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Infinity-Swedeheart Registry Based Randomized Clinical Trial (R-RCT)

Primary Purpose

Coronary Artery Disease, Ischemic Heart Disease

Status
Active
Phase
Not Applicable
Locations
Sweden
Study Type
Interventional
Intervention
DynamX Bioadaptor
Resolute Onyx
Sponsored by
Elixir Medical Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Disease

Eligibility Criteria

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

General Inclusion Criteria:

  • Patient age ≥ 18 and ≤ 85 years
  • Patient understands the trial requirements and treatment procedures and provides informed consent prior to any trial-specific tests or treatment
  • Patients with CCS (stable angina, chronic angina, and chronic coronary artery disease) or ACS (unstable angina, ST-elevated myocardial infarction, and non-ST-elevated myocardial infarction) indicated for a percutaneous intervention with stent implantation.

Angiographic Inclusion Criteria:

  • Patient has ≤ 3 lesions planned to be treated during the index procedure, each in a native epicardial vessel (including up to 1 planned Non-Target Lesion).

    1. Treatment is limited to a maximum of 2 Target Lesions per epicardial vessel. Any planned Non-Target Lesion must be located in a separate vessel from Target Lesion(s).
    2. When treatment of 2 target lesions in a single epicardial vessel is planned, there must be adequate separation between lesions to ensure a gap of greater than or equal to 10 mm between study devices.
    3. If a planned Non-Target Lesion is present it must have been treated without complication* prior to randomization.
    4. The definition of epicardial vessels is the LAD, LCx and RCA, and is inclusive of their branches.
  • Target Lesion vessel diameter(s) and lesion length(s) suitable for implantation with either study device (DynamX Bioadaptor or Control) using a single device per lesion.
  • Successful pre-dilatation of a minimum of 1 Target Lesion, defined as no waist in the inflated pre-dilatation balloon (using two orthogonal views) with a pre-dilatation balloon diameter size approximately 0.25 mm smaller than reference vessel diameter but not more than 0.5 mm smaller than the reference vessel diameter. A residual diameter stenosis prior to study device implantation by visual estimate is recommended to be < 30%.

General Exclusion Criteria:

  • Acute myocardial infarction with Killip class III and IV
  • Known history of chronic heart failure with LVEF < 30%
  • Life expectancy < 2 years
  • Patients on renal dialysis or with known eGFR < 30 ml/min
  • Planned surgery necessitating interruption of dual antiplatelet therapy within 6 months after the index procedure
  • Known intolerance to components of the study device or control stent or medication required (e.g. intolerance to concomitant anticoagulation or antiplatelet therapy)
  • Patient has a current diagnosis of active COVID-19 disease
  • Patient is currently participating in another clinical trial with an investigational device or an investigational drug that has the potential to impact study results (such as, anti-thrombotic or anti-platelet medications) that has not yet completed its primary endpoint
  • Known pregnancy or breastfeeding
  • Patient is, in the opinion of the Investigator, unable to comply with the requirements of the study protocol or is unsuitable for the study for any reason
  • Subject has undergone prior PCI in a target vessel during the last 12 months. (A target lesion can be randomized and treated if a vessel contains a stent older than 12 months if the stent is more than 10 mm from the intended target lesion.)

Angiographic Exclusion Criteria:

  • Lesions in the left main artery
  • Venous or arterial bypass grafts
  • In-stent restenosis
  • Chronic total occlusion
  • Ostial lesions (< 3 mm of the ostium of the RCA, LAD or LCx)
  • Prior stent located in a Non-Target Vessel < 48 hours prior to the index procedure
  • Lesion with severe calcification requiring rotablation or atherectomy
  • Bifurcation lesions requiring a planned 2 or more stent technique

