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Study Comparing the CYPHER® ELITE™ to the CYPHER® Bx VELOCITY® Sirolimus-Eluting Stent Systems (ELITE)

Primary Purpose

Coronary Artery Disease, Coronary Atherosclerosis

Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
CYPHER® ELITE™ Sirolimus-Eluting Stent System
CYPHER® Bx VELOCITY® Sirolimus-eluting Stent System
Sponsored by
Cordis Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Disease focused on measuring Atherosclerosis, de novo native coronary lesion

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects with de novo atherosclerotic CAD in 1 or 2 vessels;
  • The subject must be >/= 18 years of age;
  • Female of childbearing potential must have a negative pregnancy test within 7 days prior to enrollment;
  • Diagnosis of angina pectoris as defined by stable angina pectoris Canadian Cardiovascular Society Classification (Class I, II, III) OR non-ST segment elevation acute coronary syndrome (Braunwald Classification B&C) OR non-ST segment elevation myocardial infarction >/= 48 hours from the time of study index procedure OR asymptomatic subjects with a positive stress test;
  • Treatment of </= two lesions in one or two major coronary arteries (1 target lesion in each of 2 vessels or 2 target lesions in 1 vessel);
  • Target vessel diameter must be >/= 2.25mm and </= 4.0 in diameter (visual estimate);
  • Target lesion stenosis is > 50% and < 100% (visual estimate);
  • Target lesion length <30mm (for each target lesion(s)) with a total implanted stent length < 66mm. Additional stents can be used to treat dissections, etc,: however, these must be the same stent to which the subject has been randomized in the study.
  • Subject or Legally Authorized Representative must provide written informed consent prior to the procedure using a form that is approved by the Institutional Review Board/Independent Ethics Committee.

Exclusion Criteria:

  • ST Segment Elevation Myocardial Infarction (STEMI) within 30 days of the study index procedure;
  • Unprotected left main coronary disease with >/= 50% stenosis;
  • Total coronary occlusion or TIMI grade 0 or 1 in the target vessel;
  • Angiographic evidence of thrombus within target lesion(s);
  • Calcified target lesion(s) which cannot be, in the investigator's opinion, successfully pre-dilated;
  • Bifurcation disease involving a side branch >/= 2 mm in diameter;
  • Prior stent within 5 mm of target lesion(s);
  • Ostial target lesion(s);
  • Target lesion(s) within a coronary bypass graft (e.g., saphenous vein or arterial graft);
  • Documented left ventricular ejection fraction </= 25%;
  • Impaired renal function (creatinine > 250 μmol/L or > 2.5 mg/dl) at the time of treatment;
  • Pretreatment with devices other than conventional balloon angioplasty;
  • Significant angulation in the target vessel that, in the Investigator's opinion, may preclude stent delivery and deployment;
  • Subject previously treated with brachytherapy;
  • Recipient of heart transplant;
  • Subject with a life expectancy less than 12 months;
  • Known allergies to the following: aspirin, clopidogrel bisulfate and ticlopidine, heparin, stainless steel, contrast agent (that cannot be managed medically), or sirolimus that cannot be managed medically;
  • Any significant medical condition which, in the Investigator's opinion, may interfere with the subject's optimal participation in the study;
  • Currently participating in an investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the study endpoints;
  • In the Investigator's opinion, the lesion is not suitable for stenting;
  • Known bleeding or hypercoagulable disorder;
  • Known or suspected active infection at the time of the study procedures;
  • Subject is known to be pregnant, a prisoner, mentally incompetent, and/or alcohol or drug abuser;
  • Subject has had major surgical or interventional procedures unrelated to this study within 30 days prior to this study or planned surgical or interventional procedures within 30 days of entry into this study.

Sites / Locations

  • Washington Hospital Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

1

2

Arm Description

CYPHER® ELITE™ Sirolimus-Eluting Stent System.

CYPHER® Bx VELOCITY® Sirolimus-eluting Stent System

Outcomes

Primary Outcome Measures

Percentage of Participants Who Experienced Target Lesion Failure (TLF)
The primary endpoint for this study is the percentage of participants who experienced Target Lesion Failure (TLF) during the 12 months post-procedure. A TLF event is defined as clinically-driven target lesion revascularization, target vessel myocardial infarction, or cardiac death that could not be clearly attributed to a vessel other than the target vessel at 12 months post-procedure.

