Randomized Comparison of Abluminus DES+ Sirolimus-Eluting Stents Versus Everolimus-Eluting Stents in Coronary Artery Disease Patients With Diabetes Mellitus Global

NCT ID: NCT04236609

Last Updated: 2023-03-27

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

3050 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-15

Study Completion Date

2024-09-30

Brief Summary

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To compare in diabetic patients eligible for percutaneous coronary intervention (PCI) with minimal exclusion criteria, the efficacy and safety of Abluminus DES+ sirolimus- eluting stents (SES) versus XIENCE Everolimus-Eluting Stents (EES). At least 40% of patients are expected to be affected by multivessel coronary artery disease and 30% with acute coronary syndrome

Detailed Description

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This study aims to determine which DES will best treat the diabetic population. Specifically, the research question of this trial is to evaluate the use of a novel sirolimus-eluting stent coated with drug-eluting polymer after crimping on the balloon as compared to the standard-of-care EES in the treatment of de novo coronary artery disease in patients with diabetes mellitus. ABILITY is a prospective, multi-center, multinational, randomized, open label, 2-arm parallel group, post-approval study.

Conditions

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Diabetes Coronary Artery Disease Acute Coronary Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Target lesions should be treated in accordance with the randomization schedule after meeting the clinical and angiographic inclusion and exclusion criteria following the instruction for use of the study stent.

Additional lesions (other vessels) may be staged up to 45 days post-index procedure but must be treated with the same stent.

Dual antiplatelet therapy must be prescribed in alignment with the Instructions for Use of the DES and the guidelines
Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors
The staff (i.e. research nurses, research coordinators and other practitioners) involved in the follow-up care of study subjects and the Clinical Events Committee (CEC) adjudicators will be blinded to the patient assignment;

Study Groups

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Abluminus DES+ sirolimus- eluting stents (SES)

Enrolled patients will undergo angioplasty with Abluminus DES+ sirolimus- eluting stents (SES) and will be followed for two years. The DES procedure will be conducted in accordance with the CE mark instructions for use for the Abluminus DES+ sirolimus- eluting stents (SES).

Group Type ACTIVE_COMPARATOR

Abluminus DES+ Sirolimus Eluting Stent System (SES)

Intervention Type DEVICE

The Sirolimus-eluting stent manufactured by Envision and distributed by Concept Medical

XIENCE Everolimus-Eluting Stents (EES)

Enrolled patients will undergo angioplasty with XIENCE Everolimus-Eluting Stents (EES) and will be followed for two years. The DES procedure will be conducted in accordance with the CE mark instructions for use for the XIENCE Everolimus-Eluting Stents (EES).

Group Type ACTIVE_COMPARATOR

XIENCE Everolimus Eluting Coronary Stent System (XIENCE family)

Intervention Type DEVICE

The Everolimus-eluting stent manufactured and distributed by Abbott Vascular Santa Clara, CA

Interventions

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Abluminus DES+ Sirolimus Eluting Stent System (SES)

The Sirolimus-eluting stent manufactured by Envision and distributed by Concept Medical

Intervention Type DEVICE

XIENCE Everolimus Eluting Coronary Stent System (XIENCE family)

The Everolimus-eluting stent manufactured and distributed by Abbott Vascular Santa Clara, CA

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Patient understands the trial requirements and the treatment procedures and provides written informed consent;
2. Age ≥ 18 years of age (\> 19 years of age for South Korea and ≥ 21 years of age for Singapore);
3. Diabetic patient: either:

1. Patient with a previous documented diagnosis of diabetes mellitus (Type 1 or Type 2) and currently undergoing pharmacological treatment (oral hypoglycemic agents or insulin)
2. Newly diagnosed diabetes: either:

i. Fasting plasma glucose (FPG) ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for ≥8 hours1 or ii. Two-hour plasma glucose ≥200 mg/dL (11.1 mmol/L) following a 75g oral glucose tolerance test or iii. HbA1c level ≥ 7% (53 mmol/mol) Patients who are newly diagnosed are included even if they are not on pharmacological treatment (oral hypoglycemic agents or insulin)
4. Symptomatic coronary artery disease including chronic stable angina, silent ischemia, and non-ST-segment elevation acute coronary syndrome (NSTE-ACS)
5. Patient is eligible for percutaneous coronary intervention (PCI); Previous PCI (with balloon angioplasty or stenting) is allowed if performed \>12 months before index procedure;
6. Patient is willing and able to comply with all protocol-required follow-up evaluations.

