search
Back to results

Vein-Coronary Atherosclerosis And Rosiglitazone After Bypass Surgery: The VICTORY Trial (VICTORY)

Primary Purpose

Diabetes, Coronary Artery Bypass Grafting

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Rosiglitazone or placebo
Sponsored by
Laval University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Diabetes focused on measuring Atherosclerosis progression, Ischemic heart disease, Saphenous vein graft, Metabolic risk factors, Rosiglitazone

Eligibility Criteria

40 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: AT SCREENING: Male or female, aged ≥ 40 years & ≤ 75 years. Women of childbearing potential with contraceptive measure, or of non-childbearing potential or surgically sterile. Type 2 diabetes mellitus. Patients with no new medication for hyperglycemia and no change in dose of oral hypoglycemic medication within the last 3 mo prior to screening. Diabetic patients with ischemic heart disease and CABG with at least one SVG (≥1 yr & ≤10 yrs). Patient agrees to participate. Patient legally capable of giving consent and understand what participation in study entails, potential risks and benefits, freedom to withdraw without any prejudice to subsequent medical arrangement or treatment, sign an ICF prior to any protocol specific procedure. AT IVUS & ANGIOGRAPHY (VISIT 2): Subject eligible if at least 1), 2) and 3) of the following criteria apply: Patient with at least 1 patent SVG. Segment length of at least 40 mm in SVG suitable for IVUS. Reference of target (SVG) diameter ≥ 2.5 mm. If anastomosed native coronary artery or non grafted coronary artery can be evaluated, the following criteria must be met: Reference of target anastomosed native coronary artery or non grafted coronary artery diameter≥ 2.5 mm. Segment length of at least 20 mm in anastomosed native coronary artery corresponding to SVG chosen or, in case of impossibility of performing IVUS in the anastomosed coronary artery, a non grafted coronary artery (≥ 30 mm length segment) might be used for reference. Exclusion Criteria: AT SCREENING: Clinically significant abnormality at screening tests & exams. Type 1 diabetes or history of diabetic ketoacidosis. Uncontrolled type 2 diabetes mellitus. Recent MI or ACS (≤ 90 days). History of hypersensitivity to thiazolidinediones (TZD) or compounds of similar chemical structures. Last LVEF≤ 35%. SBP>170mmHg or DBP>100mmHg at screening/baseline should be appropriately treated and under control prior to randomization. Unstable or Canadian Cardiovascular Society class III and IV angina, acute heart failure or congestive heart failure (NYHA class III and IV). History of hepatocellular reaction/severe oedema/other potentially fluid-related AE associated with use of any TZD or PPAR-γ agonist. Hepatic disease. Renal dysfunction. Anemia. TG ≥ 10 mmol/L. History of PCI in all SVG(s). Known occlusion(s) of all SVG(s). Treatment involving TZD within 3 mo prior to screening. Chronic use (≥ 6 mo) of insulin for glycemic control at any time in the past or administration of insulin any time within the last 12 mo. Allergy to contrast agents. Current intake of anorectic agents or have been taken off an anorectic agent or equivalent within 3 mo prior to screening. Patients for whom oral or injectable corticosteroids are used on a regular or recurrent basis. Recent history/suspicion of current drug abuse or alcohol abuse within last 6 mo. Women breast feeding, pregnant, or planning to become pregnant during conduct of trial and for 30 days after study completion. Other illness that precludes survival. History of malignancy within the last 5 yrs. Concurrent participation in other investigational device or drug studies and/or having received any experimental therapeutic agents within 30 days of the screening. Use of any investigational drug for glycemic control within 3 mo of the screening. Patient travelling out of town/country for periods exceeding 2 mo. Medical condition which may interfere with intake and/or absorption of study medication. Patients unwilling or unable to comply with procedures. Recent major surgery within 90 days of the screening. AT IVUS AND ANGIOGRAPHY (VISIT 2): PCI was performed on the target segment(s) after CABG. Target SVG and/or target native coronary artery show ≥ 50% angiographic lesion precluding IVUS. Thrombus/thrombus aspect in target vessels. Target vessel has been subjected to surgical endarterectomy.