Sites / Locations

  • Mälarsjukhuset Eskilstuna
  • Hallands sjukhus
  • Helsingborgs lasarett
  • Blekingesjukhuset i Karlskrona
  • Centralsjukhuset Karlstad
  • Skånes Universitetssjukhus i Lund
  • Skånes Universitetssjukhus i Malmö
  • Capio St Görans sjukhus
  • Danderyds sjukhus
  • Karolinska Universitetssjukhuset Huddinge
  • Karolinska Universitetssjukhuset Solna
  • Södersjukhuset
  • Sundsvall Hospital
  • Sunderby sjukhus
  • Norrlands universitetssjukhus Umeå
  • Akademiska Sjukhuset
  • Västmanlands sjukhus i Västerås
  • Universitetssjukhuset Örebro
  • Östersunds sjukhus

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

DynamX Bioadaptor

Medtronic Resolute Onyx Stent

Arm Description

Elixir Medical DynamX™ Sirolimus Eluting Coronary Bioadaptor

Medtronic Resolute Onyx™ Zotarolimus-Eluting Coronary Stent System

Outcomes

Primary Outcome Measures

Target Lesion Failure (TLF)
Device Oriented Clinical Endpoint (DOCE) of target lesion failure (TLF; cardiovascular death, target vessel myocardial infarction (TV-MI), or ischemia-driven target lesion revascularization (ID-TLR))

Secondary Outcome Measures

Device Success
Lesion-Level Analysis
Procedural Success
Patient-Level Analysis
Composite Rate of Device Oriented Clinical Endpoint (DOCE)
Composite Device Oriented Clinical Endpoint (DOCE) (TLF; cardiovascular death, TV-MI, ischemia-driven TLR)
Composite Rate of Patient Oriented Clinical Endpoint (POCE)
Composite Patient Oriented Clinical Endpoint (POCE) (all-cause mortality, any stroke, any myocardial infarction (includes non-target vessel territory) and any revascularization). Note: Stroke to be collected and included in the POCE at 1 year and 5 years only.
Rate of Target Vessel Failure (TVF)
Target vessel failure (TVF; cardiovascular death, target vessel myocardial infarction (TV-MI), or target vessel revascularization (TVR))
Composite Rate of cardiovascular death, any myocardial infarction and any revascularization
Composite of cardiovascular death, any myocardial infarction and any revascularization
Rate of Ischemia driven target lesion revascularization (ID-TLR)
Ischemia driven target lesion revascularization (ID-TLR)
Rate of Target Lesion Revascularization (TLR)
All Target Lesion Revascularization
Rate of Target Vessel Revascularization (TVR)
All Target Vessel Revascularization
Rate of Ischemia driven target vessel revascularization (ID-TVR)
Ischemia driven target vessel revascularization (ID-TVR)
Rate of Ischemia driven non target vessel revascularization (ID-NTVR)
Ischemia driven non target vessel revascularization (ID-NTVR)
Rate of Non target vessel revascularization (NTVR)
Non target vessel revascularization (NTVR)
Rate of All revascularization
All revascularization
Rate of Myocardial Infarction
All MI, Q-Wave and Non Q-Wave MI, TV-MI, NTV-MI
Rate of Death
Cardiovascular Death, All-Cause Death
Composite: Cardiovascular death or myocardial infarction
Composite: Cardiovascular death or myocardial infarction
Composite: All-cause death or myocardial infarction
Composite: All-cause death or myocardial infarction
Composite: All-cause death, myocardial infarction or target vessel revascularization
Composite: All-cause death, myocardial infarction or target vessel revascularization
Rate of any stroke
Any stroke (collected at 1 year and 5 years only)
Anginal Status
Anginal Status by Seattle Angina Questionnaire-7 (SAQ-7)
Rate of Stent Thrombosis
Composite: Probable or definite stent thrombosis Probable Stent Thrombosis Definite Stent Thrombosis

Full Information

First Posted
September 15, 2020
Last Updated
September 5, 2023
Sponsor
Elixir Medical Corporation
Collaborators
Uppsala University
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1. Study Identification

