XIENCE 28 Global Study
Bleeding Disorder · Stroke, Ischemic · Stroke Hemorrhagic · Hematological Disease · Thrombocytopenia
Bottom Line
View on ClinicalTrials.gov: NCT03355742 ↗Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- XIENCE (Device); DAPT (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Abbott Medical Devices
- Primary completion
- Oct 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants With Composite of Net Adverse Clinical Endpoint (NACE), by Propensity Score Quintiles |
2; 5; 10; 15; 40 | — |
| SECONDARY Number of Participants With Composite of Net Adverse Clinical Endpoint (NACE) |
121 | — |
| SECONDARY Number of Participants With Composite of Net Adverse Clinical Endpoint (NACE) |
121 | — |
| SECONDARY Number of Participants With Stent Thrombosis (ARC Definite/Probable, ARC Definite) |
4 | — |
| SECONDARY Number of Participants With Stent Thrombosis (ARC Definite/Probable, ARC Definite) |
4 | — |
| SECONDARY Number of Participants With Stent Thrombosis (ARC Definite/Probable, ARC Definite) |
4 | — |
| SECONDARY Number of Participants With All Death, Cardiac Death, Vascular Death, Non-cardiovascular Death |
43 | — |
| SECONDARY Number of Participants With All Death, Cardiac Death, Vascular Death, Non-cardiovascular Death |
43 | — |
| SECONDARY Number of Participants With All Death, Cardiac Death, Vascular Death, Non-cardiovascular Death |
43 | — |
| SECONDARY Number of Participants With All Myocardial Infarction (MI) and MI Attributed to Target Vessel (TV-MI, Modified ARC) |
27 | — |
| SECONDARY Number of Participants With All Myocardial Infarction (MI) and MI Attributed to Target Vessel (TV-MI, Modified ARC) |
27 | — |
| SECONDARY Number of Participants With All Myocardial Infarction (MI) and MI Attributed to Target Vessel (TV-MI, Modified ARC) |
27 | — |
| SECONDARY Number of Participants With Composite of Cardiac Death or MI (Modified ARC) |
45 | — |
| SECONDARY Number of Participants With Composite of Cardiac Death or MI (Modified ARC) |
45 | — |
| SECONDARY Number of Participants With Composite of Cardiac Death or MI (Modified ARC) |
45 | — |
| SECONDARY Number of Participants With Composite of All Death or All MI (Modified ARC) |
70 | — |
| SECONDARY Number of Participants With Composite of All Death or All MI (Modified ARC) |
70 | — |
| SECONDARY Number of Participants With Composite of All Death or All MI (Modified ARC) |
70 | — |
| SECONDARY Number of Participants With All Stroke, Ischemic Stroke and Hemorrhagic Stroke |
6 | — |
| SECONDARY Number of Participants With All Stroke, Ischemic Stroke and Hemorrhagic Stroke |
6 | — |
| SECONDARY Number of Participants With All Stroke, Ischemic Stroke and Hemorrhagic Stroke |
6 | — |
| SECONDARY Number of Participants With Clinically-indicated Target Lesion Revascularization (CI-TLR) |
10 | — |
| SECONDARY Number of Participants With Clinically-indicated Target Lesion Revascularization (CI-TLR) |
10 | — |
| SECONDARY Number of Participants With Clinically-indicated Target Lesion Revascularization (CI-TLR) |
10 | — |
| SECONDARY Number of Participants With Clinically-indicated Target Vessel Revascularization (CI-TVR) |
9 | — |
| SECONDARY Number of Participants With Clinically-indicated Target Vessel Revascularization (CI-TVR) |
9 | — |
| SECONDARY Number of Participants With Clinically-indicated Target Vessel Revascularization (CI-TVR) |
9 | — |
| SECONDARY Number of Participants With Target Lesion Failure (TLF, Composite of Cardiac Death, TV-MI and CI-TLR) |
42 | — |
| SECONDARY Number of Participants With Target Lesion Failure (TLF, Composite of Cardiac Death, TV-MI and CI-TLR) |
42 | — |
| SECONDARY Number of Participants With Target Lesion Failure (TLF, Composite of Cardiac Death, TV-MI and CI-TLR) |
42 | — |
| SECONDARY Number of Participants With Target Vessel Failure (TVF, a Composite of Cardiac Death, TV-MI and CI-TVR) |
44 | — |
| SECONDARY Number of Participants With Target Vessel Failure (TVF, a Composite of Cardiac Death, TV-MI and CI-TVR) |
44 | — |
| SECONDARY Number of Participants With Target Vessel Failure (TVF, a Composite of Cardiac Death, TV-MI and CI-TVR) |
44 | — |
| SECONDARY Number of Participants With Bleeding Defined by the Bleeding Academic Research Consortium (BARC) Type 2-5 and Type 3-5 |
44; 20 | — |
| SECONDARY Number of Participants With Bleeding Defined by the BARC, Type 2-5 and Type 3-5 |
19; 7 | — |
| SECONDARY Number of Participants With Bleeding Defined by BARC, Type 2-5 and Type 3-5 |
61; 27 | — |
Summary
Eligibility Criteria
Inclusion Criteria
- Subject is considered at HBR, defined as meeting one or more of the following criteria at the time of registration and in the opinion of the referring physician, the risk of major bleeding with > 1-month DAPT outweighs the benefit:
- Subjects ≥ 75 years of age.
