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DUrable Polymer-based STent CHallenge of Promus ElemEnt Versus ReSolute Integrity (DUTCHPEERS)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02175706
Recruitment Status : Unknown
Verified February 2017 by Clemens von Birgelen, Thorax Centrum Twente.
Recruitment status was:  Active, not recruiting
First Posted : June 26, 2014
Last Update Posted : February 3, 2017
Information provided by (Responsible Party):
Clemens von Birgelen, Thorax Centrum Twente

Brief Summary:


The introduction of drug-eluting stents (DES) in the treatment of coronary artery disease has led to a significant reduction in morbidity but there are further demands on DES performance. Such demands are an optimized performance in very challenging coronary lesions; third generation DES were developed in an effort to further improve DES performance in such challenging lesions. Two CE-certified third generation DES (Resolute Integrity and Promus Element stents) are currently available; there are no data that indicate an advantage of one of these DES over the other.


To investigate whether the clinical outcome is similar after implantation of the Promus Element versus the Resolute Integrity stent (non-inferiority hypothesis).

Study design:

Multicenter, prospective, randomized single-blinded study.

Study population:

Patients who require percutaneous coronary interventions (PCI) for the treatment of coronary stenoses with an indication for DES use, according to current guidelines and/or the operators clinical judgement. All clinical syndromes will be included.


In patients who are eligible for DES implantation, the type of DES implanted will be randomized (Resolute Integrity stent versus Promus Element stent). At the start of the study, both DES will also be used in routine clinical practice.

Main study endpoints:

The primary endpoint is the incidence of target vessel failure at one year follow-up. Target vessel failure (TVF) is a composite endpoint consisting of cardiac death, target vessel MI, or clinically driven target vessel revascularization. Further secondary clinical and angiographic endpoints will be investigated, defined in accordance with suggestions of the Academic Research Consortium (ARC). Of note, the angiographic assessment is based on clinically indicated projections only and results in no additional x-ray exposure. There is no routine angiographic follow-up. If angiographic data are available in patients who undergo symptom-driven re-catheterization, we will analyze these data to get insight into the mechanisms of potential DES restenosis.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Patients will receive the routine clinical treatment. As a consequence, the risks of this trial do not exceed the risks of any routine PCI procedure.

Condition or disease Intervention/treatment Phase
Coronary Artery Disease Angina Pectoris Unstable Angina Pectoris Acute Coronary Syndrome Coronary Stenosis Coronary Restenosis Device: Resolute Integrity® Device: Promus Element® Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 1811 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Treatment
Official Title: DUrable Polymer-based STent CHallenge of Promus ElemEnt Versus ReSolute Integrity (DUTCH PEERS): Randomized Multicenter Trial in All-Comers Population Treated Within Eastern NeThErlands-2 (TWENTE-2).
Study Start Date : November 2010
Actual Primary Completion Date : May 2013
Estimated Study Completion Date : June 2017

Arm Intervention/treatment
Active Comparator: Resolute Integrity®
The coating of Resolute Integrity consists of zotarolimus as antiproliferative agent and the BioLinx® polymer system. This polymer system consists of a blend of three different polymers: (1) the hydrophobic C10 polymer, which aids in the control of drug release; (2) the hydrophilic C19 polymer, which supports biocompatibility; and (3) polyvinyl pyrro-lidinone, which increases the initial drug burst and enhances the elution rate.
Device: Resolute Integrity®
Biolinx-zotarolimus coating on a chobalt-cromium alloy stent platform that has a novel sinusoidal design.
Other Name: Resolute Integrity® drug eluting stent

Active Comparator: Promus Element®

Promus Element utilizes everolimus, which has been shown to reduce tissue proliferation in the coronary vessels following stent implantation.

Promus Element is composed of the Element platform, a thin fluoropolymer coating, and Everolimus.

Device: Promus Element®
fluoropolymer-everolimus coating on a novel stent platform made from a platinum-chromium alloy
Other Name: Promus Element® drug eluting stent

Primary Outcome Measures :
  1. Target-vessel failure (TVF) [ Time Frame: 1 year ]

    Components of the primary endpoint in hierarchical order:

    1. Cardiac death. All deaths are considered cardiac, unless an unequivocal non-cardiac cause can be established;
    2. Target vessel related MI that is Q-wave or non-Q-wave myocardial infarction that can be related to the target vessel or cannot be related to another vessel;
    3. Clinically driven repeated target vessel revascularization by means of CABG or PCI.

Secondary Outcome Measures :
  1. Death at 1 and 2 year follow-up [ Time Frame: 1 and 2 year ]
    Death distinguished into: cardiac, vascular, other causes, all-cause mortality

  2. Myocardial infarction at 1 and 2 year follow-up [ Time Frame: 1 and 2 year ]
    Myocardial infarction distinguished into Q-wave and non-Q-wave myocardial infarction

  3. Revascularization at 1 and 2 year follow-up [ Time Frame: 1 and 2 year ]
    Target-vessel revascularization distinguished into PCI or CABG

  4. Stent thrombosis at 1 and 2 year follow-up [ Time Frame: 1 and 2 year ]
    Stent thrombosis was distinguished into definite, probable and possible according to the Academic Research Consortium (ARC) definition.

Other Outcome Measures:
  1. Longitudinal stent deformation [ Time Frame: 1 year ]
    Identification of deformation of a stent in the longitudinal axis during coronary angiographic assessment.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Minimum age of 18 years;
  • Coronary artery disease and lesion(s) eligable for treatment with drug eluting stents according to clinical guidelines and/or the operators' judgement;
  • Patient is willing and able to cooperate with study procedures and required follow-up visits; and patient has been informed and agrees on the participation by signing an EC approved written informed consent.

Exclusion Criteria:

  • Participation in another randomized drug or device study before reaching primary endpoint;
  • Planned surgery within 6 months of PCI unless dual antiplatelet therapy is maintained throughout the peri-surgical period;
  • Intolerance to aspirin, clopidogrel or ticlopidin, heparin, or components of the two DES examined;
  • Known pregnancy;
  • Life expectancy of less than 1 year.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02175706

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Medisch Centrum Alkmaar
Alkmaar, Netherlands
Ziekenhuis Rijnstate
Arnhem, Netherlands
Scheper Ziekenhuis
Emmen, Netherlands
Medisch Spectrum Twente
Enschede, Netherlands
Sponsors and Collaborators
Thorax Centrum Twente
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Principal Investigator: Clemens von Birgelen, MD,PhD,Prof Thorax Centrum Twente
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Responsible Party: Clemens von Birgelen, Professor, Thorax Centrum Twente Identifier: NCT02175706    
Other Study ID Numbers: 1.6
First Posted: June 26, 2014    Key Record Dates
Last Update Posted: February 3, 2017
Last Verified: February 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Coronary Artery Disease
Acute Coronary Syndrome
Angina Pectoris
Angina, Unstable
Coronary Stenosis
Coronary Restenosis
Coronary Disease
Myocardial Ischemia
Heart Diseases
Cardiovascular Diseases
Arterial Occlusive Diseases
Vascular Diseases
Chest Pain
Neurologic Manifestations
Signs and Symptoms