Stentys Coronary Stent System Clinical Trial in Patients With Acute Myocardial Infarction (APPOSITION V)
Primary Purpose
Acute Myocardial Infarction
Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
STENTYS self-apposing stent
VISION balloon-expandable stent
Sponsored by
About this trial
This is an interventional treatment trial for Acute Myocardial Infarction focused on measuring STEMI, BMS, Self-expanding stent
Eligibility Criteria
Inclusion Criteria:
General Inclusion Criteria
- Subject ≥ 18 years old.
- Subject experiencing clinical symptoms consistent with AMI of >30 min. in duration.
- ST elevation ≥1 mm in ≥2 contiguous leads or new left bundle branch block, or true posterior MI with ST depression of ≥1 mm in ≥2 contiguous anterior leads.
- Symptom duration is <12 hours prior to signing informed consent.
- Subject should be in catheterization laboratory and procedure started within 2 hours of consent.
- Patient provides written informed consent.
- Patient agrees to all required follow-up procedures and visits.
Angiographic Inclusion Criteria
- Based on coronary anatomy, PCI is indicated for the culprit lesion with anticipated use of stenting.
- The vessel diameter is either known or expected to be 2.5-4.0mm, without excessive tortuosity or diffuse distal disease.
Lesion length ≥12mm and ≤ 23mm
-
Exclusion Criteria:
General Exclusion Criteria
- Currently enrolled in another investigational device or drug trial that has not completed the primary endpoint or that clinically interferes with the current study endpoints.
- A previous coronary interventional procedure of any kind within 30 days prior to the procedure.
- Female patients of childbearing potential known to be pregnant.
- Patients undergoing cardiopulmonary resuscitation.
- Cardiogenic shock (SBP <80 mmHg for >30 minutes, or requiring IV pressors or emergency IABP for hypotension).
- The subject requires multivessel PCI at time of index procedure or any staged procedure of the target vessel within 9 months or any non-target vessel within 30 days post-procedure.
- The target lesion requires treatment with a device other than PTCA prior to stent placement (such as, but not limited to, directional coronary atherectomy, excimer laser, rotational atherectomy, etc.). Thrombus aspiration may be used per operator discretion.
- Attempted thrombolysis.
- Co-morbid condition(s) that could limit the subject's ability to participate in the trial or to comply with follow-up requirements, or impact the scientific integrity of the trial.
- Concurrent medical condition with a life expectancy of less than 12 months.
- Known left ventricular ejection fraction (LVEF) < 25% at the most recent evaluation (prior to the index hospitalization).
- History of cerebrovascular accident or transient ischemic attack in the last 6 months.
- Active peptic ulcer or active gastrointestinal (GI) bleeding.
- History of bleeding diathesis or coagulopathy or inability to accept blood transfusions.
- Known hypersensitivity or contraindication to aspirin, heparin or bivalirudin, clopidogrel or ticlopidine, cobalt, nickel, or sensitivity to contrast media, which cannot be adequately pre-medicated.
- Known serum creatinine level > 2.5 mg/dl, eGFR <30, or hemodialysis dependent.
Angiographic Exclusion Criteria
- Unprotected left main coronary artery disease (obstruction greater than 60% in the left main coronary artery that is not protected by at least one non-obstructed bypass graft to the left anterior descending (LAD) or left circumflex (LCX) artery or a branch thereof).
- Multi-vessel intervention required during the index procedure.
Sites / Locations
- Foundation Cardiovascular medicine
- Mount Sinai Hospital
- AMC
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
STENTYS self-apposing stent
VISION balloon-expandable stent
Arm Description
Intervention to treat STEMI with the STENTYS self-apposing stent
STEMI treatment with a VISION balloon-expandable stent
Outcomes
Primary Outcome Measures
Target Vessel Failure
From date of randomization until the date of first documented TVF, assessed up to 12 months.
Secondary Outcome Measures
Acute Stent Malapposition
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01732341
Brief Title
Stentys Coronary Stent System Clinical Trial in Patients With Acute Myocardial Infarction
Acronym
APPOSITION V
Official Title
APPOSITION V: Stentys Coronary Stent System Clinical Trial in Patients With Acute Myocardial Infarction
Study Type
Interventional
2. Study Status
Record Verification Date
November 2015
Overall Recruitment Status
Terminated
Why Stopped
Decision to discontinue patient follow-up at 2 years.
Study Start Date
May 2013 (undefined)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
March 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stentys
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This study will test compare the Stentys Stent with the Multi-Link Vision™ stent system (Abbott Vascular Inc.)in patients with a heart attack. It is expected that the Stentys stent is not worse than the Vision stent.
Detailed Description
Coronary artery disease continues to be the most common cause of morbidity and mortality in the occidental world. Treatment of coronary atherosclerotic disease has been significantly advanced by interventional cardiology, and in particular the advent of coronary arterial stents. In comparison to angioplasty alone, stents have reduced the incidence of angiographic as well as clinical restenosis, the recurrence of angina, the need for coronary arterial bypass graft (CABG) surgery, the need for repeat revascularization and the occurrence of major adverse cardiac events (MACE).However,problems remain due to failure to achieve optimal stent apposition and normal myocardial reperfusion. Early stent malapposition may be due to incomplete expansion or undersizing of balloon-expandable stents. Several studies have emphasized the importance of early malapposition in the setting of ST elevation MI, in which substantial thrombotic burden and the presence of diffuse vasoconstriction may be contributory. The Stentys Coronary Stent System includes a self-expanding bare metal (nitinol) stent on a rapid exchange (RX) delivery system. In view of the theoretical implications of malapposition, the self-expanding property may offer a potential benefit.