- Clinical indication for chronic (at least 6 months) or lifelong anticoagulation therapy.
- History of major bleeding which required medical attention within 12 months of the index procedure.
- History of stroke (ischemic or hemorrhagic).
- Renal insufficiency (creatinine ≥ 2.0 mg/dl) or failure (dialysis dependent).
- Systemic conditions associated with an increased bleeding risk (e.g. hematological disorders, including a history of or current thrombocytopenia defined as a platelet count 2 lesions requiring treatment within both the LAD and a diagonal branch in total.
- If there are two target lesions within the same epicardial vessel, the two target lesions must be at least 15 mm apart per visual estimation; otherwise this is considered as a single target lesion.
- Target lesion must be located in a native coronary artery with visually estimated reference vessel diameter between 2.25 mm and 4.25 mm.
- Exclusive use of XIENCE family of stent systems during the index procedure.
- Target lesion has been treated successfully, which is defined as achievement of a final in-stent residual diameter stenosis of 5 minutes, and no ST segment elevation > 0.5mm or depression lasting > 5 minutes.
Exclusion Criteria
- Subject with an indication for the index procedure of acute ST-segment elevation MI (STEMI).
- Subject has a known hypersensitivity or contraindication to aspirin, heparin/bivalirudin, P2Y12 inhibitors (clopidogrel/prasugrel/ticagrelor), everolimus, cobalt, chromium, nickel, tungsten, acrylic and fluoro polymers or contrast sensitivity that cannot be adequately pre-medicated.
- Subject with implantation of another drug-eluting stent (other than XIENCE) within 12 months prior to index procedure.
- Subject has a known left ventricular ejection fraction (LVEF) <30%.
- Subject judged by physician as inappropriate for discontinuation from P2Y12 inhibitor use at 1 month, due to another condition requiring chronic P2Y12 inhibitor use.
- Subject with planned surgery or procedure necessitating discontinuation of P2Y12 inhibitor within 1 month following index procedure.
- Subject with a current medical condition with a life expectancy of less than 12 months.
- Subject intends to participate in an investigational drug or device trial within 12 months following the index procedure.
- Pregnant or nursing subjects and those who plan pregnancy in the period up to 1 year following index procedure. Female subjects of child-bearing potential must have a negative pregnancy test done within 7 days prior to the index procedure per site standard test.
Note: Female subjects of childbearing potential should be instructed to use safe contraception (e.g., intrauterine devices, hormonal contraceptives: contraceptive pills, implants, transdermal patches hormonal vaginal devices, injections with prolonged release). It is accepted, in certain cases, to include subjects having a sterilised regular partner or subjects using a double barrier contraceptive method. However, this should be explicitly justified in special circumstances arising from the trial design, product characteristics and/or trial population.
- Presence of other anatomic or comorbid conditions, or other medical, social, or psychological conditions that, in the investigator's opinion, could limit the subject's ability to participate in the clinical investigation or to comply with follow-up requirements, or impact the scientific soundness of the clinical investigation results.
- Subject is currently participating in another clinical trial that has not yet completed its primary endpoint.
Angiographic Exclusion Criteria
- Target lesion is in a left main location.
- Target lesion is
Data sourced from ClinicalTrials.gov (NCT03355742). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.