Bioresorbable Polymer-Coated EES in Patients at High Bleeding Risk Undergoing PCI Followed by 1-Month DAPT (POEM)
Performance of Bioresorbable Polymer-Coated Everolimus-Eluting Synergy® Stent in Patients at High Bleeding Risk Undergoing Percutaneous Coronary Revascularization Followed by 1-Month Dual Antiplatelet Therapy
Objective: To evaluate the safety of bioresorbable polymer-coated everolimus-eluting Synergy® stent followed by 1-month dual antiplatelet therapy in patients at high-bleeding risk.
Study population: Real world high-bleeding risk (HBR) patients with coronary artery disease (stable as well as acute coronary syndromes) who qualify for percutaneous coronary interventions.
Study size: A total of 1023 patients will be enrolled. Study design: Prospective, single-arm, multicentre trial, powered for non-inferiority with respect to objective performance criteria (OPC).
Antiplatelet therapy: Dual antiplatelet therapy with aspirin 100 mg od and a P2Y12 inhibitor for a duration of 1 month, after which single antiplatelet therapy with aspirin will be recommended indefinitely. In case of need for oral anticoagulation, patients will receive an oral anticoagulant in addition to a P2Y12 inhibitor without aspirin for 30 days.
Primary endpoint: Composite of cardiac death, myocardial infarction, or definite/probable stent thrombosis at 1-year follow-up.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Milan
-
Rozzano, Milan, Italy, 20089
- Recruiting
- Humanitas Research Hospital
-
Principal Investigator:
- Bernhard Reimers, MD
-
Principal Investigator:
- Giulio Stefanini, MD, PhD
-
Contact:
- Giulio Stefanini, MD, PhD
- Phone Number: 0282247384
- Email: giulio.stefanini@hunimed.eu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
All patients will need to have symptomatic coronary artery disease including patients with chronic stable angina, silent ischemia, or acute coronary syndromes (including NSTE-ACS and STE-ACS) and presence of one or more coronary artery stenoses >50% in a native coronary artery or a saphenous bypass graft that treated with one or multiple Synergy® stents.
Moreover, in order to be included patients will need to meet at least 1 of the following HBR criteria:
- Age ≥75 years
- Oral anticoagulation planned to continue after PCI
- Hemoglobin <11 g/l,
- Transfusion within 4 week before inclusion
- Platelet count <100'000
- Hospital admission for bleeding in previous 12 months
- Stroke in previous 12 months
- History of intracerebral hemorrhage
- Severe chronic liver disease
- Creatinine clearance <40 ml/min
- Cancer in previous 3 years
- Planned major surgery in next 12 months
- Glucocorticoids or NSAID planned for >30 days after PCI
- Expected non-adherence to >30 days of dual antiplatelet therapy
Exclusion Criteria:
- Cardiogenic shock
- Major active bleeding at the time of PCI
- Expected non-adherence with 1 month DAPT
- Known intolerance to aspirin, clopidogrel, or ticagrelor
- Inability to provide informed consent
- Currently participating in another trial before reaching first endpoint
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Study arm
1023 real world high-bleeding risk (HBR) patients with coronary artery disease (stable as well as acute coronary syndromes) who qualify for percutaneous coronary interventions will be included in the study.
|
After percutaneous coronary intervention with bioresorbable polymer-coated everolimus-eluting Synergy® stent implantation, dual antiplatelet therapy with aspirin 100 mg od and a P2Y12 inhibitor will be continued for a duration of 1 month, after which single antiplatelet therapy with aspirin will be recommended indefinitely.
In case of need for oral anticoagulation, patients will receive an oral anticoagulant in addition to a P2Y12 inhibitor without aspirin for 30 days.
After percutaneous coronary intervention with bioresorbable polymer-coated everolimus-eluting Synergy® stent implantation, dual antiplatelet therapy with aspirin 100 mg od and a P2Y12 inhibitor will be continued for a duration of 1 month, after which single antiplatelet therapy with aspirin will be recommended indefinitely.
In case of need for oral anticoagulation, patients will receive an oral anticoagulant in addition to a P2Y12 inhibitor without aspirin for 30 days.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Major Adverse Cardiac Events (MACE)
Time Frame: 1 year
|
Composite of cardiac death, myocardial infarction, and definite/probable stent thrombosis
|
1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
All-cause death
Time Frame: 30 days and 1 year
|
All-cause death
|
30 days and 1 year
|
|
Cardiac death
Time Frame: 30 days and 1 year
|
Cardiac death
|
30 days and 1 year
|
|
Myocardial infarction
Time Frame: 30 days and 1 year
|
Myocardial infarction (defined according to III universal definition)
|
30 days and 1 year
|
|
Stent thrombosis
Time Frame: 30 days and 1 year
|
Stent thrombosis (defined according to ARC criteria)
|
30 days and 1 year
|
|
Target-vessel revascularization
Time Frame: 30 days and 1 year
|
Target-vessel revascularization (any and clinically driven)
|
30 days and 1 year
|
|
Target-lesion revascularization
Time Frame: 30 days and 1 year
|
Target-lesion revascularization (any and clinically driven)
|
30 days and 1 year
|
|
Major bleeding
Time Frame: 30 days and 1 year
|
Major bleeding (BARC 3 to 5)
|
30 days and 1 year
|
|
Cerebrovascular event
Time Frame: 30 days and 1 year
|
Cerebrovascular event
|
30 days and 1 year
|
|
Target-lesion failure
Time Frame: 30 days and 1 year
|
composite of cardiac death, target-vessel myocardial infarction, or clinically-driven target-lesion revascularization
|
30 days and 1 year
|
|
Patient oriented composite endpoint
Time Frame: 30 days and 1 year
|
Composite of any death, any MI, any revascularization
|
30 days and 1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Myocardial Ischemia
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Arteriosclerosis
- Arterial Occlusive Diseases
- Coronary Disease
- Coronary Artery Disease
- Acute Coronary Syndrome
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Analgesics
- Sensory System Agents
- Anti-Inflammatory Agents, Non-Steroidal
- Analgesics, Non-Narcotic
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Fibrinolytic Agents
- Fibrin Modulating Agents
- Platelet Aggregation Inhibitors
- Cyclooxygenase Inhibitors
- Antipyretics
- Aspirin
Other Study ID Numbers
Other Study ID Numbers
- 012017POEM
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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