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Coronary Artery DiseasePhase 4NCT00954707

CYPRESS - CYPHER for Evaluating Sustained Safety

A Phase 4 study testing Clopidogrel & Aspirin, Prasugrel & Aspirin in people with Coronary Artery Disease, run by Cordis US Corp. at 1 site in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

CYPRESS: A Prospective,Randomized,Multi-Center,Double-Blind Trial to Assess the Effectiveness and Safety of Different Durations of Dual Anti-Platelet Therapy (DAPT) in Subjects Undergoing Percutaneous Coronary Intervention with the CYPHER® Sirolimus-eluting Coronary Stent (CYPHER® Stent) Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Coronary Artery Disease
What is being tested?
Clopidogrel & Aspirin, Prasugrel & Aspirin
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
2,509 participants
Where
1 siteUnited States
Study dates
Aug 2009to Mar 2016
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

DAPT Group - Inclusion Criteria:

Phase I: Enrollment Inclusion Criteria

Subjects must meet ALL of the following inclusion criteria to be enrolled in the study:

  • The subject must be 18 years of age.
  • Subjects undergoing percutaneous intervention with stent deployment
  • Subjects without known contraindication to dual antiplatelet therapy for at least 30 months after enrollment and stent implantation.
  • The subject or Legally Authorized Representative has consented to participate and has authorized the collection and release of his/her medical information by signing the "Patient Informed Consent Form" that is approved by the Institutional Review Board or Independent Ethics Committee. The informed consent will be valid for the duration of the trial or until the subject withdraws.

DAPT Group Phase II: Randomization Inclusion Criterion at 12 months

Subjects must meet the following criterion to be eligible for randomization in the study:

  • Subject is 12 Month Clear

DAPT Group - Exclusion Criteria:

Phase I: Enrollment Exclusion Criteria

Subjects will be excluded if ANY of the following exclusion criteria apply:

  • Index procedure requiring use of a stent with a nominal diameter < 2.25 mm or > 3.5 mm.
  • Pregnant women.
  • Planned (at time of enrollment) surgery necessitating discontinuation of antiplatelet therapy within the 30 months following enrollment.
  • Current medical condition with a life expectancy of less than 3 years.
  • Concurrent enrollment in another device or drug study where the primary endpoint has not been reached or the device/drug might affect major endpoint outcomes in either Phase I or Phase II of the study.
  • The subject may only be enrolled in the study once.
  • Subjects on warfarin or similar anticoagulant therapy.
  • Subjects with hypersensitivity or allergies to one of the drugs or components indicated in the Instructions for Use for the device implanted.
  • Subjects unable to give informed consent.
  • Subject treated with both DES and BMS during the index procedure.

DAPT Group Phase II: Randomization Exclusion Criteria at 12 months

Subjects will be excluded from randomization if any of the following criteria are met:

  • Pregnant women.
  • Subject switched thienopyridine type within 6 months prior to randomization
  • Percutaneous coronary interventions or cardiac surgery between 6 weeks post index procedure and randomization.
  • Planned surgery necessitating discontinuation of antiplatelet therapy within the 21 months following randomization.
  • Current medical condition with a life expectancy of less than 3 years.
  • Subjects on subsequent warfarin or similar anticoagulant therapy.
  • Subjects who do not receive any CYPHER® Stent during the index procedure.

Non-DAPT Group

The following inclusion and exclusion criteria are for the Non-DAPT subjects. These criteria will be used to determine if the subject meets the near on-label definition

Non-DAPT Group - Inclusion Criteria:

Subjects must meet ALL of the following criteria to be enrolled in this study:

  1. The subject must be ≥18 years of age
  2. Index procedure requiring use of a stent with a nominal diameter 2.25mm to 3.5mm
  3. Lesion Length ≤ 34mm
  4. Up to 2 lesions in up to 2 vessels (2 in one vessel or 1 in each of 2 vessels)
  5. Ejection fraction > 30%
  6. Target lesion stenosis is >50% and <100% (visual estimate)
  7. Female of childbearing potential must have a negative pregnancy test within 10 days prior to enrollment
  8. The subject or Legally Authorized Representative has consented to participate and has authorized the collection and release of his/her medical information by signing the "Patient Informed Consent Form"

