Comparison One vs Six Months of Dual Antiplatelet Therapy After Implanted Firehawk TM Stent in High Bleeding Risk Patients With Coronary Artery Disease

Last updated: September 8, 2020
Sponsor: Shanghai MicroPort Medical (Group) Co., Ltd.
Overall Status: Active - Recruiting

Phase

4

Condition

Coronary Artery Disease

Cardiac Disease

Vascular Diseases

Treatment

N/A

Clinical Study ID

NCT03287167
TARGET SAFE
  • Ages > 18
  • All Genders

Study Summary

This study is to assess the clinical non-inferiority of 1 month (short-term) vs 6 months (long-term) of dual anti-platelet therapy in patients undergoing percutaneous intervention implanted sirolimus -eluting stent with abluminal grooves containing a biodegradable polymer in High Bleeding Risk patients with coronary artery disease.

Eligibility Criteria

Inclusion

General Inclusion Criteria:

  • Age ≥ 18 years;

  • Subjects (or legal guardians) understand the testing requirements and procedures, andprovide written informed consent;

  • Subjects could undergo percutaneous coronary intervention (PCI);

  • Subjects have symptomatic coronary artery disease or have confirmed asymptomaticischemia;

  • Subjects are eligible candidates for coronary artery bypass graft surgery (CABG);

  • Left ventricular ejection fraction (LVEF) within 60 days ≥ 30%;

  • Subjects were willing to accept the trial plan calls for all subsequent evaluations;

  • Subjects can endure 6 months dual anti-platelet therapy, and met one or more criteriaas the following:

1.Age ≥ 75years; 2.Subjects with hemoglobin<10g/dL, or subjects received transfusiontherapy 4 weeks ago; 3.Subjects with renal insufficiency (eGFR < 60 ml / min); 4.Subjects with HAS-BLED score ≥3.0; 5.Femal patients with acute cononary syndrome; 6.BMI < 18.5 Kg/M2; 7.Subjects with congestive heart failure and with LVEF30%-50%; 8.Subjects had a history of hospitalization due to bleeding; 9.Subjects withthrombocytopenia (platelet < 100,000 / mm3); 10.Subjects had a histroy of intracranialhemorrhage; 11.Subjects had a histroy of intracranial ischemia stroke in 6 months; 12.Subjects plan to receive non-steroidal anti-inflammatory or steroid treatment formore than 30 days after the baseline PCI; 14.Subjects were expected to receiveadditional treatment after PCI and cannot undergo long-term DAPT therapy; 15.Subjectshad a history of stomach ulcers or active ulcers. Angiographic Inclusion Criteria

  • Target lesions must be new and have a visually estimated reference diameter ≥2.25 mmand ≤4.0 mm in autologous coronary artery;

  • Target lesions must be moderate-severe calcification;

  • No limitations in target lesion length and number, and the number of implanted stentsis less than 4;

  • ALL target lesion must be able to successfully expand and implant Firehawk™ stent.

Exclusion

Clinical Exclusion Criteria:

  • Subjects recently suffer from MI (within 4 week) and ECG changes/clinical symptomsconsistent with AMI, or accompanied with increased cardiac biomarkers (CK-MB, CK, TNTor TNI) and at least one of the following :
  1. CK-MB> 3ULN, regardless of the value of total CK;

  2. If CK-MB or CK was not detected, but cTN> 1ULN, and at least one of thefollowing:

  3. Ischemic symptoms and ECG changes of new ischemia;

  4. Development of pathologic Q waves in the ECG;

  5. Imaging evidence of new loss of viable myocardium or new regional wallmotion abnormality.

  • Subject had Re-MI before randomized;

  • Subject with hemodynamic instability (Killip class IV);

  • Subjects were detected ventricular aneurysm greater than 3.0*2.0cm or intraventricularthrombosis by cardiac ultrasonography in 30 days;

  • Subjects with Life-threatening arrhythmias;

  • Subjects were expected to receive oral anticoagulation therapy after the baseline PCI;

  • Subjects cannot endure dual anti-platelet therapy for 1 month;

  • Subjects with mechanical complications after myocardial infarction;

  • Subjects had an organ transplant or are waiting for an organ transplant;

  • Subjects are receiving chemotherapy or will receive a chemotherapy within 30 daysafter PCI;

  • Subjects with abnormal counts of white blood cell (WBC);

  • Subjects with verified or suspected acute liver disease, including lab results ofacute liver disease;

  • Subjects had permanent neurological diseases in the past 6 months;

  • Subjects had any PCI (such as balloon angioplasty, stent, cutting balloon) treatmentin target vessels within 12 months prior to baseline;

  • Non-target vessel had been implanted non-research stent 5 months ago before thebaselin PCI.

  • Subjects plan to undergo PCI or CABG within 1 year after the baseline PCI;

  • Subjects have any coronary endovascular brachytherapy treatment previously;

  • Subjects associated with drugs allergy (such as sirolimus, or structure-relatedcompounds fluorinated polymers, thiophenepyridine or aspirin);

  • Subjects are suffering from other serious illness (such as cancer, congestive heartfailure), which may cause drop in life expectancy to less than 12 months;

  • Subjects are currently abusing drugs (such as alcohol, cocaine, heroin, etc);

  • Subject plan to undergo any operations that may lead to confuse with the programme;

  • Subjects were participating in another study of drug or medical device which did notmeet its primary endpoint;

  • Subjects plan to pregnant within 12 months after baseline;

  • Subjects are pregnant or breastfeeding women. Angiographic Exclusion Criteria (visual estimate):

  • Target lesions with the following criteria: left main, saphenous vein grafts orarterial grafts, via saphenous vein grafts or arterial graft, more than 4 stents havebeen implanted and in-stent sestenosis;

  • Subjects with unprotected left main coronary artery disease (diameter stenosis >50%);

  • Subjects have a protected left main coronary artery disease (diameter stenosis> 50%and left coronary artery bypass surgery), as well as target lesions located in the LADand LCX;

  • Subjects with other lesions of clinical significance, may be need intervention within 12 months after baseline.

Study Design

Total Participants: 1720
Study Start date:
June 01, 2019
Estimated Completion Date:
July 30, 2023

Study Description

This is a prospective, double -blind,multi-center,randomized controlled trial. Approximately 1,720 subjects in high bleeding risk with coronary artery disease will be enrolled in no more than 40 research centers in China. All participants met the inclusion criteria will be 1:1 randomized to 1 month or 6months of DAPT after implanting Firehawk™ coronary stent. Clinical follow-up will be carried out at 30 days, 6 months, 12 months, 2 years after index procedure.The primary study endpoint is Net Adverse Clinical and Cerebral Events (NACCE), a composite of all-cause death, myocardial infarction (MI), cerebral vascular accident (CVA) and major bleeding ([BARC] definition) at 12 months. Subjects that complete of 12 months follow-up will be regarded as having completed the primary endpoint. The secondary study endpoints contain cost-effectiveness at 12 months, ARC defined stent thrombosis (ST) ; NACCE ;major adverse cardiovascular events (MACE),major adverse cardiovascular and cerebral events (MACCE),target lesion revascularization (TLR),target vessel failure(TVF) , major bleeding at 30 days,6,12 and 24 months of follow-up.

Connect with a study center

  • The General Hospital of Shenyang Military

    Shenyang, Liaoning
    China

    Active - Recruiting

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