Evaluation of Vascular Regeneration After a Drug Eluting Stent Implantation (REVER)

Evaluation of Vascular Regeneration After a Drug Eluting Stent Implantation and the Development of Neointimal Hyperplasia and Stent Restenosis (REVER Trial).

This is a prospective cohort, one center. twenty patients who will undergo percutaneous stent implantation with everolimus eluting stent will be include. The primary endpoint was the correlation between the change (baseline vs. 1 week) in the number of circulating endothelial progenitor cells and in cell functionality following an everolimus eluting stent implantation with the grade of neointimal hyperplasia measured by optical coherence tomography

Study Overview

• Status: Completed
• Conditions: Stable Angina

Detailed Description

For the purpose of the study, flow cytometry analyses will be performed before intervention, at 1 week, 1 month and 9 months. In addition, cell functionality analyses will be performed by quantification of colony forming units, aldehidrodehidrogenase activity, cell proliferation by WST-1 and senescence by !-galactosidase enzyme. At 9 months the degree of neointimal proliferation will be measured by optical coherence tomography . A clinical follow-up will be performed at 1 year. Secondary endpoints include: 1. to correlate the change in the number and cell functionality of circulation progenitor cells following everolimus eluting stent and the injury score analyses measured by optical coherence tomography, and the percentage of non covered struts by optical coherence tomography at 9 months.

2.-. To evaluate the role of other subtypes of cells CD 133+/Kinase Insert Domain Receptor (KDR+), CD 14+, mesenchymal stem cells, endothelial cell markers (VE cadherina, P1H12), integrin expression of Macrophage-1 antigen (MAC-1) and the development of neointimal hyperplasia.

• Study Type: Observational
• Enrollment (Actual): 20

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

stable angina

Description

Inclusion Criteria:

• Patients who present stable angina, silent ischemia or unstable angina whenever there is no elevation of markers of myocardial damage above the limit of normality
• Presence of at least one severe coronary stenosis (> 70% by visual analysis), susceptible of percutaneous treatment with stent implantation and an optical coherence Tomography study
• All patients should be taking statins at least 2 months prior to their inclusion in the study.

Exclusion Criteria:

• Age under 18 years and pregnant or fertile age,
• Patients with ST-elevation myocardial infarction or non-ST-elevation acute coronary syndrome with markers of recent myocardial damage (<3 months),
• Patients in whom a drug-eluting stent and a bare stent have been implanted in the same procedure.
• Percutaneous treatment of restenotic lesions or total chronic occlusions.
• The use of stent pre-implantation ablation techniques (rotablator, directional atherectomy).
• Chronic renal insufficiency with serum creatinine greater than or equal to 2.5.
• Coronary revascularization in previous 3 months.
• Severe ventricular dysfunction (<25%).
• Major trauma or surgery in the previous 3 months.
• Previous organ transplantation, active neoplastic process or inflammatory disease, treatment with immunosuppressors.
• Contraindication or allergy to thienopyridines.
• Life expectancy less than one year.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The correlation between the change (baseline vs 1 week) of circulating with neointimal hyperplasia endothelial progenitor cells and in cell functionality following an Everolimus eluting stent implantation with the grade of neointimal hyperplasia	Correlation between the change (baseline vs 1 week) in the number of circulating endothelial progenitor cells and in cell functionality following an everolimus eluting stent implantation with the grade of neointimal hyperplasia measured by optical coherence Tomography	9 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
to correlate number of cell and functionality of progenitor cells and injury score following everolimus eluting stent	to correlate the number and cell functionality of progenitor cells following everolimus eluting stent and the injury score analyses measured by optical coherence tomography	baseline
to evaluate other subtypes of cells with neointimal hyperplasia	To evaluate the role of other subtypes of cells CD 133+/KDR+, following an everolimus eluting stent implantation with the grade of neointimal hyperplasia measured by optical coherence Tomography	9 months
to evaluate other subtypes of cells with neointimal hyperplasia	the role of other subtypes of cells CD 14+ following an everolimus eluting stent implantation with the grade of neointimal hyperplasia measured by optical coherence Tomography	9 months
to evaluate endothelial cell markers with neointimal hyperplasia	the role of endothelial cell markers (VE cadherin, P1H12) following an everolimus eluting stent implantation with the grade of neointimal hyperplasia measured by optical coherence Tomography	9 months
to evaluate integrin expression of MAC-1 (Macrophage-1 antigen) with neointimal hyperplasia	the role of integrin expression of MAC-1(Macrophage-1 antigen) following an everolimus eluting stent implantation with the grade of neointimal hyperplasia measured by optical coherence Tomography	9 months

Collaborators and Investigators

• Sponsor: Hospital San Carlos, Madrid
• Collaborators: Instituto de Salud Carlos III

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2012
• Primary Completion (Actual): July 1, 2014
• Study Completion (Actual): December 31, 2016

Study Registration Dates

• First Submitted: June 25, 2017
• First Submitted That Met QC Criteria: July 8, 2017
• First Posted (Actual): July 12, 2017

Study Record Updates

• Last Update Posted (Actual): July 18, 2017
• Last Update Submitted That Met QC Criteria: July 13, 2017
• Last Verified: July 1, 2017

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Pain; Neurologic Manifestations; Chest Pain; Angina Pectoris; Angina, Stable
• Other Study ID Numbers: PI11/00299

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No