Type 2 Diabetes Clinical Trial
Official title:
A Prospective, Single Blind, Multi-center, Randomized Trial to Compare the TAXUS Element™ Coronary Stent System Against the XIENCE Prime™ Coronary Stent System in the Treatment of a Diabetic Patient PopulatiOn in India
The TUXEDO-India is a prospective, single blind, multi-center randomized clinical trial to
assess the TAXUS Element™ in a consecutive population of diabetic patients with coronary
artery disease undergoing coronary revascularization. Approximately 1,830 patients with
single or multi lesion, multi vessel coronary artery or saphenous vein graft disease ranging
in vessels ranging from 2.25 mm to 4.0 mm in diameter by visual estimate will be enrolled in
a 1:1 randomization to TAXUS Element™ vs. XIENCE™ Prime in India at up to 50 clinical sites,
to demonstrate the safety and effectiveness of TAXUS Element™ in an unrestricted population.
Procedural Endpoints:
- Device success, defined as attainment of < 30% residual stenosis of the target lesion
(visual assessment) using the TAXUS Element™ or XIENCE™ Prime stent.
- Lesion success defined as attainment of < 30% residual stenosis (visual assessment)
using any percutaneous method.
- Procedure success defined as lesion success without the occurrence of in-hospital MACE.
- Procedure complication rate including composite and individual angiographic occurrence
of dissection ≥B, distal embolization, no reflow, slow flow, abrupt closure, or
perforation.
Primary Endpoint:
Composite safety endpoint of Target Vessel Failure (TVF) rate at 12 months post-index
procedure:
- Cardiac Death related to target vessel
- Target Vessel Myocardial Infarction (TV-MI)
- Target Vessel Revascularization (TVR)
Secondary Endpoint:
Clinical endpoints measured at 30, 180 days, and 1 and 2 years post index procedure:
- TVF rate (primary endpoint 1 year)
- Target Vessel Revascularization (TVR) rate
- Target Lesion Revascularization (TLR)
- Composite of cardiac death or target vessel MI
- Composite of all deaths, all MI, all revascularizations
- Major Adverse Cardiac Events (MACE) which is the composite endpoint of cardiac death,
all myocardial infarction, and TLR
- MI (Q-wave and non-Q-wave) rate
- Cardiac death rate
- Non-cardiac death rate
- All death rate
- Cardiac death or MI rate
- All death or MI rate
- Stent thrombosis rate (definite or probable by Academic Research Consortium [ARC]
definitions)
Periprocedural endpoints:
- Technical success rate
- Clinical procedural success rate
Anti-platelet Therapy
A loading dose of either Clopidogrel (300mg, 600mg recommended), Ticlopidine (500mg), or
Prasugrel (60mg) must be given to the patient prior to index procedure. Thereafter,
Clopidogrel (75mg daily), Ticlopidine (250mg twice daily), Prasugrel (10mg) must be given
for at least 12 months after stent implantation. If the protocol mandated (loading and or
daily) dosage conflicts with local DFU, the local DFU should take precedence. Aspirin (ASA):
Must be administered concomitantly with Clopidogrel, Ticlopidine or Prasugrel and then
continued indefinitely
Sample Size Parameters:
The expected 12 month TVF rate for both groups is estimated to be 8.4% based on the data
available from the SPIRIT IV trial. Given the non-inferiority margin (delta) of 4% with
equal expected means and a one-sided 5% significance level, 824 patients in each group will
provide at least 90% power to reject the null hypothesis if it is false. When allowance is
made for 10% attrition, approximately 915 patients are required per each treatment group.
Therefore, the necessary total sample size for the trial is 1,830 patients.
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