Secondary Outcome Measures

Percentage of Lesion Success
Lesion success is defined as the attainment of < 50 percent residual stenosis (by Quantitative Coronary Angiography (QCA)) using any percutaneous method.
Percentage of Device Success - Protocol Definition
Device success is defined as achievement of a final residual diameter stenosis of <50 percent (by QCA), using the assigned device only. If QCA was not available, the visual estimate of diameter stenosis was used. Device success was based on the following two measurements. Protocol definition: Only protocol-defined study stents were included.
Percentage of Device Success - All CYPHER® Stents Included
Device success is defined as achievement of a final residual diameter stenosis of <50 percent (by QCA), using the assigned device only. If QCA was not available, the visual estimate of diameter stenosis was used. Device success was based on the following two measurements. All CYPHER® Stents were included if the final residual stenosis was <50%. Non-study CYPHER® Stents were also included.
Percentage of Participants Who Achieved Procedure Success
Procedure success is defined as achievement of a final diameter stenosis of < 50 percent (by QCA) using any percutaneous method, without the occurrence of death, Myocardial Infarction (MI), or repeat revascularization of the target lesion during the hospital stay.
Percentage of Participants Who Experienced Target Lesion Revascularization (TLR)
TLR is defined as any "clinically-driven" repeat percutaneous intervention of the target lesion or bypass surgery of the target vessel. Clinically-driven revascularizations are those in which the patient has a positive functional study, ischemic electrocardiogram (ECG) changes at rest in a distribution consistent with the target vessel, or ischemic symptoms, and an in-lesion diameter stenosis 50 percent by QCA.
Percentage of Participants Who Experienced Target Vessel Revascularization (TVR)
TVR is defined as any "clinically driven" repeat percutaneous intervention of the target vessel or bypass surgery of the target vessel. Clinically-driven revascularizations are those in which the patient has a positive functional study, ischemic ECG changes at rest in a distribution consistent with the target vessel, or ischemic symptoms, and an in-lesion diameter stenosis 50 percent by QCA.
Percentage of Participants Who Experienced Target Vessel Failure (TVF)
Target Vessel failure is defined as clinically-driven target lesion revascularization, target vessel myocardial infarction, or cardiac death that could not be clearly attributed to a vessel other than the target vessel at 12 months post-procedure.
Percentage of Participants Who Experienced Major Adverse Cardiac Events (MACE)
MAJOR ADVERSE CARDIAC EVENTS (MACE) consists of death, myocardial infarction, emergent bypass surgery, and target lesion revascularization.
Percentage of Participants Who Had Lesions of More Than 1 Vessel and Experienced Target Lesion Failure (TLF)
A Target Lesion Failure is defined as clinically-driven target lesion revascularization, target vessel myocardial infarction, or cardiac death that could not be clearly attributed to a vessel other than the target vessel at 12 months post-procedure.
Percentage of Participants Who Had Diabetes and Experienced Target Lesion Failure (TLF)
A Target Lesion Failure is defined as clinically-driven target lesion revascularization, target vessel myocardial infarction, or cardiac death that could not be clearly attributed to a vessel other than the target vessel at 12 months post-procedure.
Percentage of Participants Who Experienced Bleeding Complications
Bleeding complications include any bleeding events defined by THROMBOLYSIS IN MYOCARDIAL INFARCTION (TIMI), Global Strategies for Opening Occluded Coronary Arteries (GUSTO), and "Protocol" definitions.
Percentage of Participants Who Died
Death incidences include both Cardiac and non-cardiac death.
Percentage of Participants Who Experienced Any Myocardial Infarction (MI)
Myocardial Infarction includes both Q-wave and WHO Non-Q Wave Myocardial Infarction events.
Percentage of Participants Who Experienced Stroke
The stroke definition includes both hemorrhagic and non-hemorrhagic strokes.
Percentage of Participants Who Experienced Stent Thrombosis (Protocol Definition)
Protocol defined Stent thrombosis include both Early and Late Thrombosis. Early thrombosis is defined as composite thirty-day ischemic endpoint including death, Q-wave MI, or subabrupt closure requiring revascularization. Late thrombosis is defined as myocardial infarction occurring > 30 days after the index procedure and attributable to the target vessel with angiographic documentation (site-reported or by qualitative coronary angiography) of thrombus or total occlusion at the target site and freedom from an interim revascularization of the target vessel.
Percentage of Participants Who Experienced Stent Thrombosis (Academic Research Consortium (ARC) Definition)
Academic Research Consortium (ARC) defines STENT THROMBOSIS as consisting of the following: DEFINITE - Angiographic or pathologic confirmation; PROBABLE - Any unexplained death within the first 30 days or Any MI (related to documented acute ischemia and without another obvious cause) in the territory of the stent; POSSIBLE - Any unexplained death > 30 days. ARC Stent thrombosis should be reported as a cumulative value at the different time points and with the different separate time points.
Percentage of Participants Who Experienced Early Stent Thrombosis (Academic Research Consortium (ARC) Definition)
Those ARC stent thromboses occurred between 0 and 30 days post-procedure are early stent thrombosis.
Percentage of Participants Who Experienced Late Stent Thrombosis (Academic Research Consortium (ARC) Definition)
Those ARC stent thromboses occurred between 31 to 360 days post-procedure are late stent thrombosis.