7. Presence of ≥1 de novo coronary artery stenosis \>50% in a native coronary artery which can be treated with a stent ranging in diameter from 2.25 to 4.0 mm and can be covered with 1 or multiple stents; and
8. No limitation to the number of treated lesions, number of vessels, or lesion length if the patient is judged eligible for PCI by the treating physician according to the local standard of care.

Exclusion Criteria

1. Patient lacking capacity (i.e. patient suffering from dementia and others) to provide informed consent
2. Patient in cardiogenic shock;
3. Patient has known allergy to the study stent system or protocol-required concomitant medications (e.g. aspirin, clopidogrel, prasugrel, ticagrelor, heparin, stainless steel, platinum, chromium, sirolimus, everolimus, radiographic contrast material) that cannot be adequately pre-medicated;
4. Planned surgery (cardiac and non-cardiac) within 6 months after the index procedure unless the dual-antiplatelet therapy (DAPT) can be maintained throughout the peri-surgical period;
5. Patient undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI)
6. Patient is pregnant, nursing, or is a woman of child-bearing potential who is not surgically sterile, \< 2 years postmenopausal, or does not consistently use effective methods of contraception\*;
7. Patient has any other serious medical illness (e.g., cancer, end-stage congestive heart failure) that may reduce life expectancy to less than 12 months;
8. Acute or chronic renal dysfunction (creatinine \>3.0 mg/dl);
9. Currently participating in another investigational drug or device study.

10. In-stent restenotic lesions;
11. Lesions involving venous or arterial bypass grafts.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Concept Medical Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Roxana Mehran

