Ischemic and Bleeding Outcomes After Angiolite Stent Implantation and an Abbreviated Dual Antiplatelet Therapy (ANGIODAPT)

iVascular

Status and phase

Enrolling

Phase 3

Conditions

Coronary Artery Disease

Treatments

Device: Xience: Everolimus-eluting stent

Drug: 12-month DAPT (Standard of care)

Device: Angiolite: Sirolimus-eluting stent

Drug: 1-month DAPT

Study type

Interventional

Funder types

Industry

Identifiers

NCT05952206

ANGIODAPT-01

Details and patient eligibility

About

Factorial 2x2, all-comer, multicentre, randomized controlled trial (ratio 1:1:1:1). First, the study will compare (first randomization) the non-inferiority in target lesion failure of angiolite stent versus Xience stent family. Immediately after the first randomization, the study compares (second randomization) the superiority in bleeding Bleeding Academic Research Consortium (BARC) 2, 3, or 5 of abbreviated DAPT versus standard of care. Both primary endpoints will be evaluated at 12 months of follow-up. The study will be open-label for the stent type and the antiplatelet regimen.

Enrollment

2,312 estimated patients

Sex

All

Ages

18 to 95 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Age >18 - < 95 years;
Presence of one or more coronary artery stenosis of 50% or more in a native coronary artery or in a saphenous venous or arterial bypass conduit suitable for coronary stent implantation. The vessel should have a reference vessel diameter of at least 2.00 mm (no limitation on the number of treated lesions, vessels, or lesion length);
Able to provide informed consent and willing to participate in the trial.

Exclusion criteria

Known intolerance to acetylsalicylic acid, P2Y12 inhibitors (clopidogrel, prasugrel, or ticagrelor), sirolimus, everolimus, or chromium-cobalt.;
Known severe hepatic impairment Child-Pug stage C;
Prior PCI (not related to the study) performed in the last 45 days;
Planned non-cardiac surgery during the first month after PCI, unless dual antiplatelet therapy is maintained throughout the peri-surgical period;
Planned coronary artery bypass graft (CABG) or any other cardiac surgery (valvular for instance) following index PCI;
Active major bleeding or major surgery within the last 30 days;
Known stroke (any type) within the 30 days prior to the randomization;
Women of childbearing potential being defined as woman from the onset of menstruation (menarche) until they become postmenopausal, unless they are permanently sterile. A postmenopausal state is clarified as having no menstrual periods for 12 consecutive months without any other medical cause. Women who have undergone permanent sterilization methods, including hysterectomy, bilateral salpingectomy, and bilateral oophorectomy, can be enrolled in the study
Currently participating in another randomized controlled trial and not yet at its primary endpoint;
Life expectancy less than one year due to non-cardiovascular comorbidity.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Factorial Assignment

Masking

None (Open label)

2,312 participants in 4 patient groups

Angiolite and abbreviated DAPT

Experimental group

Description:

Acute coronary syndrome patients: * Need for OAC: TAT + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6 months. * No need for OAC: DAPT with acetylsalicylic acid + prasugrel or ticagrelor for 1M. Only the same P2Y12 inhibitor up to 12M. Chronic coronary syndrome patients: * Need for OAC: TAT + clopidogrel + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6M. * No need for OAC: DAPT with acetylsalicylic acid + clopidogrel for one month. Only clopidogrel up to 12M.

Treatment:

Drug: 1-month DAPT

Device: Angiolite: Sirolimus-eluting stent

Xience stent family and abbreviated DAPT

Experimental group

Description:

Acute coronary syndrome patients: * Need for OAC: TAT + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6M. * No need for OAC: DAPT with acetylsalicylic acid + prasugrel or ticagrelor for 1 month. Only the same P2Y12 inhibitor up to 12M. Chronic coronary syndrome patients: * Need for OAC: TAT + clopidogrel + OAC for one week. Double therapy composed of clopidogrel + OAC up to 6M. * No need for OAC: DAPT with acetylsalicylic acid + clopidogrel for one month. Only clopidogrel up to 12M.

Treatment:

Drug: 1-month DAPT

Device: Xience: Everolimus-eluting stent

Angiolite and standard of care DAPT

Active Comparator group

Description:

Acute coronary syndrome patients: * Need for OAC: Recommendations of the current ESC guideline: 1M of TAT (acetylsalicylic acid + clopidogrel + OAC). Dual therapy (acetylsalicylic acid or clopidogrel + OAC) up to 12M. If ischemic concerns prevail, TAT can be extended up to 6M and dual therapy up to 12M. * No need for OAC: Recommendations of the current ESC guideline: DAPT with acetylsalicylic acid and prasugrel or ticagrelor is recommended up to 12M. Chronic coronary syndrome: * Need for OAC: Recommendations of the current ESC guidelines: 1M of TAT (acetylsalicylic acid + clopidogrel + OAC). Dual therapy (acetylsalicylic acid or clopidogrel + OAC) up to 12M. If ischemic concerns prevail, TAT can be extended up to 6M and dual therapy up to 12M. * No need for OAC: Recommendations of the current ESC guidelines: DAPT composed of acetylsalicylic acid + clopidogrel up to 6M. Then, continue with acetylsalicylic acid.

Treatment:

Device: Angiolite: Sirolimus-eluting stent

Drug: 12-month DAPT (Standard of care)

Xience stent family and standard of care DAPT

Active Comparator group

Description:

Treatment:

Drug: 12-month DAPT (Standard of care)

Device: Xience: Everolimus-eluting stent