Full Information

First Posted
July 11, 2008
Last Updated
December 17, 2013
Sponsor
Cordis Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT00715884
Brief Title
Study Comparing the CYPHER® ELITE™ to the CYPHER® Bx VELOCITY® Sirolimus-Eluting Stent Systems
Acronym
ELITE
Official Title
A Prospective, Single-Blind, Randomized, Multi-Center Study Comparing the CYPHER® ELITE™ to the CYPHER® Bx VELOCITY® Sirolimus-Eluting Stent Systems (ELITE).
Study Type
Interventional

2. Study Status

Record Verification Date
December 2013
Overall Recruitment Status
Unknown status
Study Start Date
July 2008 (undefined)
Primary Completion Date
March 2010 (Actual)
Study Completion Date
September 2014 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cordis Corporation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objective of this study is to show similar (non-inferior) safety and effectiveness between CYPHER® ELITE™ and CYPHER® Bx VELOCITY® Sirolimus-Eluting Stent Systems in a prospective, multi-center, randomized clinical study for the treatment of de novo native coronary lesions.
Detailed Description
A prospective, single-blind, randomized, multicenter, two arm study. The objective of this study is to show similar (non-inferior) safety and effectiveness between CYPHER® ELITE™ and CYPHER® Bx VELOCITY® Sirolimus-Eluting Stent Systems in a prospective, multi-center, randomized clinical study for the treatment of de novo native coronary lesions.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease, Coronary Atherosclerosis
Keywords
Atherosclerosis, de novo native coronary lesion

