EVOLVE Short DAPT Study

NCT ID: NCT02605447

Last Updated: 2020-09-25

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

2009 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-16

Study Completion Date

2019-07-17

Brief Summary

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The EVOLVE Short DAPT Study is a prospective, multicenter, single-arm study designed to assess the safety of 3-month DAPT in subjects at high risk for bleeding undergoing PCI with a SYNERGY Stent System.

Detailed Description

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The primary objective of the EVOLVE Short DAPT Study is to assess the safety of 3-month dual antiplatelet therapy (DAPT) in subjects at high risk for bleeding undergoing percutaneous coronary intervention (PCI) with the SYNERGY Stent System.

The study will be conducted up to 120 sites worldwide in the United States, Europe, Japan, and Brazil with planned enrollment of up to 2,250 subjects. Clinical follow-up will be required at the following time points: 3 months, 6 months, 12 months and 15 months post index procedure.

Subjects must be treated with one of the following P2Y12 inhibitors (clopidogrel, prasugrel, or ticagrelor) for 3 months following the index procedure. Subjects must be treated with aspirin for the duration of the trial. The minimum daily maintenance dose of aspirin should be 75-100 mg.

Subjects are eligible for discontinuation of P2Y12 inhibitor at 3 months if they meet both of the following criteria: subject was treated with 3 months of study required antiplatelet therapy post index procedure; and subject was free from events (stroke, MI, PCI, coronary artery bypass graft \[CABG\], and stent thrombosis) between the index procedure and the 3 month visit.

Subjects are not eligible for discontinuation of P2Y12 inhibitor at 3 months if any of the following criteria are met: subject who experiences a stroke, MI, PCI, CABG and/or stent thrombosis, during the 0-3 month period (between the date of the index procedure and the date of the 3-month follow-up visit); or subject who is non-compliant with study required antiplatelet therapy during the 0-3 month period (between the date of the index procedure and the date of the 3-month follow-up visit); or subject judged inappropriate for discontinuation from P2Y12 inhibitor use at 3 months due to another condition requiring chronic P2Y12 inhibitor use.

All enrolled subjects who receive a SYNERGY stent must be followed at all milestones through 15-months, regardless of eligibility to discontinue P2Y12 inhibitor. Following the 3-month milestone, subjects who experience MI or stent thrombosis events should be treated per the investigator's discretion and should be followed through the 15-month visit.

Conditions

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Coronary Artery Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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SYNERGY stent + 3 month DAPT

Subject with implantation of at least one SYNERGY stent within the preceding 3 calendar days that takes the required dual antiplatelet therapy (3 months of P2Y12 inhibitor, 15 months of aspirin)

Group Type EXPERIMENTAL

3 months of dual antiplatelet therapy (DAPT)

Intervention Type DRUG

3 months of P2Y12 inhibitor (clopidogrel, prasugrel or ticagrelor) plus 15-months of aspirin

SYNERGY Stent System

Intervention Type DEVICE

SYNERGY Everolimus-Eluting Platinum Chromium Coronary Stent System

Interventions

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3 months of dual antiplatelet therapy (DAPT)

3 months of P2Y12 inhibitor (clopidogrel, prasugrel or ticagrelor) plus 15-months of aspirin

Intervention Type DRUG

SYNERGY Stent System

SYNERGY Everolimus-Eluting Platinum Chromium Coronary Stent System

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Subject is considered at high risk for bleeding, defined as meeting one or more of the following criteria at the time of enrollment:

* ≥ 75 years of age and, in the opinion of the investigator, the risk of major bleeding associated with \>3 months of DAPT outweighs the benefit,
* need for chronic or lifelong anticoagulation,
* history of major bleeding (severe/life threatening or moderate bleeding based on the GUSTO classification) within 12 months of the index procedure,
* history of stroke (ischemic or hemorrhagic),
* renal insufficiency (creatinine ≥2.0 mg/dl) or failure (dialysis dependent),
* platelet count ≤100,000/μL
2. Subject must be at least 18 years of age
3. Subject must have had implantation of at least one SYNERGY stent within the preceding 3 calendar days
4. Subject must be able to take study required antiplatelet therapy (as required per protocol)
5. Subject is willing to comply with all protocol requirements, including agreement to stop taking P2Y12 inhibitor at the 3-month milestone, if eligible per protocol
6. Subject (or legal guardian) understands the trial requirements and the treatment procedures and provides written informed consent before any study-specific procedures are performed
7. For subjects less than 20 years of age enrolled at a Japanese site, the subject/ the subject's legal representative must provide written informed consent before any study-specific tests or procedures are performed

