Drug-eluting Stents to Treat Unprotected Coronary Left Main Disease (LEFT-MAIN-2)
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Purpose
The purpose of this study is to evaluate the efficacy of two different drug-eluting stents (Everolimus and Zotarolimus-eluting) for treatment of unprotected left main coronary artery disease.
| Condition | Intervention | Phase |
|---|---|---|
|
Coronary Disease |
Device: Everolimus-eluting stent (Xience) Device: Zotarolimus-eluting stent (Endeavor Resolute) |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Prospective Randomized Trial of Everolimus- and Zotarolimus-eluting Stents for Treatment of Unprotected Left Main Coronary Artery Disease: ISAR-LEFT-MAIN-2 |
- Incidence of major adverse cardiac event (MACE) defined as a composite of death, myocardial infarction and target lesion revascularization. [ Time Frame: 1 year follow-up ] [ Designated as safety issue: No ]
- Angiographic restenosis at follow-up coronary angiography. [ Time Frame: 6-9 months follow-up ] [ Designated as safety issue: No ]
| Enrollment: | 650 |
| Study Start Date: | December 2007 |
| Estimated Study Completion Date: | September 2012 |
| Estimated Primary Completion Date: | September 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: EES
Everolimus-eluting stent (Xience)
|
Device: Everolimus-eluting stent (Xience)
stent is implanted due to randomization
Other Name: Xience
|
|
Experimental: ZES
Zotarolimus-eluting stent (Endeavor Resolute)
|
Device: Zotarolimus-eluting stent (Endeavor Resolute)
stent is implanted due to randomization
Other Name: Endeavor Resolute
|
Detailed Description:
Restenosis in the left main coronary artery may have severe consequences given the large proportion of the myocardium compromised in this condition, and, in several studies, it has been linked to the 6-month mortality after the index procedure. Drug-eluting stents have reduced the restenosis rate and the need for target vessel revascularization not only in simple lesion but also in high risk subsets of patients and lesions such as diabetics, long lesions or bifurcations. There are no data about their efficacy in left main coronary artery disease. Thus, the aim of this study is to investigate the performance of two different drug-eluting stents (Everolimus and Zotarolimus-eluting) in left main coronary lesions.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients older than age 18 with ischemic symptoms or evidence of myocardial ischemia in the presence of ≥ 50 % stenosis located in unprotected LMCA who are unable to undergo CABG because of cardiac surgeons' refusal (poor surgical candidates) or their own unwillingness.
- Pretreatment with a loading dose of 600 mg clopidogrel.
- Informed, written consent by the patients or her/his legally-authorized representative for participation in the study.
Exclusion Criteria:
- Cardiogenic shock.
- ST-segment elevation acute myocardial infarction (ST-segment ≥ 0.1 mV elevation in ≥ 2 contiguous ECG leads persisting for at least 20 minutes) within 48 hours from symptom onset.
- In-stent restenosis.
- Malignancies or other comorbid conditions with life expectancy less than one year or that may result in protocol non-compliance.
- Prior coronary artery bypass surgery with revascularization of LAD and/or LCx.
- Planned staged PCI procedure within 30 days from index procedure or prior PCI within the last 30 days.
- An elective surgical procedure is planned that would necessitate interruption of clopidogrel during the first six months post enrollment.
- Known allergy to the study medications: aspirin, clopidogrel, UHF; sirolimus, paclitaxel; true anaphylaxis after prior exposure to contrast media.
- Pregnancy (present, suspected or planned).
- Patient's inability to fully cooperate with the study protocol.
Contacts and Locations| Germany | |
| Bad Segeberger Kliniken | |
| Bad Segeberg, Germany | |
| Deutsches Herzzentrum Muenchen | |
| Munich, Germany, 80636 | |
| First Medizinische Klinik, Klinikum rechts der Isar | |
| Munich, Germany, 81675 | |
| Italy | |
| Azienda Ospedaliero Universitaria di Ferrara | |
| Ferrara, Italy, 44100 | |
| Study Chair: | Adnan Kastrati, MD | Deutsches Herzzentrum Muenchen |
| Principal Investigator: | Julinda Mehill, MD | Deutsches Herzzentrum Muenchen |
More Information
Publications:
| Responsible Party: | Deutsches Herzzentrum Muenchen |
| ClinicalTrials.gov Identifier: | NCT00598637 History of Changes |
| Other Study ID Numbers: | GE IDE No. S02807 |
| Study First Received: | January 10, 2008 |
| Last Updated: | January 3, 2012 |
| Health Authority: | Germany: German Institute of Medical Documentation and Information |
Keywords provided by Deutsches Herzzentrum Muenchen:
|
drug eluting stent left main disease |
Additional relevant MeSH terms:
|
Coronary Artery Disease Coronary Disease Myocardial Ischemia Heart Diseases Cardiovascular Diseases Arteriosclerosis Arterial Occlusive Diseases Vascular Diseases Everolimus Sirolimus |
Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Antibiotics, Antineoplastic Antineoplastic Agents Therapeutic Uses Antifungal Agents Anti-Infective Agents Anti-Bacterial Agents |
ClinicalTrials.gov processed this record on May 16, 2013