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
678 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
CYPHER® ELITE™ Sirolimus-Eluting Stent System.
Arm Title
2
Arm Type
Active Comparator
Arm Description
CYPHER® Bx VELOCITY® Sirolimus-eluting Stent System
Intervention Type
Device
Intervention Name(s)
CYPHER® ELITE™ Sirolimus-Eluting Stent System
Other Intervention Name(s)
Cypher ELITE
Intervention Description
Drug eluting stent
Intervention Type
Device
Intervention Name(s)
CYPHER® Bx VELOCITY® Sirolimus-eluting Stent System
Other Intervention Name(s)
CYPHER Bx VELOCITY
Intervention Description
Drug eluting stent
Primary Outcome Measure Information:
Title
Percentage of Participants Who Experienced Target Lesion Failure (TLF)
Description
The primary endpoint for this study is the percentage of participants who experienced Target Lesion Failure (TLF) during the 12 months post-procedure. A TLF event is defined as clinically-driven target lesion revascularization, target vessel myocardial infarction, or cardiac death that could not be clearly attributed to a vessel other than the target vessel at 12 months post-procedure.
Time Frame
12-months post-procedure
Secondary Outcome Measure Information:
Title
Percentage of Lesion Success
Description
Lesion success is defined as the attainment of < 50 percent residual stenosis (by Quantitative Coronary Angiography (QCA)) using any percutaneous method.
Time Frame
At procedure
Title
Percentage of Device Success - Protocol Definition
Description
Device success is defined as achievement of a final residual diameter stenosis of <50 percent (by QCA), using the assigned device only. If QCA was not available, the visual estimate of diameter stenosis was used. Device success was based on the following two measurements. Protocol definition: Only protocol-defined study stents were included.
Time Frame
At procedure
Title
Percentage of Device Success - All CYPHER® Stents Included
Description
Device success is defined as achievement of a final residual diameter stenosis of <50 percent (by QCA), using the assigned device only. If QCA was not available, the visual estimate of diameter stenosis was used. Device success was based on the following two measurements. All CYPHER® Stents were included if the final residual stenosis was <50%. Non-study CYPHER® Stents were also included.
Time Frame
At procedure
Title
Percentage of Participants Who Achieved Procedure Success
Description
Procedure success is defined as achievement of a final diameter stenosis of < 50 percent (by QCA) using any percutaneous method, without the occurrence of death, Myocardial Infarction (MI), or repeat revascularization of the target lesion during the hospital stay.
Time Frame
At procedure during hospital stay
Title
Percentage of Participants Who Experienced Target Lesion Revascularization (TLR)
Description
TLR is defined as any "clinically-driven" repeat percutaneous intervention of the target lesion or bypass surgery of the target vessel. Clinically-driven revascularizations are those in which the patient has a positive functional study, ischemic electrocardiogram (ECG) changes at rest in a distribution consistent with the target vessel, or ischemic symptoms, and an in-lesion diameter stenosis 50 percent by QCA.
Time Frame
12 months post-procedure
Title
Percentage of Participants Who Experienced Target Vessel Revascularization (TVR)
Description
TVR is defined as any "clinically driven" repeat percutaneous intervention of the target vessel or bypass surgery of the target vessel. Clinically-driven revascularizations are those in which the patient has a positive functional study, ischemic ECG changes at rest in a distribution consistent with the target vessel, or ischemic symptoms, and an in-lesion diameter stenosis 50 percent by QCA.
Time Frame
12 months post procedure
Title
Percentage of Participants Who Experienced Target Vessel Failure (TVF)
Description
Target Vessel failure is defined as clinically-driven target lesion revascularization, target vessel myocardial infarction, or cardiac death that could not be clearly attributed to a vessel other than the target vessel at 12 months post-procedure.
Time Frame
12 months post procedure
Title
Percentage of Participants Who Experienced Major Adverse Cardiac Events (MACE)
Description
MAJOR ADVERSE CARDIAC EVENTS (MACE) consists of death, myocardial infarction, emergent bypass surgery, and target lesion revascularization.
Time Frame
12 months post procedure
Title
Percentage of Participants Who Had Lesions of More Than 1 Vessel and Experienced Target Lesion Failure (TLF)
Description
A Target Lesion Failure is defined as clinically-driven target lesion revascularization, target vessel myocardial infarction, or cardiac death that could not be clearly attributed to a vessel other than the target vessel at 12 months post-procedure.
Time Frame
12 months post procedure
Title
Percentage of Participants Who Had Diabetes and Experienced Target Lesion Failure (TLF)
Description
A Target Lesion Failure is defined as clinically-driven target lesion revascularization, target vessel myocardial infarction, or cardiac death that could not be clearly attributed to a vessel other than the target vessel at 12 months post-procedure.
Time Frame
12 months post procedure
Title
Percentage of Participants Who Experienced Bleeding Complications
Description
Bleeding complications include any bleeding events defined by THROMBOLYSIS IN MYOCARDIAL INFARCTION (TIMI), Global Strategies for Opening Occluded Coronary Arteries (GUSTO), and "Protocol" definitions.
Time Frame
12 months post procedure
Title
Percentage of Participants Who Died
Description
Death incidences include both Cardiac and non-cardiac death.
Time Frame
12 months post procedure
Title
Percentage of Participants Who Experienced Any Myocardial Infarction (MI)
Description
Myocardial Infarction includes both Q-wave and WHO Non-Q Wave Myocardial Infarction events.
Time Frame
