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Primary Endpoint Results of the EVOLVE Trial: A Randomized Evaluation of a Novel Bioabsorbable Polymer-Coated, Everolimus-Eluting Coronary Stent : TRANSCATHETER CARDIOVASCULAR THERAPEUTICS

Identifieur interne : 005986 ( Main/Exploration ); précédent : 005985; suivant : 005987

Primary Endpoint Results of the EVOLVE Trial: A Randomized Evaluation of a Novel Bioabsorbable Polymer-Coated, Everolimus-Eluting Coronary Stent : TRANSCATHETER CARDIOVASCULAR THERAPEUTICS

Auteurs : Ian T. Meredith [Australie] ; Stefan Verheye [Belgique] ; Christophe L. Dubois [Belgique] ; Joseph Dens [Belgique] ; Jean Fajadet [France] ; Didier Carrie [France] ; Simon Walsh [Royaume-Uni] ; Keith G. Oldroyd [Royaume-Uni] ; Olivier Varenne [France] ; Seif El-Jack [Nouvelle-Zélande] ; Raul Moreno [Espagne] ; Anita A. Joshi [États-Unis] ; Dominic J. Allocco [États-Unis] ; Keith D. Dawkins [États-Unis]

Source :

RBID : Pascal:12-0184814

Descripteurs français

English descriptors

Abstract

Objectives This study sought to compare the safety and efficacy of 2 dose formulations of SYNERGY, a novel bioabsorbable polymer everolimus-eluting stent (EES) (Boston Scientific Corp., Natick, Massachusetts) compared with the durable polymer PROMUS Element EES (Boston Scientific Corp.). Background Durable polymer coatings on drug-eluting stents have been associated with chronic inflammation and impaired healing. Bioabsorbable polymer-coated drug-delivery systems may reduce the risk of late adverse events, including stent thrombosis, and thus the need for prolonged dual-antiplatelet therapy. Methods A total of 291 patients with a de novo lesion ≤28 mm in length, in a coronary artery of ≥2.25 to ≤3.5 mm diameter, were enrolled in the EVOLVE study, a prospective, randomized, single-blind, noninferiority trial. Patients were randomly assigned in a 1:1:1 ratio to PROMUS Element, SYNERGY, or SYNERGY half dose. The primary clinical endpoint was the 30-day rate of target lesion failure, defined as cardiac death or myocardial infarction related to the target vessel, or target lesion revascularization. The primary angiographic endpoint was 6-month in-stent late loss measured by quantitative coronary angiography. Results The 30-day primary clinical endpoint of target lesion failure occurred in 0%, 1.1%, and 3.1% of patients in the PROMUS Element, SYNERGY, and SYNERGY half dose groups, respectively. The 6-month in-stent late loss was 0.15 ± 0.34 mm for PROMUS Element, 0.10 ± 0.25 mm for SYNERGY, and 0.13 ± 0.26 mm for SYNERGY half dose (SYNERGY, difference -0.06, upper 95.2% confidence limit: 0.02, p for noninferiority <0.001; SYNERGY half dose, difference -0.03, upper 95.2% confidence limit: 0.05, p for noninferiority <0.001). Clinical event rates remained low and comparable between groups, with no stent thromboses in any group at 6 months. Conclusions The EVOLVE trial confirms the effective delivery of everolimus by a unique directional bioabsorbable polymer system utilizing the SYNERGY stent. (A Prospective Randomized Multicenter Single-Blind Noninferiority Trial to Assess the Safety and Performance of the Evolution Everolimus-Eluting Monorail Coronary Stent System [Evolution Stent System] for the Treatment of a De Novo Atherosclerotic Lesion [EVOLVE]; NCT01135225).