Role: STUDY_CHAIR

Mount Sinai Heart

Locations

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The Prince Charles Hospital

Chermside, , Australia

Site Status

St Vincent Hospital

Melbourne, , Australia

Site Status

The Wollongong Hospital

Wollongong, , Australia

Site Status

University Heart Center Graz

Graz, , Austria

Site Status

Kardinal Schwarzenberg Klinikum

Schwarzach im Pongau, , Austria

Site Status

National Heart Foundation Hospital & Research Institute

Dhaka, , Bangladesh

Site Status

Antwerp Cardiovascular Center Middelheim

Antwerp, , Belgium

Site Status

UZ Leuven

Leuven, , Belgium

Site Status

Instituto Dante Pazzanese de Cardiologia

São Paulo, , Brazil

Site Status

INSTITUTO DO CORAÇÃO - InCor University of São Paulo Medical School

São Paulo, , Brazil

Site Status

University Hospital Brno, Department of Medecine Cardiology

Brno, , Czechia

Site Status

University Hospital Královské Vinohrady, Department of Medecine Cardiology

Prague, , Czechia

Site Status

Clinique Axium

Aix-en-Provence, , France

Site Status

CHRU Brest

Brest, , France

Site Status

Clinique de Fontaine

Fontaine-lès-Dijon, , France

Site Status

Groupe Hospitalier Mutualiste de Grenoble

Grenoble, , France

Site Status

Hôpital La Timone, Service Cardiologie

Marseille, , France

Site Status

Hôpital Privé Jacques Cartier

Massy, , France

Site Status

CHU de Nîmes

Nîmes, , France

Site Status

Hôpital Cochin

Paris, , France

Site Status

Klinik für Kardiologie und Angiologie II, Herz-Zentrum Bad Krozingen

Bad Krozingen, , Germany

Site Status

Kerckhoff-Klinik GmbH Abteilung Kardiologie/Herzchirurgie

Bad Nauheim, , Germany

Site Status

Herzzentrum, Segeberger Kliniken GmbH

Bad Segeberg, , Germany

Site Status

Charite Berlin, Department of Cardiology, Campus Benjamin Franklin

Berlin, , Germany

Site Status

Helios Amper-Klinikum Dachau, Dept. of Cardiology & Pneumology

Dachau, , Germany

Site Status

Elisabeth Krankenhaus Essen

Essen, , Germany

Site Status

121/ MVZ Hamburg, DEU

Hamburg, , Germany

Site Status

UKSH, Campus Kiel, Department of Cardiology

Kiel, , Germany

Site Status

Heart Center Leipzig

Leipzig, , Germany

Site Status

Universitaetsklinikum Tubingen, DEU

Tübingen, , Germany

Site Status

Schwarzwald Baar Klinikum Villingen-Schwenningen GmbH

Villingen-Schwenningen, , Germany

Site Status

Madras Medical Mission

Chennai, , India

Site Status

Krishna Institute of Medical Sciences

Secunderabad, , India

Site Status

National University of Ireland, Galway Galway University Hospital

Galway, , Ireland

Site Status

IRCCS - Policlinico San Donato

San Donato Milanese, Milano, Italy

Site Status

GVM - Cotignola

Cotignola, Ravenna, Italy

Site Status

Fondazione Poliambulanza di Brescia

Brescia, , Italy

Site Status

P.O. G. Rodolico

Catania, , Italy

Site Status

075/ Magna Graecia University

Catanzaro, , Italy

Site Status

Casa di Cura Montevergine

Mercogliano, , Italy

Site Status

Istituto Sant'Ambrogio

Milan, , Italy

Site Status

San Carlo Clinic

Milan, , Italy

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San Raffaele Hospital

Milan, , Italy

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133/Clinica Mederranea

Napoli, , Italy

Site Status

Division of Cardiology, University of Campania "Luigi Vanvitelli"

Napoli, , Italy

Site Status

156/ Policlinico San Matteo

Pavia, , Italy

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Ospedale degli infermi

Rivoli, , Italy

Site Status

Azienda Ospedaliera San Camillo Forlanini

Roma, , Italy

Site Status

Policlinico Umberto I, "Sapienza" University of Rome Dept.of Cardiovascular, Respiratory, Nephrologic & Anesthesiologic Sciences

Roma, , Italy

Site Status

Institut Jantung Negara

Kuala Lumpur, , Malaysia

Site Status

Instituto nacional de cardiologia ignacio chavez

Mexico City, , Mexico

Site Status

Grupo Intervención San Luis - Hospital de Especialidades de la Salud - San Luis Potosí City

San Luis Potosí City, , Mexico

Site Status

IMSS Hospital de Especialidades UMAE 71

Torreón, , Mexico

Site Status

Amsterdam UMC

Amsterdam, , Netherlands

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Maasstad Hospital

Rotterdam, , Netherlands

Site Status

XII Oddział Kardiologiczny PAKS w Bełchatowie

Bełchatów, , Poland

Site Status

Polsko-Amerykańskie Kliniki Serca III Oddział Kardiologii Inwazyjnej, Angiologii i Elektrokardiologii

Bielsko-Biala, , Poland

Site Status

MCSN AHoP Chrzanow

Chrzanów, , Poland

Site Status

Zgierskie Centrum Kardiologii Med-Pro Polsko-Amerykańskie Kliniki Serca

Dąbrowa Górnicza, , Poland

Site Status

American Heart of Poland

Kędzierzyn-Koźle, , Poland

Site Status

University Hospital Krakow

Krakow, , Poland

Site Status

Miedziowe Centrum Zdrowia SA

Lubin, , Poland

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Nyskie Centrum Kardiologiczne Polsko-Amerykańskich Klinik Serca w Nysie