12 months post procedure
Title
Percentage of Participants Who Experienced Stroke
Description
The stroke definition includes both hemorrhagic and non-hemorrhagic strokes.
Time Frame
12 months post procedure
Title
Percentage of Participants Who Experienced Stent Thrombosis (Protocol Definition)
Description
Protocol defined Stent thrombosis include both Early and Late Thrombosis. Early thrombosis is defined as composite thirty-day ischemic endpoint including death, Q-wave MI, or subabrupt closure requiring revascularization. Late thrombosis is defined as myocardial infarction occurring > 30 days after the index procedure and attributable to the target vessel with angiographic documentation (site-reported or by qualitative coronary angiography) of thrombus or total occlusion at the target site and freedom from an interim revascularization of the target vessel.
Time Frame
12 months post procedure
Title
Percentage of Participants Who Experienced Stent Thrombosis (Academic Research Consortium (ARC) Definition)
Description
Academic Research Consortium (ARC) defines STENT THROMBOSIS as consisting of the following: DEFINITE - Angiographic or pathologic confirmation; PROBABLE - Any unexplained death within the first 30 days or Any MI (related to documented acute ischemia and without another obvious cause) in the territory of the stent; POSSIBLE - Any unexplained death > 30 days. ARC Stent thrombosis should be reported as a cumulative value at the different time points and with the different separate time points.
Time Frame
12 months post procedure
Title
Percentage of Participants Who Experienced Early Stent Thrombosis (Academic Research Consortium (ARC) Definition)
Description
Those ARC stent thromboses occurred between 0 and 30 days post-procedure are early stent thrombosis.
Time Frame
0-30 days post-procedure
Title
Percentage of Participants Who Experienced Late Stent Thrombosis (Academic Research Consortium (ARC) Definition)
Description
Those ARC stent thromboses occurred between 31 to 360 days post-procedure are late stent thrombosis.
Time Frame
31-360 days post-procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects with de novo atherosclerotic CAD in 1 or 2 vessels; The subject must be >/= 18 years of age; Female of childbearing potential must have a negative pregnancy test within 7 days prior to enrollment; Diagnosis of angina pectoris as defined by stable angina pectoris Canadian Cardiovascular Society Classification (Class I, II, III) OR non-ST segment elevation acute coronary syndrome (Braunwald Classification B&C) OR non-ST segment elevation myocardial infarction >/= 48 hours from the time of study index procedure OR asymptomatic subjects with a positive stress test; Treatment of </= two lesions in one or two major coronary arteries (1 target lesion in each of 2 vessels or 2 target lesions in 1 vessel); Target vessel diameter must be >/= 2.25mm and </= 4.0 in diameter (visual estimate); Target lesion stenosis is > 50% and < 100% (visual estimate); Target lesion length <30mm (for each target lesion(s)) with a total implanted stent length < 66mm. Additional stents can be used to treat dissections, etc,: however, these must be the same stent to which the subject has been randomized in the study. Subject or Legally Authorized Representative must provide written informed consent prior to the procedure using a form that is approved by the Institutional Review Board/Independent Ethics Committee. Exclusion Criteria: ST Segment Elevation Myocardial Infarction (STEMI) within 30 days of the study index procedure; Unprotected left main coronary disease with >/= 50% stenosis; Total coronary occlusion or TIMI grade 0 or 1 in the target vessel; Angiographic evidence of thrombus within target lesion(s); Calcified target lesion(s) which cannot be, in the investigator's opinion, successfully pre-dilated; Bifurcation disease involving a side branch >/= 2 mm in diameter; Prior stent within 5 mm of target lesion(s); Ostial target lesion(s); Target lesion(s) within a coronary bypass graft (e.g., saphenous vein or arterial graft); Documented left ventricular ejection fraction </= 25%; Impaired renal function (creatinine > 250 μmol/L or > 2.5 mg/dl) at the time of treatment; Pretreatment with devices other than conventional balloon angioplasty; Significant angulation in the target vessel that, in the Investigator's opinion, may preclude stent delivery and deployment; Subject previously treated with brachytherapy; Recipient of heart transplant; Subject with a life expectancy less than 12 months; Known allergies to the following: aspirin, clopidogrel bisulfate and ticlopidine, heparin, stainless steel, contrast agent (that cannot be managed medically), or sirolimus that cannot be managed medically; Any significant medical condition which, in the Investigator's opinion, may interfere with the subject's optimal participation in the study; Currently participating in an investigational drug or device study that has not completed the primary endpoint or that clinically interferes with the study endpoints; In the Investigator's opinion, the lesion is not suitable for stenting; Known bleeding or hypercoagulable disorder; Known or suspected active infection at the time of the study procedures; Subject is known to be pregnant, a prisoner, mentally incompetent, and/or alcohol or drug abuser; Subject has had major surgical or interventional procedures unrelated to this study within 30 days prior to this study or planned surgical or interventional procedures within 30 days of entry into this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lowell Satler, MD
Organizational Affiliation
Medstar Health Research Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Washington Hospital Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Study Comparing the CYPHER® ELITE™ to the CYPHER® Bx VELOCITY® Sirolimus-Eluting Stent Systems

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