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<term>Everolimus</term>
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<front>
<div type="abstract" xml:lang="en">Objectives This study sought to compare the safety and efficacy of 2 dose formulations of SYNERGY, a novel bioabsorbable polymer everolimus-eluting stent (EES) (Boston Scientific Corp., Natick, Massachusetts) compared with the durable polymer PROMUS Element EES (Boston Scientific Corp.). Background Durable polymer coatings on drug-eluting stents have been associated with chronic inflammation and impaired healing. Bioabsorbable polymer-coated drug-delivery systems may reduce the risk of late adverse events, including stent thrombosis, and thus the need for prolonged dual-antiplatelet therapy. Methods A total of 291 patients with a de novo lesion ≤28 mm in length, in a coronary artery of ≥2.25 to ≤3.5 mm diameter, were enrolled in the EVOLVE study, a prospective, randomized, single-blind, noninferiority trial. Patients were randomly assigned in a 1:1:1 ratio to PROMUS Element, SYNERGY, or SYNERGY half dose. The primary clinical endpoint was the 30-day rate of target lesion failure, defined as cardiac death or myocardial infarction related to the target vessel, or target lesion revascularization. The primary angiographic endpoint was 6-month in-stent late loss measured by quantitative coronary angiography. Results The 30-day primary clinical endpoint of target lesion failure occurred in 0%, 1.1%, and 3.1% of patients in the PROMUS Element, SYNERGY, and SYNERGY half dose groups, respectively. The 6-month in-stent late loss was 0.15 ± 0.34 mm for PROMUS Element, 0.10 ± 0.25 mm for SYNERGY, and 0.13 ± 0.26 mm for SYNERGY half dose (SYNERGY, difference -0.06, upper 95.2% confidence limit: 0.02, p for noninferiority <0.001; SYNERGY half dose, difference -0.03, upper 95.2% confidence limit: 0.05, p for noninferiority <0.001). Clinical event rates remained low and comparable between groups, with no stent thromboses in any group at 6 months. Conclusions The EVOLVE trial confirms the effective delivery of everolimus by a unique directional bioabsorbable polymer system utilizing the SYNERGY stent. (A Prospective Randomized Multicenter Single-Blind Noninferiority Trial to Assess the Safety and Performance of the Evolution Everolimus-Eluting Monorail Coronary Stent System [Evolution Stent System] for the Treatment of a De Novo Atherosclerotic Lesion [EVOLVE]; NCT01135225).</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Australie</li>
<li>Belgique</li>
<li>Espagne</li>
<li>France</li>
<li>Nouvelle-Zélande</li>
<li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
<region>
<li>Communauté de Madrid</li>
<li>Massachusetts</li>
<li>Midi-Pyrénées</li>
<li>Occitanie (région administrative)</li>
<li>Victoria (État)</li>
<li>Île-de-France</li>
</region>
<settlement>
<li>Madrid</li>
<li>Melbourne</li>
<li>Paris</li>
<li>Toulouse</li>
</settlement>
</list>
<tree>
<country name="Australie">
<region name="Victoria (État)">
<name sortKey="Meredith, Ian T" sort="Meredith, Ian T" uniqKey="Meredith I" first="Ian T." last="Meredith">Ian T. Meredith</name>
</region>
</country>
<country name="Belgique">
<noRegion>
<name sortKey="Verheye, Stefan" sort="Verheye, Stefan" uniqKey="Verheye S" first="Stefan" last="Verheye">Stefan Verheye</name>
</noRegion>
<name sortKey="Dens, Joseph" sort="Dens, Joseph" uniqKey="Dens J" first="Joseph" last="Dens">Joseph Dens</name>
<name sortKey="Dubois, Christophe L" sort="Dubois, Christophe L" uniqKey="Dubois C" first="Christophe L." last="Dubois">Christophe L. Dubois</name>
</country>
<country name="France">
<region name="Occitanie (région administrative)">
<name sortKey="Fajadet, Jean" sort="Fajadet, Jean" uniqKey="Fajadet J" first="Jean" last="Fajadet">Jean Fajadet</name>
</region>
<name sortKey="Carrie, Didier" sort="Carrie, Didier" uniqKey="Carrie D" first="Didier" last="Carrie">Didier Carrie</name>
<name sortKey="Varenne, Olivier" sort="Varenne, Olivier" uniqKey="Varenne O" first="Olivier" last="Varenne">Olivier Varenne</name>
</country>
<country name="Royaume-Uni">
<noRegion>
<name sortKey="Walsh, Simon" sort="Walsh, Simon" uniqKey="Walsh S" first="Simon" last="Walsh">Simon Walsh</name>
</noRegion>
<name sortKey="Oldroyd, Keith G" sort="Oldroyd, Keith G" uniqKey="Oldroyd K" first="Keith G." last="Oldroyd">Keith G. Oldroyd</name>
</country>
<country name="Nouvelle-Zélande">
<noRegion>
<name sortKey="El Jack, Seif" sort="El Jack, Seif" uniqKey="El Jack S" first="Seif" last="El-Jack">Seif El-Jack</name>
</noRegion>
</country>
<country name="Espagne">
<region name="Communauté de Madrid">
<name sortKey="Moreno, Raul" sort="Moreno, Raul" uniqKey="Moreno R" first="Raul" last="Moreno">Raul Moreno</name>
</region>
</country>
<country name="États-Unis">
<region name="Massachusetts">
<name sortKey="Joshi, Anita A" sort="Joshi, Anita A" uniqKey="Joshi A" first="Anita A." last="Joshi">Anita A. Joshi</name>
</region>
<name sortKey="Allocco, Dominic J" sort="Allocco, Dominic J" uniqKey="Allocco D" first="Dominic J." last="Allocco">Dominic J. Allocco</name>
<name sortKey="Dawkins, Keith D" sort="Dawkins, Keith D" uniqKey="Dawkins K" first="Keith D." last="Dawkins">Keith D. Dawkins</name>
</country>
</tree>
</affiliations>
</record>

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