Rapamycin+Estradiol- vs. Rapamycin-Eluting Stents to Reduce Restenosis (ISAR-PEACE)
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Purpose
The purpose of this study is to evaluate whether adding estradiol to rapamycin better prevents coronary artery reblockage after drug-eluting stent implantation.
| Condition | Intervention | Phase |
|---|---|---|
|
Coronary Heart Disease |
Device: rapamycin plus 17beta estradiolvalerat-eluting stent Device: rapamycin-eluting stent |
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 Rapamycin Plus Estradiol-Eluting Stents Versus Rapamycin-Eluting Stents For The Reduction of Coronary Restenosis (ISAR-PEACE) |
- in-stent late luminal loss [ Time Frame: 6 months ]
- In-segment binary angiographic restenosis [ Time Frame: 1 year ]
- Need of target lesion revascularization [ Time Frame: 1 year ]
- Combined incidence of death or myocardial infarction [ Time Frame: 1 year ]
- Incidence of stent thrombosis. [ Time Frame: 1 year ]
| Enrollment: | 502 |
| Study Start Date: | March 2005 |
| Study Completion Date: | October 2006 |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
rapamycin plus 17beta estradiolvalerat-eluting stent
|
Device: rapamycin plus 17beta estradiolvalerat-eluting stent
rapamycin plus 17beta estradiolvalerat-eluting stent was implanted due to randomisation
|
|
Experimental: 2
rapamycin-eluting stent
|
Device: rapamycin-eluting stent
rapamycin-eluting stent was implanted due to randomisation
|
Detailed Description:
Coronary artery reblockage remains still a drawback of percutaneous coronary interventions even in the era of drug-eluting stents (DES). DESs working principle consists of the delivery of controlled amounts of antiproliferative agents at the local level, which results in the suppression of neontimal proliferation, the main cause of lumen re-narrowing after stent implantation. At present, several DES platforms have been developed and evaluated for clinical use. They differ between them with regard to the stent type, anti-proliferative drug, presence or absence of polymers employed for drug storage and modification of drug-release kinetics as well as type of polymer used for this purpose. Although their mid-term efficacy has been well-established, there is an ongoing debate on the potential of an increased incidence of late stent thrombosis, particularly after discontinuation of thienopyridine therapy, as well as of delayed onset of restenosis or catch-up phenomenon with DESs. Based on animal and human pathological data, investigators have linked the above-mentioned concerns to the presence of permanent polymers in DESs, which have a proinflammatory and prothrombogenic potential, and sometimes may induce a hypersensitivity reaction. On the other hand, lack of or delayed reendothelialization is considered an important factor for development of coronary reblockage. Estradiol has been shown to promote rapid reendothelialization of the stent and to reduce the restenosis after PCI. This trial will compare the anti-restenotic efficacy of the polymer-free rapamycin plus 17β estradiolvalerat -eluting stent with that of the polymer-free rapamycin-eluting stent in patients with coronary artery disease. The ISAR stent is a rough surface stainless steel stent which allows coating without the need of polymer (PF ISAR stent) in the cath lab.
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% de novo stenosis located in native coronary vessels.
- Written, informed consent by the patient or her/his legally-authorized representative for participation in the study.
Exclusion Criteria:
- Target lesion located in the left main trunk or bypass graft.
- In-stent restenosis.
- Acute ST-elevation myocardial infarction.
- Cardiogenic shock.
- Malignancies or other comorbid conditions (for example severe liver, renal and pancreatic disease) with life expectancy less than 12 months or that may result in protocol non-compliance.
- Known allergy to the study medications: aspirin, clopidogrel, rapamycin, estradiol, stainless steel.
- Pregnancy (present, suspected or planned) or positive pregnancy test.
- Previous enrollment in this trial.
- Patient's inability to fully cooperate with the study protocol.
Contacts and Locations| Germany | |
| 1. Medizinische Klinik, Klinikum rechts der Isar | |
| Muenchen, Germany, 81675 | |
| Deutsches Herzzentrum Muenchen | |
| Munich, Germany, 80636 | |
| Study Chair: | Albert Schoemig, MD | Deutsches Herzzentrum Muenchen |
| Principal Investigator: | Adnan Kastrati, MD | Deutsches Herzzentrum Muenchen |
More Information
Publications:
| ClinicalTrials.gov Identifier: | NCT00402636 History of Changes |
| Other Study ID Numbers: | GE IDE No. S02505 |
| Study First Received: | November 21, 2006 |
| Last Updated: | November 27, 2007 |
| Health Authority: | Germany: Federal Institute for Drugs and Medical Devices |
Additional relevant MeSH terms:
|
Coronary Artery Disease Myocardial Ischemia Coronary Disease Heart Diseases Cardiovascular Diseases Arteriosclerosis Arterial Occlusive Diseases Vascular Diseases Estradiol Sirolimus Everolimus Estrogens |
Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions Antibiotics, Antineoplastic Antineoplastic Agents Therapeutic Uses Antifungal Agents Anti-Infective Agents Immunosuppressive Agents Immunologic Factors Anti-Bacterial Agents |
ClinicalTrials.gov processed this record on May 22, 2013