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| ID | Type | Description | Link |
|---|---|---|---|
| CTRI/2011/06/001830 | Registry Identifier | Clinical Trial Registry - India |
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| Name | Class |
|---|---|
| Boston Scientific Corporation | INDUSTRY |
| Max Neeman Medical International Ltd. | UNKNOWN |
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The TUXEDO-India is a prospective, single blind, multi-center randomized clinical trial to assess the TAXUS Element™ in a consecutive population of diabetic patients with coronary artery disease undergoing coronary revascularization. Approximately 1,830 patients with single or multi lesion, multi vessel coronary artery or saphenous vein graft disease ranging in vessels ranging from 2.25 mm to 4.0 mm in diameter by visual estimate will be enrolled in a 1:1 randomization to TAXUS Element™ vs. XIENCE™ Prime in India at up to 50 clinical sites, to demonstrate the safety and effectiveness of TAXUS Element™ in an unrestricted population.
Procedural Endpoints:
Primary Endpoint:
Composite safety endpoint of Target Vessel Failure (TVF) rate at 12 months post-index procedure:
Secondary Endpoint:
Clinical endpoints measured at 30, 180 days, and 1 and 2 years post index procedure:
Periprocedural endpoints:
Anti-platelet Therapy
A loading dose of either Clopidogrel (300mg, 600mg recommended), Ticlopidine (500mg), or Prasugrel (60mg) must be given to the patient prior to index procedure. Thereafter, Clopidogrel (75mg daily), Ticlopidine (250mg twice daily), Prasugrel (10mg) must be given for at least 12 months after stent implantation. If the protocol mandated (loading and or daily) dosage conflicts with local DFU, the local DFU should take precedence. Aspirin (ASA): Must be administered concomitantly with Clopidogrel, Ticlopidine or Prasugrel and then continued indefinitely
Sample Size Parameters:
The expected 12 month TVF rate for both groups is estimated to be 8.4% based on the data available from the SPIRIT IV trial. Given the non-inferiority margin (delta) of 4% with equal expected means and a one-sided 5% significance level, 824 patients in each group will provide at least 90% power to reject the null hypothesis if it is false. When allowance is made for 10% attrition, approximately 915 patients are required per each treatment group. Therefore, the necessary total sample size for the trial is 1,830 patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TAXUS Element™ Paclitaxel-Eluting System | Experimental | The TAXUS® Element™ stent system is a multifunctional device providing a mechanical structure for vascular lumen support and a pharmacological agent targeted toward reducing or preventing the incidence of restenosis. The TAXUS Element™ stent is a balloon expandable, stainless steel platinum alloy stent, coated with paclitaxel in a slow-release system, pre-mounted on a high-pressure Monorail delivery catheter and is intended for use in the treatment of coronary artery disease. The pharmacological agent, paclitaxel, is incorporated into a triblock polymer matrix and applied to the surface of the stent. The polymer matrix provides controlled release of available paclitaxel. The TAXUS Element™ stent design is built upon the TAXUS Express and TAXUS Liberte design experience, but incorporates several improved stent design characteristics. The TAXUS Element™ stent also has a smaller tip profile, designed to enhance the ability to cross tighter and/or more complex lesions. |
|
| XIENCE PRIME™ ™ Everolimus-Eluting Stent System | Active Comparator | The everolimus-eluting stent (EES, manufactured and distributed by Abbott Vascular, Santa Clara, CA, as XIENCE PRIME™ ) is a balloon expandable stent manufactured from a flexible cobalt chromium alloy with a multicellular design and 0.0032-in strut thickness which is coated with a thin (7.8 μm) nonadhesive, durable, biocompatible acrylic polymer and fluorinated copolymer releasing everolimus. Everolimus [40-O-(2-hydroxyethyl)- rapamycin], a semisynthetic macrolide immunosuppressant, inhibits growth factor-stimulated cell proliferation by causing cell-cycle arrest in the late G1 stage, thereby suppressing neointimal formation. Comparative analysis in an in vivo rabbit aortoiliac model has shown more rapid endothelialization with the EES compared to SES, PES, and ZES. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TAXUS Element™ Paclitaxel-Eluting Stent System | Device | Texus Element is the next generation Boston Scientific paclitexel-eluting coronary sten and received DCGI approval on April 13th, 2010. |
| Measure | Description | Time Frame |
|---|---|---|
| Composite safety endpoint of Target Vessel Failure (TVF) rate at 12 months post-index procedure: • Cardiac Death related to target vessel • Target Vessel Myocardial Infarction (TV-MI) • Target Vessel Revascularization (TVR) | TVS is defined as any ischemia-driven revascularization of the target vessel( TVR), MI (Q-wave and non-Q-wave) related to the target vessel, or cardiac death related to the target vessel. | 12 Months |
| Measure | Description | Time Frame |
|---|---|---|
| Target Lesion Revascularization (TLR) TVF rate (primary endpoint 1 year) Target Vessel Revascularization rate Target Lesion Revascularization Composite of cardiac death or target vessel | Measured at 30,180 days,and 1 and 2 years post index procedure | |
| Ischemia Driven Target Lesion Revascularization (TLR) Rate TVF rate (primary endpoint 1 year) Target Vessel Revascularization rate Target Lesion Revascularization Composite of cardiac death or target vessel |
| Measure | Description | Time Frame |
|---|---|---|
| Device Success | Device Success Defined as attainment of <30% residual stenosis of the target lesion (visual assessment) using the TAXUS Element or XIENCE Prime stent. | Baseline |
| Lesion Success | Lesion success defined as attainment of <30% residual stenosis (visual assessment) uring any percutaneous method |
Inclusion Criteria:
CI1. Patient must have a diagnosis of diabetes mellitus (Type 1 or Type 2) defined according to the American Diabetes Association as history of one of the followings :
4. Elevated HbA1c level 6.5 And currently undergoing pharmacological treatment 5.Patients admitted with ACS NSTEMI and HbA1c > 7 can be included even if they were not on pharmacological treatment. CI2. Patient (or legal guardian) understands the trial requirements and the treatment procedures and provides written informed consent before any trial-specific tests or procedures are performed CI3. Patient is eligible for percutaneous coronary intervention (PCI) CI4. Patient has symptomatic coronary artery disease or documented silent ischemia. CI5. Patient is willing to comply with all protocol-required follow-up evaluations.