Sites / Locations

  • QEII Health Sciences Center - Halifax Infirmary
  • Hamilton Health Sciences - Mc Master Clinic
  • Toronto General Hospital
  • CRMSBC
  • CHUM Notre-Dame Hospital
  • Laval Hospital
  • Hospital Del Mar
  • Hospital Universitari Vall D'Hebron
  • Hospital Universitarion Son Dureta

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Rosiglitazone (Avandia)

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Change in plaque volume in one SVG (by IVUS)

Secondary Outcome Measures

1 Change in plaque volume in segment of anastomosed coronary artery
2 Changes in lumen and total vessel volumes and lumen plaque total vessel areas in SVG and coronary segments
3 Changes in qualitative plaque characterization in the SVG and coronary segments
4 Patients showing atherosclerosis changes
5 Atherosclerosis changes concordance and discordance
6 New occlusions in native coronary arteries or SVGs
7 Changes in reference and minimum lumen diameters of the SVG
8 Per patient percentage of initially patent SVGs that had significant progression of atherosclerosis at the site of greatest change at follow-up
9 Changes of indices for comprehensive lipid thrombosis and pro-inflammatory profiles as well as glucose-insulin homeostasis, microalbuminuria, adhesion molecules, adipokines, and other markers relevant to the evaluation and management of cardiovascular
10 Changes in abdominal areas and volumes of adipose tissue areas
11 Changes in body composition, body weight, waist circumference and BMI
12 Clinical laboratory parameters, physical examinations, vital signs, ECGs, concomitant medication and adverse events
13 Death, MI, TIA, stroke, hospitalization and ischemia-driven interventions
14 Fluid retention

Full Information

First Posted
September 12, 2005
Last Updated
October 9, 2008
Sponsor
Laval University
Collaborators
GlaxoSmithKline
search

1. Study Identification

Unique Protocol Identification Number
NCT00169832
Brief Title
Vein-Coronary Atherosclerosis And Rosiglitazone After Bypass Surgery: The VICTORY Trial
Acronym
VICTORY
Official Title
A Multicenter Randomized Double-Blind Trial Comparing Rosiglitazone to Placebo for the Prevention of Atherosclerosis Progression After Coronary Bypass Surgery in Diabetic Patients
Study Type
Interventional

2. Study Status

Record Verification Date
October 2008
Overall Recruitment Status
Completed
Study Start Date
June 2003 (undefined)
Primary Completion Date
July 2007 (Actual)
Study Completion Date
July 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Laval University
Collaborators
GlaxoSmithKline

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
HYPOTHESES Rosiglitazone in diabetic patients with previous coronary bypass surgery may prevent or slow the progression of atherosclerosis in SVGs and native coronary arteries. Rosiglitazone has favorable effects on adipose tissue distribution variables as well as on thrombosis, pro-inflammatory, and lipid profiles in diabetic patients after coronary bypass artery surgery. Rosiglitazone therapy influences favorably metabolism and clinical outcomes in diabetic patients after coronary artery bypass surgery. OBJECTIVES PRIMARY To assess the efficacy of rosiglitazone to reduce atherosclerosis progression in vein grafts in diabetic patients after coronary bypass surgery by using IVUS imaging after a 12 mo follow-up. SECONDARY To prospectively compare the secondary IVUS endpoints. To prospectively compare the angiographic endpoints. To prospectively compare the metabolic risk factor endpoints. To prospectively compare the body composition and distribution endpoints. To prospectively compare the clinical outcomes of rosiglitazone versus standard care using composite endpoints.
Detailed Description
STUDY DESIGN This is a prospective multicenter randomized placebo-controlled double-blind trial assessing the efficacy and safety of rosiglitazone in the prevention of atherosclerosis progression in vein grafts and native coronary arteries of diabetic patients. Stable diabetic patients with previous coronary bypass surgery (≥ 1 year ≤ 10 years) will be screened. After baseline evaluation, all eligible patients will undergo baseline coronary angiogram. IVUS will be performed in a segment length of at least 40 mm in a SVG suitable for IVUS analysis and in a segment length of at least 20 mm in the anastomosed native coronary artery corresponding to the SVG chosen. Following the IVUS procedure, patients will be randomized to either rosiglitazone treatment or to placebo in addition to their standard clinical care. Study drug will be titrated over an 8-week period up to a dose of 8 mg/day (or to maximum tolerated dose). The patients will receive the study drug or the placebo for 50-54 weeks in a double-blind manner. At the beginning and at 2, 4, 6, 8, 10 and 12 months of treatment, patients will be subjected to a set of morphological, physiological and metabolic evaluations. At the final visit (12 months), patients will also be submitted to IVUS and angiography.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes, Coronary Artery Bypass Grafting
Keywords
Atherosclerosis progression, Ischemic heart disease, Saphenous vein graft, Metabolic risk factors, Rosiglitazone