Nysa, , Poland

Site Status

Centrum Kardiologii Inwazyjnej, Elektroterapii i Angiologii w Pińczowie

Pińczów, , Poland

Site Status

Szpital Kliniczny Przemienienia Pańskiego

Poznan, , Poland

Site Status

Oddział Kardiologii Szpitale Polskie Sztum

Sztum, , Poland

Site Status

X Department of Invasive Cardiology, Tychy American Heart of Poland SA

Tychy, , Poland

Site Status

I Oddział Kardiologii AHoP

Ustroń, , Poland

Site Status

Department of Interventional Cardiology Med-Pro American Heart of Poland

Zgierz, , Poland

Site Status

Changi General Hospital

Singapore, , Singapore

Site Status

Gachon University Gil Medical Center

Incheon, , South Korea

Site Status

Örebro Univ. Hospital, Dpt. of cardiology

Örebro, , Sweden

Site Status

Uppsala University hosp

Uppsala, , Sweden

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Cardiocentro Ticino

Lugano, , Switzerland

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Hôpital de La Tour

Meyrin, , Switzerland

Site Status

Triemli Hospital

Zurich, , Switzerland

Site Status

University Hospital Zürich

Zurich, , Switzerland

Site Status

National Cheng Kung University Hospital

Tainan City, , Taiwan

Site Status

Mackay Memorial Hospital

Taipei, , Taiwan

Site Status

Belfast Health and Social Care Trust

Belfast, , United Kingdom

Site Status

Royal blackburn hospital

Blackburn, , United Kingdom

Site Status

The Royal Bournemouth Hospital

Bournemouth, , United Kingdom

Site Status

Brighton & Sussex University NHS Hospitals Trust

Brighton, , United Kingdom

Site Status

Golden Jubilee National Hospital

Clydebank, , United Kingdom

Site Status

Craigavon Area Hospital

Craigavon, , United Kingdom

Site Status

Ninewells Hospital

Dundee, , United Kingdom

Site Status

King's College Hospital NHS Foundation Trust

London, , United Kingdom

Site Status

Royal Free Hopsital

London, , United Kingdom

Site Status

Freeman Hospital

Newcastle upon Tyne, , United Kingdom

Site Status

Worcestershire Acute NHS Trust, Worcestershire Royal Hospital

Worcester, , United Kingdom

Site Status

Countries

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Australia Austria Bangladesh Belgium Brazil Czechia France Germany India Ireland Italy Malaysia Mexico Netherlands Poland Singapore South Korea Sweden Switzerland Taiwan United Kingdom

References

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International Diabetes Federation 2015. IDF DIABETES ATLAS Seventh Edition. 2015; ISBN: 978-2-930229-81-2

Reference Type BACKGROUND

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Kufner S, Byrne RA, Dommasch M, Massberg S, Schoemig A, Kastrati A. Comparison of "limus"-eluting stents with permanent-vs biodegradable polymer in patients with diabetes mellitus with coronary artery disease. Eur Heart J 2012; 33: 558-9

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Popma JJ, Leon MB, Moses JW, Holmes DR Jr, Cox N, Fitzpatrick M, Douglas J, Lambert C, Mooney M, Yakubov S, Kuntz RE; SIRIUS Investigators. Quantitative assessment of angiographic restenosis after sirolimus-eluting stent implantation in native coronary arteries. Circulation. 2004 Dec 21;110(25):3773-80. doi: 10.1161/01.CIR.0000150331.14687.4B. Epub 2004 Dec 13.

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Mulukutla SR, Vlachos HA, Marroquin OC, Selzer F, Holper EM, Abbott JD, Laskey WK, Williams DO, Smith C, Anderson WD, Lee JS, Srinivas V, Kelsey SF, Kip KE. Impact of drug-eluting stents among insulin-treated diabetic patients: a report from the National Heart, Lung, and Blood Institute Dynamic Registry. JACC Cardiovasc Interv. 2008 Apr;1(2):139-47. doi: 10.1016/j.jcin.2008.02.005.

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Stenestrand U, James SK, Lindback J, Frobert O, Carlsson J, Schersten F, Nilsson T, Lagerqvist B; SCAAR/SWEDEHEART study group. Safety and efficacy of drug-eluting vs. bare metal stents in patients with diabetes mellitus: long-term follow-up in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Eur Heart J. 2010 Jan;31(2):177-86. doi: 10.1093/eurheartj/ehp424. Epub 2009 Nov 10.

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Maeng M, Jensen LO, Galloe AM, Thayssen P, Christiansen EH, Hansen KN, Helqvist S, Botker HE, Lassen JF, Thuesen L. Comparison of the sirolimus-eluting versus paclitaxel-eluting coronary stent in patients with diabetes mellitus: the diabetes and drug-eluting stent (DiabeDES) randomized angiography trial. Am J Cardiol. 2009 Feb 1;103(3):345-9. doi: 10.1016/j.amjcard.2008.09.084. Epub 2008 Nov 12.

