Stentys Coronary Stent System Clinical Trial in Patients With Acute Myocardial Infarction

Acute Myocardial Infarction Clinical Trial

— APPOSITION V  

Official title:

APPOSITION V: Stentys Coronary Stent System Clinical Trial in Patients With Acute Myocardial Infarction

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT01732341
• Other study ID #: STENTYS
• Status: Terminated
• Phase: Phase 3
• First received: November 2, 2012
• Last updated: April 19, 2017
• Start date: May 2013
• Est. completion date: March 2017

Study information

• Verified date: November 2015
• Source: Stentys
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 318
• Est. completion date: March 2017
• Est. primary completion date: December 2015
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

General Inclusion Criteria

1. Subject = 18 years old.

2. Subject experiencing clinical symptoms consistent with AMI of >30 min. in duration.

3. 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.

4. Symptom duration is <12 hours prior to signing informed consent.

5. Subject should be in catheterization laboratory and procedure started within 2 hours of consent.

6. Patient provides written informed consent.

7. Patient agrees to all required follow-up procedures and visits.

Angiographic Inclusion Criteria

1. Based on coronary anatomy, PCI is indicated for the culprit lesion with anticipated use of stenting.

2. The vessel diameter is either known or expected to be 2.5-4.0mm, without excessive tortuosity or diffuse distal disease.

3. Lesion length =12mm and = 23mm

Exclusion Criteria:

General Exclusion Criteria

1. 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.

2. A previous coronary interventional procedure of any kind within 30 days prior to the procedure.

3. Female patients of childbearing potential known to be pregnant.

4. Patients undergoing cardiopulmonary resuscitation.

5. Cardiogenic shock (SBP <80 mmHg for >30 minutes, or requiring IV pressors or emergency IABP for hypotension).

6. 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.

7. 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.

8. Attempted thrombolysis.

9. 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.

10. Concurrent medical condition with a life expectancy of less than 12 months.

11. Known left ventricular ejection fraction (LVEF) < 25% at the most recent evaluation (prior to the index hospitalization).

12. History of cerebrovascular accident or transient ischemic attack in the last 6 months.

13. Active peptic ulcer or active gastrointestinal (GI) bleeding.

14. History of bleeding diathesis or coagulopathy or inability to accept blood transfusions.

15. 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.

16. Known serum creatinine level > 2.5 mg/dl, eGFR <30, or hemodialysis dependent.

Angiographic Exclusion Criteria

1. 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).

2. Multi-vessel intervention required during the index procedure.

Related Conditions & MeSH terms

• Acute Myocardial Infarction
• Infarction
• Myocardial Infarction

Intervention

Device:
• STENTYS self-apposing stent
Intervention to treat STEMI with the STENTYS self-apposing stent
• VISION balloon-expandable stent
STEMI treatment with a VISION balloon-expandable stent

Locations

Country	Name	City	State
Netherlands	AMC	Amsterdam
United States	Foundation Cardiovascular medicine	La Jolla	California
United States	Mount Sinai Hospital	New York	New York

Sponsors (1)

Lead Sponsor	Collaborator
Stentys

Countries where clinical trial is conducted

United States,  Netherlands, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Target Vessel Failure	From date of randomization until the date of first documented TVF, assessed up to 12 months.	12 months.
Secondary	Acute Stent Malapposition		Immediately after procedure