Unique Protocol Identification Number
NCT04562805
Brief Title
Infinity-Swedeheart Registry Based Randomized Clinical Trial (R-RCT)
Official Title
Infinity-Swedeheart Study: Registry Based Randomized Clinical Trial (R-RCT) Comparing Long Term Outcomes of the DynamX Bioadaptor to the Resolute Onyx Stent in a More-comer PCI Patient Population
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 30, 2020 (Actual)
Primary Completion Date
August 2024 (Anticipated)
Study Completion Date
August 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Elixir Medical Corporation
Collaborators
Uppsala University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The Infinity-Swedeheart trial is a prospective, multicenter, single-blind, randomized registry-based clinical trial. Eligible patients will be randomized 1:1 (DynamX Bioadaptor : Resolute Onyx).
Detailed Description
The Infinity-Swedeheart trial is a prospective, multicenter, single-blind, randomized registry-based clinical trial. Eligible patients will be randomized 1:1 (DynamX Bioadaptor : Resolute Onyx). 2400 Patients will be randomized in Sweden. Patients will be followed at 30 days and 1 year by phone, and at 6 months and 2 to 5 years through clinical and diagnostic registries.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease, Ischemic Heart Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Masking Description
The patients will be blinded to the assigned device from the point of randomization onward. Study site personnel will be trained not to disclose the treatment assignment to the patient. Site personnel assigned to conduct phone follow-up visits will be provided with a standard interview script in order to reduce bias. The Clinical Event Committee will be blinded to the fullest extent possible with only redacted source documents included in the event packages.
Allocation
Randomized
Enrollment
2400 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
DynamX Bioadaptor
Arm Type
Experimental
Arm Description
Elixir Medical DynamX™ Sirolimus Eluting Coronary Bioadaptor
Arm Title
Medtronic Resolute Onyx Stent
Arm Type
Active Comparator
Arm Description
Medtronic Resolute Onyx™ Zotarolimus-Eluting Coronary Stent System
Intervention Type
Device
Intervention Name(s)
DynamX Bioadaptor
Intervention Description
DynamX Bioadaptor Treatment
Intervention Type
Device
Intervention Name(s)
Resolute Onyx
Intervention Description
Resolute Onyx Treatment
Primary Outcome Measure Information:
Title
Target Lesion Failure (TLF)
Description
Device Oriented Clinical Endpoint (DOCE) of target lesion failure (TLF; cardiovascular death, target vessel myocardial infarction (TV-MI), or ischemia-driven target lesion revascularization (ID-TLR))
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Device Success
Description
Lesion-Level Analysis
Time Frame
During Study Procedure
Title
Procedural Success
Description
Patient-Level Analysis
Time Frame
In-Hospital, assessed up to 7 days
Title
Composite Rate of Device Oriented Clinical Endpoint (DOCE)
Description
Composite Device Oriented Clinical Endpoint (DOCE) (TLF; cardiovascular death, TV-MI, ischemia-driven TLR)
Time Frame
30 days, 6 months, 1-5 years
Title
Composite Rate of Patient Oriented Clinical Endpoint (POCE)
Description
Composite Patient Oriented Clinical Endpoint (POCE) (all-cause mortality, any stroke, any myocardial infarction (includes non-target vessel territory) and any revascularization). Note: Stroke to be collected and included in the POCE at 1 year and 5 years only.
Time Frame
30 days, 6 months, 1-5 years
Title
Rate of Target Vessel Failure (TVF)
Description
Target vessel failure (TVF; cardiovascular death, target vessel myocardial infarction (TV-MI), or target vessel revascularization (TVR))
Time Frame
30 days, 6 months, 1-5 years
Title
Composite Rate of cardiovascular death, any myocardial infarction and any revascularization
Description