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Dibra A, Kastrati A, Mehilli J, Pache J, Schuhlen H, von Beckerath N, Ulm K, Wessely R, Dirschinger J, Schomig A; ISAR-DIABETES Study Investigators. Paclitaxel-eluting or sirolimus-eluting stents to prevent restenosis in diabetic patients. N Engl J Med. 2005 Aug 18;353(7):663-70. doi: 10.1056/NEJMoa044372. Epub 2005 Aug 16.

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Stone GW, Midei M, Newman W, Sanz M, Hermiller JB, Williams J, Farhat N, Mahaffey KW, Cutlip DE, Fitzgerald PJ, Sood P, Su X, Lansky AJ; SPIRIT III Investigators. Comparison of an everolimus-eluting stent and a paclitaxel-eluting stent in patients with coronary artery disease: a randomized trial. JAMA. 2008 Apr 23;299(16):1903-13. doi: 10.1001/jama.299.16.1903.

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Grube E, Chevalier B, Guagliumi G, Smits PC, Stuteville M, Dorange C, Papeleu P, Kaul U, Dzavik V. The SPIRIT V diabetic study: a randomized clinical evaluation of the XIENCE V everolimus-eluting stent vs the TAXUS Liberte paclitaxel-eluting stent in diabetic patients with de novo coronary artery lesions. Am Heart J. 2012 May;163(5):867-875.e1. doi: 10.1016/j.ahj.2012.02.006. Epub 2012 Apr 11.

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Garcia-Garcia HM, McFadden EP, Farb A, Mehran R, Stone GW, Spertus J, Onuma Y, Morel MA, van Es GA, Zuckerman B, Fearon WF, Taggart D, Kappetein AP, Krucoff MW, Vranckx P, Windecker S, Cutlip D, Serruys PW; Academic Research Consortium. Standardized End Point Definitions for Coronary Intervention Trials: The Academic Research Consortium-2 Consensus Document. Eur Heart J. 2018 Jun 14;39(23):2192-2207. doi: 10.1093/eurheartj/ehy223.

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Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD; Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). J Am Coll Cardiol. 2018 Oct 30;72(18):2231-2264. doi: 10.1016/j.jacc.2018.08.1038. Epub 2018 Aug 25. No abstract available.

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Lansky AJ, Messe SR, Brickman AM, Dwyer M, van der Worp HB, Lazar RM, Pietras CG, Abrams KJ, McFadden E, Petersen NH, Browndyke J, Prendergast B, Ng VG, Cutlip DE, Kapadia S, Krucoff MW, Linke A, Moy CS, Schofer J, van Es GA, Virmani R, Popma J, Parides MK, Kodali S, Bilello M, Zivadinov R, Akar J, Furie KL, Gress D, Voros S, Moses J, Greer D, Forrest JK, Holmes D, Kappetein AP, Mack M, Baumbach A. Proposed Standardized Neurological Endpoints for Cardiovascular Clinical Trials: An Academic Research Consortium Initiative. J Am Coll Cardiol. 2017 Feb 14;69(6):679-691. doi: 10.1016/j.jacc.2016.11.045.

Reference Type RESULT
PMID: 28183511 (View on PubMed)

Mehran R, Rao SV, Bhatt DL, Gibson CM, Caixeta A, Eikelboom J, Kaul S, Wiviott SD, Menon V, Nikolsky E, Serebruany V, Valgimigli M, Vranckx P, Taggart D, Sabik JF, Cutlip DE, Krucoff MW, Ohman EM, Steg PG, White H. Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the Bleeding Academic Research Consortium. Circulation. 2011 Jun 14;123(23):2736-47. doi: 10.1161/CIRCULATIONAHA.110.009449. No abstract available.

Reference Type RESULT
PMID: 21670242 (View on PubMed)

Other Identifiers

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COMED.CT.DES.001

Identifier Type: -

Identifier Source: org_study_id

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