This study is designed to evaluate the safety and effectiveness of the Stentys Coronary Stent System in the treatment of de novo stenotic lesions in coronary arteries in patients undergoing primary revascularization due to AMI as compared to the Multi-Link Vision™ coronary stent system (Abbott Vascular Inc. The study is powered for non-inferiority of the Stentys Coronary Stent System compared to the Vision Stent System.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myocardial Infarction
Keywords
STEMI, BMS, Self-expanding stent
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
318 (Actual)
8. Arms, Groups, and Interventions
Arm Title
STENTYS self-apposing stent
Arm Type
Experimental
Arm Description
Intervention to treat STEMI with the STENTYS self-apposing stent
Arm Title
VISION balloon-expandable stent
Arm Type
Active Comparator
Arm Description
STEMI treatment with a VISION balloon-expandable stent
Intervention Type
Device
Intervention Name(s)
STENTYS self-apposing stent
Intervention Description
Intervention to treat STEMI with the STENTYS self-apposing stent
Intervention Type
Device
Intervention Name(s)
VISION balloon-expandable stent
Intervention Description
STEMI treatment with a VISION balloon-expandable stent
--------------------------------------------------------------------------------
Primary Outcome Measure Information:
Title
Target Vessel Failure
Description
From date of randomization until the date of first documented TVF, assessed up to 12 months.
Time Frame
12 months.
Secondary Outcome Measure Information:
Title
Acute Stent Malapposition
Time Frame
Immediately after procedure
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
General Inclusion Criteria
Subject ≥ 18 years old.
Subject experiencing clinical symptoms consistent with AMI of >30 min. in duration.
ST elevation ≥1 mm in ≥2 contiguous leads or new left bundle branch block, or true posterior MI with ST depression of ≥1 mm in ≥2 contiguous anterior leads.
Symptom duration is <12 hours prior to signing informed consent.
Subject should be in catheterization laboratory and procedure started within 2 hours of consent.
Patient provides written informed consent.
Patient agrees to all required follow-up procedures and visits.
Angiographic Inclusion Criteria
Based on coronary anatomy, PCI is indicated for the culprit lesion with anticipated use of stenting.
The vessel diameter is either known or expected to be 2.5-4.0mm, without excessive tortuosity or diffuse distal disease.
Lesion length ≥12mm and ≤ 23mm
-
Exclusion Criteria:
General Exclusion Criteria
Currently enrolled in another investigational device or drug trial that has not completed the primary endpoint or that clinically interferes with the current study endpoints.
A previous coronary interventional procedure of any kind within 30 days prior to the procedure.
Female patients of childbearing potential known to be pregnant.
Patients undergoing cardiopulmonary resuscitation.
Cardiogenic shock (SBP <80 mmHg for >30 minutes, or requiring IV pressors or emergency IABP for hypotension).
The subject requires multivessel PCI at time of index procedure or any staged procedure of the target vessel within 9 months or any non-target vessel within 30 days post-procedure.
The target lesion requires treatment with a device other than PTCA prior to stent placement (such as, but not limited to, directional coronary atherectomy, excimer laser, rotational atherectomy, etc.). Thrombus aspiration may be used per operator discretion.
Attempted thrombolysis.
Co-morbid condition(s) that could limit the subject's ability to participate in the trial or to comply with follow-up requirements, or impact the scientific integrity of the trial.
Concurrent medical condition with a life expectancy of less than 12 months.
Known left ventricular ejection fraction (LVEF) < 25% at the most recent evaluation (prior to the index hospitalization).
History of cerebrovascular accident or transient ischemic attack in the last 6 months.
Active peptic ulcer or active gastrointestinal (GI) bleeding.
History of bleeding diathesis or coagulopathy or inability to accept blood transfusions.
Known hypersensitivity or contraindication to aspirin, heparin or bivalirudin, clopidogrel or ticlopidine, cobalt, nickel, or sensitivity to contrast media, which cannot be adequately pre-medicated.
Known serum creatinine level > 2.5 mg/dl, eGFR <30, or hemodialysis dependent.
Angiographic Exclusion Criteria
Unprotected left main coronary artery disease (obstruction greater than 60% in the left main coronary artery that is not protected by at least one non-obstructed bypass graft to the left anterior descending (LAD) or left circumflex (LCX) artery or a branch thereof).
Multi-vessel intervention required during the index procedure.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Roxana Mehran, MD
Organizational Affiliation
Mount Sinai Hospital, New York NY
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Maurice Buchbinder, MD
Organizational Affiliation
Fouyndation Cardiovascular Research, La Jolla, CA
Official's Role
Principal Investigator
Facility Information:
Facility Name
Foundation Cardiovascular medicine
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
Mount Sinai Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
AMC
City
Amsterdam
Country
Netherlands
12. IPD Sharing Statement
Citations:
PubMed Identifier
25440792
Citation
Grundeken MJ, Lu H, Mehran R, Cutlip DE, Leon MB, Yeung A, Koch KT, Montalescot G, van Geuns RJ, Spaargaren R, Buchbinder M. APPOSITION V: STENTYS coronary stent system clinical trial in subjects with ST-segment elevation myocardial infarction--rationale and design. Am Heart J. 2014 Nov;168(5):652-60. doi: 10.1016/j.ahj.2014.07.011. Epub 2014 Jul 24.
Results Reference
derived
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Stentys Coronary Stent System Clinical Trial in Patients With Acute Myocardial Infarction
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