Functional Assessment of the Infart-related Artery With Bioactive and Polymer-free Coronary Stents (The FUNCOMBO Trial)

NCT ID: NCT04202172

Last Updated: 2020-10-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-05

Study Completion Date

2020-09-01

Brief Summary

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A total of 50 patients with ST-elevation myocardial infarction (STEMI) undergoing primary-percutaneous coronary intervention (PPCI) will be randomized to two different coronary stents: BIOFREEDOM vs. COMBO stent.

All patients will undergo to 6-month scheduled coronary angiography to evaluate the endothelial function response of the distal coronary segment and other functional parameters.

Detailed Description

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The bioengineered COMBO stent (Orbus Neich, Fort Lauderdale, Florida, United States) has a dual-therapy strategy, which combines a sirolimus-eluting coating with an anti-CD34 antibody layer to promote vessel healing. Sirolimus release (5 μg/mm) is completed in 30 days, and the biodegradable polymer disappears within 90 days.

CD34 antibodies are immobilized on the surface of the stent and capture circulating endothelial progenitor cells (EPCs). The captured EPCs are triggered by sheer stress from the circulating blood and other cell signals to differentiate and mature into endothelial cells. COMBO Plus is the only stent with a biological coating that actively repairs the vessel morphology. However, little is known regarding the endothelial function after stent implantation.

Conditions

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Endothelial Dysfunction Coronary Microvascular Disease Myocardial Infarction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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BIOFREEDOM

Implantation of Drug-eluting coronary stent without polymer in patients with myocardial infarction.

Group Type ACTIVE_COMPARATOR

Stent implantation in the infart-related artery in patients with ST elevation myocardial infarction

Intervention Type PROCEDURE

The 6-month scheduled coronary angiography will perform 3 interventions:

1. Endothelial function assessment with intracoronary acetyl-choline infusion.
2. Microcirculatory function assessment with a pressure wire during endovenous adenosine infusion.
3. Stent healing assessment using optical coherence tomography

COMBO

Implantation of Bioactive coronary stent in patients with myocardial infarction.

Group Type EXPERIMENTAL

Stent implantation in the infart-related artery in patients with ST elevation myocardial infarction

Intervention Type PROCEDURE

The 6-month scheduled coronary angiography will perform 3 interventions:

1. Endothelial function assessment with intracoronary acetyl-choline infusion.
2. Microcirculatory function assessment with a pressure wire during endovenous adenosine infusion.
3. Stent healing assessment using optical coherence tomography

Interventions

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Stent implantation in the infart-related artery in patients with ST elevation myocardial infarction

The 6-month scheduled coronary angiography will perform 3 interventions:

1. Endothelial function assessment with intracoronary acetyl-choline infusion.
2. Microcirculatory function assessment with a pressure wire during endovenous adenosine infusion.
3. Stent healing assessment using optical coherence tomography

Intervention Type PROCEDURE

Other Intervention Names

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All patients will undergo to 6-month coronary angiography after stent implantation in order to assess the endothelial and microvascular function of the infarct related artery

Eligibility Criteria

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Inclusion Criteria

* STEMI \< 12 hours undergoing primary PCI.
* ST-segment elevation of \> 1mm in \> 2 contiguous leads, or (presumably new) left bundle branch block, or true posterior MI with ST depression of \>1mm in \>2 contiguous anterior leads.
* Presence of at least one acute infarct artery target vessel with one or more de-novo coronary artery stenosis in a native coronary artery within 2.75 - 3.75 mm reference vessel diameter and \< 24 mm length (visually estimated).

Exclusion Criteria

* Inability to provide informed consent
* Female of childbearing potential (age \<50 years and last menstruation within the last 12 months), who did not undergo tubal ligation, ovariectomy or hysterectomy
* Known intolerance to aspirin, heparin, PLLA, everolimus, contrast material
* Cardiogenic Shock
* Unprotected left main coronary artery stenosis
* Distal occlusion of target vessel
* Acute myocardial infarction secondary to stent thrombosis
* Mechanical complications of acute myocardial infarction
* Severe tortuous, calcified or angulated coronary anatomy of the study vessel that in the opinion of the investigator would result in sub-optimal imaging or excessive risk of complication in the follow-up procedure
* Active bleeding or coagulopathy or patients at chronic anticoagulation therapy
* Chronic renal dysfunction with creatinine clearance \< 45 ml/minm2
* Subject is currently participating in another clinical trial that has not yet completed its primary endpoint
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Spanish Society of Cardiology

OTHER

Sponsor Role collaborator

Institut d'Investigació Biomèdica de Bellvitge

OTHER

Sponsor Role lead

Responsible Party

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Josep Gomez Lara

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Josep Gomez Lara, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Universitari de Bellvitge, L´Hospitalet de Llobregat, Spain

Neus Salvatella, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital del Mar, Barcelona, Spain

Salvatore Brugaletta, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Clinic, Barcelona, Spain

Locations

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Hospital Universitari de Bellvitge

L'Hospitalet de Llobregat, Barcelona, Spain

Site Status

Countries

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Spain

References

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Gomez-Lara J, Oyarzabal L, Brugaletta S, Salvatella N, Romaguera R, Roura G, Fuentes L, Perez Fuentes P, Ortega-Paz L, Ferreiro JL, Teruel L, Gracida M, Vaquerizo B, Sabate M, Comin-Colet J, Gomez-Hospital JA. Coronary endothelial and microvascular function distal to polymer-free and endothelial cell-capturing drug-eluting stents. The randomized FUNCOMBO trial. Rev Esp Cardiol (Engl Ed). 2021 Dec;74(12):1013-1022. doi: 10.1016/j.rec.2021.01.007. Epub 2021 Feb 24. English, Spanish.

Reference Type DERIVED
PMID: 33640311 (View on PubMed)

Other Identifiers

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AC009/18

Identifier Type: -

Identifier Source: org_study_id