Exclusion Criteria

1. Subject with an indication for the index procedure of acute ST elevation MI (STEMI)
2. Subject with an indication for the index procedure of Non ST elevation MI (NSTEMI), based on the 3rd Universal MI definition
3. Subject with treatment with another coronary stent, other than SYNERGY, during the index procedure
4. Subject with planned staged procedures. (Note: Planned staged procedures are allowed if performed within 7 days and with only SYNERGY stents).
5. Subject has a known allergy to contrast (that cannot be adequately pre-medicated), the SYNERGY stent system or protocol-required concomitant medications (e.g., everolimus or structurally related compounds, polymer or individual components, all P2Y12 inhibitors and aspirin)
6. Subject with implantation of a drug-eluting stent within 9 months prior to index procedure
7. Subject previously treated at any time with intravascular brachytherapy
8. Subject has an active peptic ulcer or active gastrointestinal (GI) bleeding
9. Subject is participating in an investigational drug or device clinical trial that has not reached its primary endpoint (Note: registry, observational, data collection studies are not exclusionary)
10. Subject intends to participate in an investigational drug or device clinical trial within 15 months following the index procedure (Note: registry, observational, data collection studies are not exclusionary)
11. Subject judged inappropriate for discontinuation from P2Y12 inhibitor use at 3 months, due to another condition requiring chronic P2Y12 inhibitor use
12. Subject with planned surgery or procedure necessitating discontinuation of P2Y12 inhibitor within 3 months following index procedure
13. Subject is a woman who is pregnant or nursing
14. Subject with a current medical condition with a life expectancy of less than 15 months
15. Target lesion(s) is located in the left main
16. Target lesion(s) is located within 3 mm of the origin of the left anterior descending (LAD) coronary artery or left circumflex (LCx) coronary artery by visual estimate
17. Subject has unprotected left main coronary artery disease ( \> 50% diameter stenosis)
18. Planned treatment of more than 3 lesion
19. Planned treatment of lesions in more than 2 major epicardial vessels
20. Target lesion(s) treated that involve complex bifurcation (i.e. bifurcation lesion requiring treatment with more than one stent)
21. Target lesion(s) is restenotic from a previous stent implantation
22. Target lesion(s) is located within a saphenous vein graft or an arterial graft
23. Target lesion(s) with a TIMI flow 0 (total occlusion) or TIMI flow 1 prior to guide wire crossing
24. Thrombus, or possible thrombus, present in the target vessel (by visual estimate)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boston Scientific Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ajay Kirtane, MD

Role: PRINCIPAL_INVESTIGATOR

Columbia University Medical Center/ NewYork Presbyterian Hospital

Stephan Windecker, Prof, MD

Role: PRINCIPAL_INVESTIGATOR

INSELSPITAL - Universitätsspital Bern

Locations

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Banner Good Samaritan Regional Medical Center

Phoenix, Arizona, United States

Site Status

St. Joseph's Hospital & Medical Center

Phoenix, Arizona, United States

Site Status

Baptist Health Medical Center (Little Rock)