Angiographic Inclusion Criteria (visual estimate)
AI1. Target lesion must be a de novo lesion located in a native coronary artery with a visually estimated reference vessel diameter (RVD) 2.25 mm and 4.0 mm. Treatment of up to 3 de novo target lesions is allowed with a maximum of two denovo target lesions per epicardial vessel.
AI2. Target lesion length must measure 34 mm (by visual estimate) AI3. Target lesion must be in a major coronary artery or branch with visually estimated stenosis 50% and <100% with Thrombolysis in Myocardial Infarction (TIMI) flow 1. AI4. If more than one target lesion will be treated, the RVD and lesion length of each must meet the above criteria. AI5. Non-study percutaneous intervention for lesions in a target vessel (including side branches) is allowed if performed 9 months prior to the index procedure. AI6. Non study percutaneous interventions for lesions in a non target vessel are allowed in the following circumstances:
Exclusion Criteria:
CE1. Patient has known allergy to the study stent system or protocol-required concomitant medications (e.g., stainless steel, platinum, chromium, nickel, iron, thienopyridines, aspirin, radiographic contrast medium) that cannot be adequately pre-medicated. CE2. Patient has any other serious medical illness (e.g., cancer, congestive heart failure) that may reduce life expectancy to less than 12 months CE3. Acute or chronic renal dysfunction (creatinine > 2.0 mg/dl or 177 μmol/l) CE4. Currently participating in another investigational drug or device study
Angiographic Exclusion Criteria (visual estimate)
AE1. Target lesion meets any of the following criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Upendra Kaul, M.D | Fortis Escorts Heart Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fortis Escorts Heart Institute | New Delhi | National Capital Territory of Delhi | 110025 | India |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | www.crf.org/crf/newsroom/news/news-archive/963-announcing-the-tct-2015-late-breaking-trials-and-first-report-investigations |
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| Xience PRIME Everolimus-Eluting Stent System | Device | The Everolimus-eluting stent manufactured and distributed by Abbott Vascular Santa Clara, CA, as Xience Prime. |
|
| Measured at 30,180 days,and 1 and 2 years post index procedure |
| Target Vessel Failure (TVF) | Measured at 30,180 days,and 1 and 2 years post index procedure |
| Ischemia Driven Target Vessel Revascularization (TVR) | Measured at 30,180 days,and 1 and 2 years post index procedure |
| Target Lesion Failure Rate | Target Lesion Failure Rate defined as any ischemia-driven revascularization of the target lesion (TLR), MI (Q-wave and non-Q-wave) related to the target vessel, or cardiac death related to the target vessel | Measured at 30,180 days,and 1 and 2 years post index procedure |
| Myocardial Infarction(MI) rate | Q-wave and Non-Q-wave, cumulative and individual | Measured at 30,180 days,and 1 and 2 years post index procedure |
| Cardiac death rate | Measured at 30,180 days,and 1 and 2 years post index procedure |
| Non-Cardiac death rate | Measured at 30,180 days,and 1 and 2 years post index procedure |
| All death or MI rate | Measured at 30,180 days,and 1 and 2 years post index procedure |
| All Death / MI / TVR Rate | Measured at 30,180 days,and 1 and 2 years post index procedure |
| Major Adverse Cardiac Event (MACE) | MACE defined as a composite of death, MI (Q-wave and non-Q-wave), emergent coronary artery bypass surgery (CABG), or target lesion revascularization (TLR) by repeat PTCA, or CABG. | Measured at 30,180 days,and 1 and 2 years post index procedure |
| Stent Thrombosis Rate | Stent thrombosis(ST) rate defined using ARC definition of definite and probable stent thrombosis and categorized as early, late or very late. | Measured at 30,180 days,and 1 and 2 years post index procedure |
| Baseline |
| Procedure Success | Procedure success defined as lesion success without the occurrence of in-hospital MACE. | Baseline |
| Procedural complication rate | Procedural complication rate including composite and individual angiographic occurrence of dissection, distal embolization, no reflow, slow flow, abrupt closure, or perforation | Baseline |
| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| D003327 | Coronary Disease |
| D003324 | Coronary Artery Disease |
| D003920 | Diabetes Mellitus |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
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