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Completed

NCT Number: NCT01182428

XIENCE V: SPIRIT WOMEN Sub-study

The purpose of this Clinical Evaluation is the continued assessment of the XIENCE Everolimus Eluting Coronary Stent System (XIENCE V® and XIENCE PRIME™ EECSS) with the primary focus on clinical outcomes in the treatment of female patients with de novo coronary artery lesions, and the characterization of the female population undergoing stent implantation with a XIENCE stent.

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Key information

Age range

18 year and older

Sex eligibility

Female

Study type

Interventional

Phase

Phase 4

Primary location

Hosital Italiano de Buenos Aires - Cardiologia, Buenos Aires, Argentina

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About this study

SPIRIT Women Randomized Sub-study is a prospective, single-blind, double arm, randomized multi-center sub-study comparing the XIENCE V® EECSS and XIENCE PRIME™ EESS to the CYPHER SELECT™ PLUS Sirolimus-eluting Coronary Stent in the treatment of female patients with coronary artery lesions.

The long term safety and efficacy of the XIENCE V EECSS have been demonstrated in the SPIRIT FIRST trial up to 5 years, the SPIRIT II trial up to 4 years, and in the SPIRIT III Randomized Control Trial (RCT) up to 3 years. In addition, these pre-approval studies have shown low rates of Target Vessel Failure and Major Adverse Cardiac Events (MACE) that were observed to plateau or gradually decline after about 1 year and were consistently lower than the comparator arm of each study. This benefit in MACE is sustained for up to 5 years and is also independent of the first year results.

The post approval SPIRIT V study demonstrated that the use of the XIENCE EECSS in complex lesions in a real-world population resulted in 1 year MACE, Stent Thrombosis and Target Lesion Revascularization rates that are comparable to those of the previously mentioned pre-approval studies which included patients with more restricted inclusion / exclusion criteria.

Therefore, based on existing data from these trials, Abbott Vascular has decided to discontinue further follow up in the SPIRIT Women study after 2 years.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

General Inclusion Criteria:

  • Patient must be female.
  • Patient must be at least 18 years of age.
  • Patient is able to verbally confirm understanding of risks, benefits and treatment alternatives and she or her legally authorized representative provides written informed consent prior to any study related procedure, as approved by the appropriate Medical Ethics Committee of the respective clinical site.
  • Patient must have evidence of myocardial ischemia (e.g., stable or unstable angina, silent ischemia, positive functional study or a reversible change in the electrocardiogram (ECG) consistent with ischemia).
  • Patient must be an acceptable candidate for coronary artery bypass graft (CABG) surgery.
  • Patient must agree to undergo all protocol-required follow-up examinations.
  • Patients of childbearing potential must have had a negative pregnancy test within 7 days before treatment, and must not be nursing at the time of treatment.

Angiographic Inclusion Criteria:

  • Patients' artery morphology and disease is suitable to be optimally treated with a maximum of 4 planned study stents.
  • Target lesions must be de novo lesions (no prior stent implant, no prior brachytherapy).
  • Target vessel reference diameter must be between 2.5 mm and 4.0 mm by visual estimate. The diameter range will be expanded to 2.25 mm when the 2.25 mm stent is available.
  • Target lesion greater than or equal to 28 mm in length by visual estimate.

General Exclusion Criteria:

  • Patient has other medical illness (e.g., cancer or congestive heart failure) or known history of substance abuse (alcohol, cocaine, heroin etc.) that may cause non-compliance with the clinical investigation plan, confound the data interpretation or is associated with a limited life expectancy (i.e., less than one year).
  • Patient has a known hypersensitivity or contraindication to aspirin, either heparin or bivalirudin, both clopidogrel and ticlopidine, everolimus, cobalt, chromium, nickel, tungsten, acrylic and fluoro polymers or contrast sensitivity that cannot be adequately pre-medicated.
  • Participation in another device or drug study or has completed the follow-up phase of another study within the last 30 days.
  • Patient who is judged to have a lesion that prevents complete inflation of an angioplasty balloon.
  • Patient has had a previous stent implant, either Bare Metal Stent (BMS) or Drug Eluting Stent (DES) within the target vessel(s)

Treatment and study plan

XIENCE V®/ XIENCE PRIME™

Device

Coronary artery placement of a XIENCE V®/ XIENCE PRIME™ Everolimus Eluting Stent System

Cypher Select

Device

XIENCE V® / XIENCE PRIME™ to CYPHER SELECT in female patients with de novo coronary artery lesions

Primary outcomes

  1. Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).