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
193 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Rosiglitazone (Avandia)
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Rosiglitazone or placebo
Other Intervention Name(s)
Avandia
Intervention Description
Rosiglitazone 4 to 8 mg/day or placebo, for 12 months
Primary Outcome Measure Information:
Title
Change in plaque volume in one SVG (by IVUS)
Time Frame
12 months
Secondary Outcome Measure Information:
Title
1 Change in plaque volume in segment of anastomosed coronary artery
Time Frame
12 months
Title
2 Changes in lumen and total vessel volumes and lumen plaque total vessel areas in SVG and coronary segments
Time Frame
12 months
Title
3 Changes in qualitative plaque characterization in the SVG and coronary segments
Time Frame
12 months
Title
4 Patients showing atherosclerosis changes
Time Frame
12 months
Title
5 Atherosclerosis changes concordance and discordance
Time Frame
12 months
Title
6 New occlusions in native coronary arteries or SVGs
Time Frame
12 months
Title
7 Changes in reference and minimum lumen diameters of the SVG
Time Frame
12 months
Title
8 Per patient percentage of initially patent SVGs that had significant progression of atherosclerosis at the site of greatest change at follow-up
Time Frame
12 months
Title
9 Changes of indices for comprehensive lipid thrombosis and pro-inflammatory profiles as well as glucose-insulin homeostasis, microalbuminuria, adhesion molecules, adipokines, and other markers relevant to the evaluation and management of cardiovascular
Time Frame
12 months
Title
10 Changes in abdominal areas and volumes of adipose tissue areas
Time Frame
12 months
Title
11 Changes in body composition, body weight, waist circumference and BMI
Time Frame
12 months
Title
12 Clinical laboratory parameters, physical examinations, vital signs, ECGs, concomitant medication and adverse events
Time Frame
12 months
Title
13 Death, MI, TIA, stroke, hospitalization and ischemia-driven interventions
Time Frame
12 months
Title
14 Fluid retention
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: AT SCREENING: Male or female, aged ≥ 40 years & ≤ 75 years. Women of childbearing potential with contraceptive measure, or of non-childbearing potential or surgically sterile. Type 2 diabetes mellitus. Patients with no new medication for hyperglycemia and no change in dose of oral hypoglycemic medication within the last 3 mo prior to screening. Diabetic patients with ischemic heart disease and CABG with at least one SVG (≥1 yr & ≤10 yrs). Patient agrees to participate. Patient legally capable of giving consent and understand what participation in study entails, potential risks and benefits, freedom to withdraw without any prejudice to subsequent medical arrangement or treatment, sign an ICF prior to any protocol specific procedure. AT IVUS & ANGIOGRAPHY (VISIT 2): Subject eligible if at least 1), 2) and 3) of the following criteria apply: Patient with at least 1 patent SVG. Segment length of at least 40 mm in SVG suitable for IVUS. Reference of target (SVG) diameter ≥ 2.5 mm. If anastomosed native coronary artery or non grafted coronary artery can be evaluated, the following criteria must be met: Reference of target anastomosed native coronary artery or non grafted coronary artery diameter≥ 2.5 mm. Segment length of at least 20 mm in anastomosed native coronary artery corresponding to SVG chosen or, in case of impossibility of performing IVUS in the anastomosed coronary artery, a non grafted coronary artery (≥ 30 mm length segment) might be used for reference. Exclusion Criteria: AT SCREENING: Clinically significant abnormality at screening tests & exams. Type 1 diabetes or history of diabetic ketoacidosis. Uncontrolled type 2 diabetes mellitus. Recent MI or ACS (≤ 90 days). History of hypersensitivity to thiazolidinediones (TZD) or compounds of similar chemical structures. Last LVEF≤ 35%. SBP>170mmHg or DBP>100mmHg at screening/baseline should be appropriately treated and