Composite of cardiovascular death, any myocardial infarction and any revascularization
Time Frame
30 days, 6 months, 1-5 years
Title
Rate of Ischemia driven target lesion revascularization (ID-TLR)
Description
Ischemia driven target lesion revascularization (ID-TLR)
Time Frame
30 days, 6 months, 1-5 years
Title
Rate of Target Lesion Revascularization (TLR)
Description
All Target Lesion Revascularization
Time Frame
30 days, 6 months, 1-5 years
Title
Rate of Target Vessel Revascularization (TVR)
Description
All Target Vessel Revascularization
Time Frame
30 days, 6 months, 1-5 years
Title
Rate of Ischemia driven target vessel revascularization (ID-TVR)
Description
Ischemia driven target vessel revascularization (ID-TVR)
Time Frame
30 days, 6 months, 1-5 years
Title
Rate of Ischemia driven non target vessel revascularization (ID-NTVR)
Description
Ischemia driven non target vessel revascularization (ID-NTVR)
Time Frame
30 days, 6 months, 1-5 years
Title
Rate of Non target vessel revascularization (NTVR)
Description
Non target vessel revascularization (NTVR)
Time Frame
30 days, 6 months, 1-5 years
Title
Rate of All revascularization
Description
All revascularization
Time Frame
30 days, 6 months, 1-5 years
Title
Rate of Myocardial Infarction
Description
All MI, Q-Wave and Non Q-Wave MI, TV-MI, NTV-MI
Time Frame
30 days, 6 months, 1-5 years
Title
Rate of Death
Description
Cardiovascular Death, All-Cause Death
Time Frame
30 days, 6 months, 1-5 years
Title
Composite: Cardiovascular death or myocardial infarction
Description
Composite: Cardiovascular death or myocardial infarction
Time Frame
30 days, 6 months, 1-5 years
Title
Composite: All-cause death or myocardial infarction
Description
Composite: All-cause death or myocardial infarction
Time Frame
30 days, 6 months, 1-5 years
Title
Composite: All-cause death, myocardial infarction or target vessel revascularization
Description
Composite: All-cause death, myocardial infarction or target vessel revascularization
Time Frame
30 days, 6 months, 1-5 years
Title
Rate of any stroke
Description
Any stroke (collected at 1 year and 5 years only)
Time Frame
1 year and 5 years
Title
Anginal Status
Description
Anginal Status by Seattle Angina Questionnaire-7 (SAQ-7)
Time Frame
30 days and 1 year
Title
Rate of Stent Thrombosis
Description
Composite: Probable or definite stent thrombosis Probable Stent Thrombosis Definite Stent Thrombosis
Time Frame
30 days, 6 months, 1-5 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
General Inclusion Criteria: Patient age ≥ 18 and ≤ 85 years Patient understands the trial requirements and treatment procedures and provides informed consent prior to any trial-specific tests or treatment Patients with CCS (stable angina, chronic angina, and chronic coronary artery disease) or ACS (unstable angina, ST-elevated myocardial infarction, and non-ST-elevated myocardial infarction) indicated for a percutaneous intervention with stent implantation. Angiographic Inclusion Criteria: Patient has ≤ 3 lesions planned to be treated during the index procedure, each in a native epicardial vessel (including up to 1 planned Non-Target Lesion). Treatment is limited to a maximum of 2 Target Lesions per epicardial vessel. Any planned Non-Target Lesion must be located in a separate vessel from Target Lesion(s). When treatment of 2 target lesions in a single epicardial vessel is planned, there must be adequate separation between lesions to ensure a gap of greater than or equal to 10 mm between study devices. If a planned Non-Target Lesion is present it must have been treated without complication* prior to randomization. The definition of epicardial vessels is the LAD, LCx and RCA, and is inclusive of their branches. Target Lesion vessel diameter(s) and lesion length(s) suitable for implantation with either study device (DynamX Bioadaptor or Control) using a single device per lesion. Successful