PROVIDENCE:Prevention of Restenosis With Oral Rosiglitazone and the Vision Stent in Diabetics With Coronary Lesions

The recruitment status of this study is unknown because the information has not been verified recently.
Verified May 2007 by Gold, Herman K., MD.
Recruitment status was  Active, not recruiting
Sponsor:
Collaborator:
Guidant Corporation
Information provided by:
Gold, Herman K., MD
ClinicalTrials.gov Identifier:
NCT00116792
First received: June 30, 2005
Last updated: May 15, 2007
Last verified: May 2007
  Purpose

We hypothesize that the combination of the thin-strut MULTI-LINK (i.e. VISION(tm) and/or MINI-VISION(tm)) stent and pharmacologic therapy with the oral PPAR-gamma agonist rosiglitazone will significantly reduce restenosis after intracoronary stenting in type 2 diabetic patients. This approach would present a more effective and economical alternative to the use of drug-eluting stents to reduce stent restenosis.


Condition Intervention Phase
Coronary Artery Disease
Diabetes Mellitus
Procedure: Percutaneous Coronary Intervention (PCI)
Phase 2
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Double-Blind
Primary Purpose: Prevention
Official Title: PROVIDENCE: Prevention of Restenosis With Oral Rosiglitazone and the Vision Stent in Diabetics With de Novo Coronary Lesions

Resource links provided by NLM:


Further study details as provided by Gold, Herman K., MD:

Primary Outcome Measures:
  • In-stent and In-segment late lumen loss

Secondary Outcome Measures:
  • In-stent mean percent diameter stenosis (%DS) and binary restenosis as measured by QCA at post-procedure and at 8 months
  • TLR and TVR at 30 days, and 8 months post procedure
  • TVF defined as cardiac death, MI, or TVR at 30 days, 8 months and l year post-procedure
  • Composite of Major Adverse Cardiac Events (MACE)
  • The association of metabolic factors and inflammatory indices including glycemia (HgbA1C), diabetic therapy other than TZDs, HSCRP, coagulation (PAI-1, FIB) and inflammatory marker levels (ADI, MPO, &MMP-9) with the risk for restenosis
  • Target HgbA1C≤7 for all patients enrolled
  • Coronary artery stenosis progression in at least one non-stented lesion
  • Coronary artery stenosis regression in at least one non-stented lesion
  • Culprit (i.e. stented artery) artery stenosis progression/regression by intravascular ultrasound (IVUS)
  • (There are 3 more secondary endpoints not listed here.)

Estimated Enrollment: 120
Study Start Date: March 2004
  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • The patients must be >18 years of age;
  • Patients must be previously diagnosed with type 2 diabetes with documented treatment with insulin, oral hypoglycemics, or diet controlled by medical history. (Undocumented or newly diagnosed diabetics must fulfill the American Diabetes Association Criteria-Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (Diabetes Care 2003;26:S5-20)).
  • Diagnosis of angina pectoris defined by Canadian Cardiovascular Society Classification (CCS I, II, III, IV) OR unstable angina pectoris (Braunwald Classification B&C, I-II-III) OR patients with documented silent ischemia;
  • Treatment of lesions in native coronary arteries requiring stenting. A total of two separate lesions can be stented, located either in the same vessel (at least 10 mm or 1 cm apart) or in two separate vessels. Additional stents may be used for procedural complications such as dissections.
  • Patient is willing to comply with the specified follow-up evaluation;
  • Patient must provide written informed consent prior to the procedure using a form that is approved by the local Institutional Review Board.
  • Target lesion is ≥2.0 mm to ≤3.5mm in diameter (visual estimate);
  • Individual lesions are ≤25 mm in length located in a native coronary artery;
  • Target lesions are de novo lesions in native coronary vessels;
  • Target lesion stenosis is ≥50% and <100% (visual estimate);

Exclusion Criteria:

  • Patient has experienced an ST-segment elevation myocardial infarction within the preceding 24 hours.
  • Ejection fraction ≤40%; class III-IV CHF
  • Active liver disease (ALT>2.5 times upper limit of normal)
  • Woman of child-bearing potential unless demonstrated 1) negative pregnancy test and 2) clear intention of an accepted method of contraception for eight months after enrollment
  • Totally occluded vessel (TIMI 0 grade flow);
  • Impaired renal function (creatinine ≥2.5 mg/dL);
  • Target lesion involves bifurcation including a side branch ≥2.5 mm in diameter (either stenosis of both main vessel and major branch or stenosis of just major branch) that would require side branch stenting which is likely to occur if side branch is diseased and intended to be stented;
  • Previous brachytherapy of target vessel;
  • Recipient of heart transplant;
  • Patient with a life expectancy less than 12 months;
  • Known allergies to cobalt, chromium, nickel, aspirin, clopidogrel bisulfate (Plavix®) and/or ticlopidine (Ticlid®), heparin, and/or rosiglitazone (Avandia®), that cannot be medically managed;
  • Any significant medical condition which in the investigator’s opinion may interfere with the patient’s optimal participation in the study;
  • Currently participating in an investigational drug or another device study;
  • Any contraindication to glycoprotein IIb/IIIa inhibitor therapy;
  • Current use of any TZD, i.e. rosiglitazone (Avandia®) or pioglitazone (Actos®)
  • Chronic or relapse/remitting hemolytic condition
  • Unprotected left main coronary disease with >50% stenosis;
  • Patients admitted for treatment of diabetic ketoacidosis >2 times in the past six months (brittle diabetics) and/or the suspicion of type I diabetes;
  • Target lesion is in a saphenous venous graft or internal mammary graft;
  • Target lesion is due to restenosis
  • 3 vessel coronary artery disease defined as ≥70% ischemia producing lesions in 3 different epicardial coronary arteries all requiring revascularization (i.e. main left main equivalent)
  Contacts and Locations
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, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00116792

Locations
United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
Sponsors and Collaborators
Gold, Herman K., MD
Guidant Corporation
Investigators
Principal Investigator: Herman K Gold, MD Massachusetts General Hospital
  More Information

No publications provided

ClinicalTrials.gov Identifier: NCT00116792     History of Changes
Other Study ID Numbers: 2003P-001717
Study First Received: June 30, 2005
Last Updated: May 15, 2007
Health Authority: United States: Food and Drug Administration

Keywords provided by Gold, Herman K., MD:
CAD
Diabetes Mellitus
Restenosis
ppar gamma
glitazone

Additional relevant MeSH terms:
Coronary Artery Disease
Coronary Disease
Diabetes Mellitus
Myocardial Ischemia
Arterial Occlusive Diseases
Arteriosclerosis
Cardiovascular Diseases
Endocrine System Diseases
Glucose Metabolism Disorders
Heart Diseases
Metabolic Diseases
Vascular Diseases
Rosiglitazone
Hypoglycemic Agents
Pharmacologic Actions
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on October 23, 2014