Little Rock, Arkansas, United States

Site Status

Arkansas Heart Hospital

Little Rock, Arkansas, United States

Site Status

Bakersfield Memorial Hospital

Bakersfield, California, United States

Site Status

USC Medical Center

Los Angeles, California, United States

Site Status

Cedars - Sinai Medical Center

Los Angeles, California, United States

Site Status

El Camino Hospital

Mountain View, California, United States

Site Status

HCA Riverside Community Hospital

Riverside, California, United States

Site Status

Sutter Medical Center, Sacramento

Sacramento, California, United States

Site Status

University of California, Davis Medical Center

Sacramento, California, United States

Site Status

Kaiser Foundation Hospital - San Francisco

San Francisco, California, United States

Site Status

John Muir Medical Center

Walnut Creek, California, United States

Site Status

South Denver Cardiology Associates, PC

Littleton, Colorado, United States

Site Status

Yale-New Haven Hospital

New Haven, Connecticut, United States

Site Status

Washington Hospital Center

Washington D.C., District of Columbia, United States

Site Status

JFK Medical Center

Atlantis, Florida, United States

Site Status

Morton Plant Mease Healthcare System

Clearwater, Florida, United States

Site Status

North Florida Regional Medical Center

Gainesville, Florida, United States

Site Status

Memorial Regional Hospital

Hollywood, Florida, United States

Site Status

Mediquest Research at Munroe Regional Medical Center

Ocala, Florida, United States

Site Status

Florida Hospital

Orlando, Florida, United States

Site Status

Florida Hospital Heartland Medical Center

Sebring, Florida, United States

Site Status

Tallahassee Memorial Hospital

Tallahassee, Florida, United States

Site Status

University Hospital

Augusta, Georgia, United States

Site Status

Medical Center of Central Georgia

Macon, Georgia, United States

Site Status

Wellstar Kennestone Hospital

Marietta, Georgia, United States

Site Status

Kootenai Medical Center

Coeur d'Alene, Idaho, United States

Site Status

Northwestern Memorial Hospital

Chicago, Illinois, United States

Site Status

Edward Hospital

Naperville, Illinois, United States

Site Status

St. John's Hospital

Springfield, Illinois, United States

Site Status

Carle Foundation Hospital

Urbana, Illinois, United States

Site Status

Franciscan St. Francis Hospital

Beech Grove, Indiana, United States

Site Status

Northern Indiana Research Alliance - Lutheran Hospital

Fort Wayne, Indiana, United States

Site Status

Community Heart and Vascular Hospital

Indianapolis, Indiana, United States

Site Status

Mercy Hospital Medical Center

Des Moines, Iowa, United States

Site Status

Jewish Hospital and St. Mary's Healthcare

Louisville, Kentucky, United States

Site Status

Cardiovascular Research, LLC

Shreveport, Louisiana, United States

Site Status

Maine Medical Center

Portland, Maine, United States

Site Status

Union Memorial Hospital

Baltimore, Maryland, United States

Site Status

Tufts Medical Center

Boston, Massachusetts, United States

Site Status

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

St. Mary's Duluth Clinic Regional Heart Center

Duluth, Minnesota, United States

Site Status

Abbott Northwestern Hospital

Minneapolis, Minnesota, United States

Site Status

HealthEast St. Joseph's Hospital

Saint Paul, Minnesota, United States

Site Status

St. Luke's Hospital of Kansas City

Kansas City, Missouri, United States

Site Status

Cox Medical Centers

Springfield, Missouri, United States

Site Status

Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Dartmouth Hitchcock Medical Center

Lebanon, New Hampshire, United States

Site Status

Deborah Heart and Lung Center

Browns Mills, New Jersey, United States

Site Status

Morristown Memorial Hospital

Morristown, New Jersey, United States

Site Status

Presbyterian Hospital

Albuquerque, New Mexico, United States

Site Status

North Shore University Hospital

Manhasset, New York, United States

Site Status

New York University Medical Center

New York, New York, United States

Site Status

Columbia University Medical Center/ NewYork Presbyterian Hospital

New York, New York, United States

Site Status

St. Joseph's Hospital Health Center

Syracuse, New York, United States

Site Status

Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

Wake Medical Center

Raleigh, North Carolina, United States

Site Status

Lindner Center for Research and Education at Christ Hospital

Cincinnati, Ohio, United States

Site Status

Good Samaritan Hospital

Cincinnati, Ohio, United States

Site Status

Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

OhioHealth Research and Innovation Institute - Riverside Methodist Hospital

Columbus, Ohio, United States

Site Status

Mercy St. Vincent Medical Center

Toledo, Ohio, United States

Site Status

Integris Baptist Medical Center

Oklahoma City, Oklahoma, United States

Site Status

Oklahoma Heart Hospital

Oklahoma City, Oklahoma, United States

Site Status

Providence St. Vincent Medical Center

Portland, Oregon, United States

Site Status

Geisinger Medical Center

Danville, Pennsylvania, United States

Site Status

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, United States

Site Status

Lankenau Hospital

Wynnewood, Pennsylvania, United States

Site Status

Sisters of Charity Providence Hospital

Columbia, South Carolina, United States

Site Status

University Medical Center-Greenville Memorial Hospital

Greenville, South Carolina, United States

Site Status

Grand Strand Regional Medical Center

Myrtle Beach, South Carolina, United States

Site Status

Jackson-Madison County General Hospital

Jackson, Tennessee, United States

Site Status

Baptist Memorial Hospital

Memphis, Tennessee, United States

Site Status

Centennial Medical Center

Nashville, Tennessee, United States

Site Status

Baylor Heart & Vascular Hospital

Dallas, Texas, United States

Site Status

St. Luke's Episcopal Hospital

Houston, Texas, United States

Site Status

The Heart Hospital Baylor Plano

Plano, Texas, United States

Site Status

St. David's Round Rock Medical Center

Round Rock, Texas, United States

Site Status

The University of Vermont Medical Center

Burlington, Vermont, United States

Site Status

Sentara Norfolk General Hospital

Norfolk, Virginia, United States

Site Status

Winchester Medical Center

Winchester, Virginia, United States

Site Status

Swedish Medical Center

Seattle, Washington, United States

Site Status

University of Washington Medical Center

Seattle, Washington, United States

Site Status

Charleston Area Medical Center

Charleston, West Virginia, United States

Site Status

Aurora St. Luke's Medical Center

Milwaukee, Wisconsin, United States

Site Status

Aspirus Heart and Vascular Institute - Research and Education

Wausau, Wisconsin, United States

Site Status

Instituto de Cardiologia Dante Pazzanese

São Paulo, , Brazil

Site Status

Instituto do Coração (InCor)