pre-dilatation of a minimum of 1 Target Lesion, defined as no waist in the inflated pre-dilatation balloon (using two orthogonal views) with a pre-dilatation balloon diameter size approximately 0.25 mm smaller than reference vessel diameter but not more than 0.5 mm smaller than the reference vessel diameter. A residual diameter stenosis prior to study device implantation by visual estimate is recommended to be < 30%. General Exclusion Criteria: Acute myocardial infarction with Killip class III and IV Known history of chronic heart failure with LVEF < 30% Life expectancy < 2 years Patients on renal dialysis or with known eGFR < 30 ml/min Planned surgery necessitating interruption of dual antiplatelet therapy within 6 months after the index procedure Known intolerance to components of the study device or control stent or medication required (e.g. intolerance to concomitant anticoagulation or antiplatelet therapy) Patient has a current diagnosis of active COVID-19 disease Patient is currently participating in another clinical trial with an investigational device or an investigational drug that has the potential to impact study results (such as, anti-thrombotic or anti-platelet medications) that has not yet completed its primary endpoint Known pregnancy or breastfeeding Patient is, in the opinion of the Investigator, unable to comply with the requirements of the study protocol or is unsuitable for the study for any reason Subject has undergone prior PCI in a target vessel during the last 12 months. (A target lesion can be randomized and treated if a vessel contains a stent older than 12 months if the stent is more than 10 mm from the intended target lesion.) Angiographic Exclusion Criteria: Lesions in the left main artery Venous or arterial bypass grafts In-stent restenosis Chronic total occlusion Ostial lesions (< 3 mm of the ostium of the RCA, LAD or LCx) Prior stent located in a Non-Target Vessel < 48 hours prior to the index procedure Lesion with severe calcification requiring rotablation or atherectomy Bifurcation lesions requiring a planned 2 or more stent technique
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Erlinge, MD, PhD
Organizational Affiliation
Skane University Hospital, Lund
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Stefan James, MD, PhD
Organizational Affiliation
Uppsala University
Official's Role
Study Chair
Facility Information:
Facility Name
Mälarsjukhuset Eskilstuna
City
Eskilstuna
Country
Sweden
Facility Name
Hallands sjukhus
City
Halmstad
Country
Sweden
Facility Name
Helsingborgs lasarett
City
Helsingborg
Country
Sweden
Facility Name
Blekingesjukhuset i Karlskrona
City
Karlskrona
Country
Sweden
Facility Name
Centralsjukhuset Karlstad
City
Karlstad
Country
Sweden
Facility Name
Skånes Universitetssjukhus i Lund
City
Lund
Country
Sweden
Facility Name
Skånes Universitetssjukhus i Malmö
City
Malmö
Country
Sweden
Facility Name
Capio St Görans sjukhus
City
Stockholm
Country
Sweden
Facility Name
Danderyds sjukhus
City
Stockholm
Country
Sweden
Facility Name
Karolinska Universitetssjukhuset Huddinge
City
Stockholm
Country
Sweden
Facility Name
Karolinska Universitetssjukhuset Solna
City
Stockholm
Country
Sweden
Facility Name
Södersjukhuset
City
Stockholm
Country
Sweden
Facility Name
Sundsvall Hospital
City
Sundsvall
Country
Sweden
Facility Name
Sunderby sjukhus
City
Södra Sunderbyn
Country
Sweden
Facility Name
Norrlands universitetssjukhus Umeå
City
Umeå
Country
Sweden
Facility Name
Akademiska Sjukhuset
City
Uppsala
Country
Sweden
Facility Name
Västmanlands sjukhus i Västerås
City
Västerås
Country
Sweden
Facility Name
Universitetssjukhuset Örebro
City
Örebro
Country
Sweden
Facility Name
Östersunds sjukhus
City
Östersund
Country
Sweden

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Infinity-Swedeheart Registry Based Randomized Clinical Trial (R-RCT)

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