under control prior to randomization. Unstable or Canadian Cardiovascular Society class III and IV angina, acute heart failure or congestive heart failure (NYHA class III and IV). History of hepatocellular reaction/severe oedema/other potentially fluid-related AE associated with use of any TZD or PPAR-γ agonist. Hepatic disease. Renal dysfunction. Anemia. TG ≥ 10 mmol/L. History of PCI in all SVG(s). Known occlusion(s) of all SVG(s). Treatment involving TZD within 3 mo prior to screening. Chronic use (≥ 6 mo) of insulin for glycemic control at any time in the past or administration of insulin any time within the last 12 mo. Allergy to contrast agents. Current intake of anorectic agents or have been taken off an anorectic agent or equivalent within 3 mo prior to screening. Patients for whom oral or injectable corticosteroids are used on a regular or recurrent basis. Recent history/suspicion of current drug abuse or alcohol abuse within last 6 mo. Women breast feeding, pregnant, or planning to become pregnant during conduct of trial and for 30 days after study completion. Other illness that precludes survival. History of malignancy within the last 5 yrs. Concurrent participation in other investigational device or drug studies and/or having received any experimental therapeutic agents within 30 days of the screening. Use of any investigational drug for glycemic control within 3 mo of the screening. Patient travelling out of town/country for periods exceeding 2 mo. Medical condition which may interfere with intake and/or absorption of study medication. Patients unwilling or unable to comply with procedures. Recent major surgery within 90 days of the screening. AT IVUS AND ANGIOGRAPHY (VISIT 2): PCI was performed on the target segment(s) after CABG. Target SVG and/or target native coronary artery show ≥ 50% angiographic lesion precluding IVUS. Thrombus/thrombus aspect in target vessels. Target vessel has been subjected to surgical endarterectomy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Olivier F Bertrand, MD, PhD
Organizational Affiliation
Laval Hospital Research Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jean-Pierre Despres, PhD
Organizational Affiliation
Laval Hospital Research Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Paul Poirier, MD, PhD
Organizational Affiliation
Laval Hospital Research Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
QEII Health Sciences Center - Halifax Infirmary
City
Halifax
State/Province
Nova Scotia
ZIP/Postal Code
B3H 3A7
Country
Canada
Facility Name
Hamilton Health Sciences - Mc Master Clinic
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8L 2X2
Country
Canada
Facility Name
Toronto General Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2C4
Country
Canada
Facility Name
CRMSBC
City
Bonaventure
State/Province
Quebec
ZIP/Postal Code
G0C 1E0
Country
Canada
Facility Name
CHUM Notre-Dame Hospital
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H2L 4M1
Country
Canada
Facility Name
Laval Hospital
City
Sainte-Foy
State/Province
Quebec
ZIP/Postal Code
G1V 4G5
Country
Canada
Facility Name
Hospital Del Mar
City
Barcelona
Country
Spain
Facility Name
Hospital Universitari Vall D'Hebron
City
Barcelona
Country
Spain
Facility Name
Hospital Universitarion Son Dureta
City
Palma de Mallorca
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
20594555
Citation
Bertrand OF, Poirier P, Rodes-Cabau J, Rinfret S, Title LM, Dzavik V, Natarajan M, Angel J, Batalla N, Almeras N, Costerousse O, De Larochelliere R, Roy L, Despres JP; VICTORY Trial Investigators. Cardiometabolic effects of rosiglitazone in patients with type 2 diabetes and coronary artery bypass grafts: A randomized placebo-controlled clinical trial. Atherosclerosis. 2010 Aug;211(2):565-73. doi: 10.1016/j.atherosclerosis.2010.06.005. Epub 2010 Jun 11.
Results Reference
derived

Learn more about this trial

Vein-Coronary Atherosclerosis And Rosiglitazone After Bypass Surgery: The VICTORY Trial

We'll reach out to this number within 24 hrs