São Paulo, , Brazil

Site Status

Herzzentrum Bad Krozingen

Bad Krozingen, , Germany

Site Status

Herz-Kreislauf-Zentrum Segeberger Kliniken GmbH

Bad Segeberg, , Germany

Site Status

Universitaetsklinikum Heidelberg

Heidelberg, , Germany

Site Status

Uni Jena

Jena, , Germany

Site Status

Fukuoka Sanno Hospital

Fukuoka, Fukuoka, Japan

Site Status

Iwate Medical University Hospital

Morioka, Iwate, Japan

Site Status

Tokai University Hospital

Isehara-shi, Kanagawa, Japan

Site Status

Shonan Kamakura General Hospital

Kamakura-shi, Kanagawa, Japan

Site Status

Saiseikai Yokohama-City Eastern Hospital

Yokohama, Kanagawa, Japan

Site Status

Mitsui Memorial Hospital

Chiyoda-ku, Tokyo, Japan

Site Status

Teikyo University Hospital

Itabashi-ku, Tokyo, Japan

Site Status

Toho University Ohashi Medical Center

Meguro-ku, Tokyo, Japan

Site Status

Kurume University Hospital

Kurume-shi, , Japan

Site Status

Osaka Saiseikai Nakatsu Hospital

Osaka, , Japan

Site Status

P. Stradins University Hospital

Riga, , Latvia

Site Status

Falu Lasarett

Falun, , Sweden

Site Status

Karlstadt Central Hospital

Karlstad, , Sweden

Site Status

Skane University Hospital

Malmo, , Sweden

Site Status

Hospital Cantonal Fribourg

Fribourg, , Switzerland

Site Status

Countries

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United States Brazil Germany Japan Latvia Sweden Switzerland

References

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Mihatov N, Kirtane AJ, Stoler R, Feldman R, Neumann FJ, Boutis L, Tahirkheli N, Kereiakes DJ, Toelg R, Othman I, Stein B, Allocco D, Windecker S, Yeh RW. Bleeding and Ischemic Risk Prediction in Patients With High Bleeding Risk (an EVOLVE Short DAPT Analysis). Am J Cardiol. 2023 Nov 15;207:370-379. doi: 10.1016/j.amjcard.2023.06.036. Epub 2023 Sep 29.

Reference Type DERIVED
PMID: 37778226 (View on PubMed)

Kirtane AJ, Stoler R, Feldman R, Neumann FJ, Boutis L, Tahirkheli N, Toelg R, Othman I, Stein B, Choi JW, Windecker S, Yeh RW, Dauerman HL, Price MJ, Underwood P, Allocco D, Meredith I, Kereiakes DJ. Primary Results of the EVOLVE Short DAPT Study: Evaluation of 3-Month Dual Antiplatelet Therapy in High Bleeding Risk Patients Treated With a Bioabsorbable Polymer-Coated Everolimus-Eluting Stent. Circ Cardiovasc Interv. 2021 Mar;14(3):e010144. doi: 10.1161/CIRCINTERVENTIONS.120.010144. Epub 2021 Mar 1.

Reference Type DERIVED
PMID: 33641374 (View on PubMed)

Balanescu DV, Aziz MK, Donisan T, Palaskas N, Lopez-Mattei J, Hassan S, Kim P, Song J, Ntim W, Cilingiroglu M, Marmagkiolis K, Iliescu C. Cancer treatment resumption in patients with new-generation drug-eluting stents. Coron Artery Dis. 2021 Jun 1;32(4):295-301. doi: 10.1097/MCA.0000000000000986.

Reference Type DERIVED
PMID: 33196581 (View on PubMed)

Mauri L, Kirtane AJ, Windecker S, Yeh RW, Dauerman HL, Price MJ, Christen T, Allocco DJ, Meredith IT, Kereiakes DJ. Rationale and design of the EVOLVE Short DAPT Study to assess 3-month dual antiplatelet therapy in subjects at high risk for bleeding undergoing percutaneous coronary intervention. Am Heart J. 2018 Nov;205:110-117. doi: 10.1016/j.ahj.2018.08.004. Epub 2018 Aug 17.

Reference Type DERIVED
PMID: 30218844 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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S2073

Identifier Type: -

Identifier Source: org_study_id

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