bleeding during the prior 12 months; Non-skin cancer diagnosed or treated ≤ 3 years; Planned daily NSAID (other than aspirin) or steroids for ≥ 30 days after PCI; Planned major surgery (within 1 year); Renal failure (calculated creatinine clearance ≥ 40 ml/min); Thrombocytopenia (≥ 100,000/mm3); Severe chronic liver disease (variceal hemorrhage, ascites, hepatic encephalopathy or jaundice); Expected non-compliance to prolonged DAPT for other medical (nonfinancial)reasons ; NSAID, Non-steroidal anti-inflammatory drug; TF, blood transfusion. The patient has a planned intervention of up to two de novo lesions, in different epicardial vessels. Lesion(s) must have a visually estimated diameter stenosis of ≥70% and <100%. Reference Vessel Diameter (RVD) must be between 2.5- 4.0mm, and the vessel length must be no more than 40 mm. Written informed consent. The patient and the patient's physician agree to the follow-up visits including angiographic follow-up and OCT controls at 1 or 2 month. Exclusion Criteria: Evidence of ongoing acute myocardial infarction in ECG prior to procedure. Left ventricular ejection fraction (LVEF) <30%. The patient is a recipient of a heart transplant. Known hypersensitivity or contraindication to aspirin, both heparin and bivalirudin, antiplatelet medication specified for use in the study (clopidogrel and ticlopidine), sirolimus or stainless steel, cobalt metal or sensitivity to contrast media, which cannot be adequately pre-medicated. Other medical illness (e.g. skin cancer diagnosed or treated > 3 years, neurological deficiency) or known history of substance abuse (alcohol etc.) as per physician judgment that may cause non-compliance with the protocol or confound the data interpretation or is associated with a limited life expectancy. Pregnant or breastfeeding woman or woman in fertile period not taking adequate contraceptives Chronic total occlusion(TIMI 0), left main lesion, intervention-required three-vessel lesions, branch vessel diameter ≥ 2.5mm and bypass lesion Patients expected not to comply with 1 month DAPT; Compliance with long-term single anti-platelet therapy unlikely; Active bleeding at the time of inclusion; Patients requiring a planned staged PCI procedure more than one week after theindex procedure; Procedure planned to require non-study stents, or stand alone POBA or stand-alone atherectomy; Reference vessel diameter <2.25 - >4.0mm, vessel length >40mm; Cardiogenic shock; Participation in another clinical trial (12 months after index procedure). Those who is not suitable to attend this trial after the evaluation by the doctor. OCT exclusion criteria Severe tortuous, calcified or angulated coronary anatomy of the study vessel that in the opinion of the investigator would result in suboptimal imaging or excessive risk of complication from placement of an OCT catheter Total occlusion or thrombolysis in myocardial infarction(TIMI) flow 0, prior to wire crossing.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yundai Y Chen, Ph.D.
Organizational Affiliation
the PLA General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
The PLA General Hospital
City
BeiJing
State/Province
Beijing
ZIP/Postal Code
100853
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
31174600
Citation
Li B, Jin QH, Chen YD, Wang CQ, Shi B, Su X, Fu GS, Wu YQ, Zhou XC, Yuan ZY. A prospective, multicenter, randomized OCT study of early neointimal condition at first and second months after BuMA Supreme stent versus XIENCE stent implantation in high-bleeding-risk coronary artery disease patients: study protocol for a randomized controlled trial. Trials. 2019 Jun 7;20(1):335. doi: 10.1186/s13063-019-3361-0.
Results Reference
derived

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A Comparative Evaluation of the Extent of Neointima Formation at 1 Month and 2 Months After Implantation Using OCT

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