    Time frame: at 1 year

    This measure adds together all subjects who were determined by an expert panel to have died, had MI or had TVR as a result of their procedure.

  2. In-stent Late Loss (LL) (Main Secondary Endpoint)

    Time frame: at 270 days

    In-stent Minimal Lumen Diameter (MLD)post-procedure - in-stent MLD at follow-up.

Secondary outcomes

  1. Clinical Device Success

    Time frame: Intra-operative

    Successful delivery and deployment of the study stent at the intended target lesion and successful withdrawal of the stent delivery system.

  2. Clinical Procedure Success

    Time frame: Intra-operative

    Successful delivery and deployment of the study stent or stents at the intended target lesion and successful withdrawal of the stent delivery system without adverse cardiac events.

  3. Adjudicated Stent Thrombosis (Definite, Probable)

    Time frame: < 1 day (Acute)

  4. Adjudicated Stent Thrombosis (Definite, Probable)

    Time frame: 1 to 30 days (Sub-Acute)

  5. Adjudicated Stent Thrombosis (Definite, Probable)

    Time frame: 30 days to 1 year (Late)

  6. Adjudicated Stent Thrombosis (Definite, Probable, Possible)

    Time frame: 30 days to 1 year (Late)

  7. Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and Clinically Indicated Target Lesion Revascularization (CI-TLR).

    Time frame: at 30 days

  8. Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and CI-TLR.

    Time frame: at 240 days

  9. Adjudicated Composite Rate of Cardiac Death, MI Attributed to the Target Vessel and CI-TLR.

    Time frame: at 1 year

  10. Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).

    Time frame: at 30 days

  11. Adjudicated Composite Rate of All Death, All MI and Target Vessel Revascularization (TVR).

    Time frame: at 240 days

  12. Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).

    Time frame: at 30 days

  13. Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).

    Time frame: at 240 days

  14. Adjudicated Composite Rate of All Death, All MI and All Revascularization (TLR/TVR/Non TVR).

    Time frame: at 1 year

  15. Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).

    Time frame: at 30 days

  16. Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).

    Time frame: at 240 days

  17. Adjudicated Cardiac Death, Non-Cardiovascular Death, Vascular Death, Q-wave MI and Non Q-wave MI (Peri-Procedural, Unrelated to PCI).

    Time frame: at 1 year

  18. In-segment Late Loss (LL)

    Time frame: at 270 days

    LL = Minimal Lumen Diameter (MLD) post-procedure minus MLD at follow-up

  19. In-stent Angiographic Binary Restenosis Rates

    Time frame: at 270 days

    Only a certain number of patients were required to have angiographic follow-up. Percent of subjects with a follow-up in-stent percent diameter stenosis of ≥ 50% per quantitative coronary angiography (QCA).

  20. In-segment Angiographic Binary Restenosis Rates

    Time frame: at 270 days

    Only a certain number of patients were required to have angiographic follow-up. Percent of subjects with a follow-up in-stent percent diameter stenosis of ≥ 50% per quantitative coronary angiography (QCA).

  21. In-stent Percent Diameter Stenosis

    Time frame: at 270 days

  22. In-segment Percent Diameter Stenosis

    Time frame: at 270 days

  23. Adjudicated Revascularization (TLR/TVR/All Revascularizations)

    Time frame: at 30 days

    Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations

  24. Adjudicated Revascularization (TLR/TVR/All Revascularizations)

    Time frame: at 240 days

    Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations

  25. Adjudicated Revascularization (TLR/TVR/All Revascularizations)

    Time frame: at 1 year

    Composite of Target Lesion Revascularization (TLR), Target Vessel Revascularization (TVR), all revascularizations

  26. Aneurysm

    Time frame: at 270 days

    All subjects with aneurysm of the target lesion up to the 270 day follow-up visit

  27. Thrombus

    Time frame: at 270 days

    All subjects with thrombus of the target lesion up to the 270 day follow-up visit

  28. Persisting Dissection

    Time frame: at 270 days

    All subjects with persisting dissection of the target lesion up to the 270 day follow-up visit

Sponsors and collaborators

Lead sponsor

Abbott Medical Devices

Industry

Registry information

Official study title

A Clinical Evaluation of the XIENCE Everolimus Eluting Coronary Stent System in the Treatment of Women With de Novo Coronary Artery Lesions

Important dates

Study start
2008
Primary completion
2011
Study completion
2011
First posted
Aug 16, 2010
Registry last updated
Aug 7, 2012

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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