Non-DAPT Group - Exclusion criteria

And must NOT meet any of the following exclusion criteria:

  1. Target Lesion includes Bifurcations with side branch diameter >2.5mm
  2. Patient with excessive calcified/angulated lesion that is not suitable for stenting in the Investigator's opinion
  3. Restenotic Target Lesion previously treated with a stent
  4. Greater than 2 overlapping stents used to treat target lesion.
  5. Target Lesion within an unprotected Left Main (LM) with ≥50% stenosis
  6. Target Lesion within a coronary bypass graft (e.g., saphenous vein or arterial graft)
  7. Chronic (> 3 months) Total Occlusion (CTO) Lesions, TIMI grade 0 or 1 in the target lesion
  8. ST segment Elevation Myocardial Infarction (STEMI) within 30 days or non-STEMI within 72 hours
  9. Renal insufficiency (creatinine >2.5 mg) or dialysis dependent
  10. Lesion with visible clot
  11. Patient with prior brachytherapy
  12. Documented left ventricular ejection fraction is ≤30%
  13. Pretreatment with devices other than conventional balloon angioplasty
  14. Recipient of heart transplant
  15. Subject with a life expectancy less than 1 year
  16. Known allergies to the following: aspirin, all commercially available anti-platelet drugs heparin, stainless steel, contrast agent (that cannot be managed medically), or sirolimus (that cannot be managed medically);
  17. Any significant medical condition which, in the Investigator's opinion, may interfere with the subject's optimal participation in the study;
  18. Currently participating in an investigational drug or device study that has either not completed the primary endpoint where the prior study drug/device might affect this study's primary endpoint
  19. In the Investigator's opinion, the lesion is not suitable for stenting.
  20. Known bleeding or hypercoagulable disorder;
  21. Known or suspected active infection at the time of the study procedures;
  22. Subject is known to be pregnant
  23. Subject is a prisoner, mentally incompetent, and/or alcohol or drug abuser;
  24. Planned (at the time of enrollment) surgery necessitating discontinuation of anti-platelet therapy within the twelve (12) months following enrollment.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University Hospitals, Case Medical Center (Cleveland)

    Cleveland, Ohio, 44106

Other trials in United States

About this study

Official title: A Prospective, Randomized, Multi-Center, Double-Blind Trial to Assess the Effectiveness and Safety of Different Durations of Dual Anti-Platelet Therapy (DAPT) in Subjects Undergoing Percutaneous Coronary Intervention With the CYPHER® Sirolimus-eluting Coronary Stent (CYPHER® Stent)

CYPRESS: A Prospective,Randomized,Multi-Center,Double-Blind Trial to Assess the Effectiveness and Safety of Different Durations of Dual Anti-Platelet Therapy (DAPT) in Subjects Undergoing Percutaneous Coronary Intervention with the CYPHER® Sirolimus-eluting Coronary Stent (CYPHER® Stent)

Read the detailed description

During Phase I (non-randomized phase) of this study, the primary objective is to assess the rate of target lesion failure in subjects implanted with the CYPHER® stent and receiving dual antiplatelet therapy for 12 months.

During Phase II (randomized phase) of this study, the primary objective is to assess safety (major and minor bleeding), MACCE, and ST rates in subjects treated with dual antiplatelet therapy for 12 or 30 months following CYPHER® stent implantation.

*Subjects treated with the CYPHER® 2.25mm stent will be followed through 60 months.

**The last 500 patients enrolled will not be eligible for randomization.

Being tested
Clopidogrel & Aspirin, Prasugrel & Aspirin, Placebo & Aspirin
Keywords
Atherosclerosis
Medical subject headings
Coronary Artery Disease, Atherosclerosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Clopidogrel & Aspirin, Prasugrel & AspirinDrug

    This population consists of subjects enrolled in the study who are free from death, MI, stroke, repeat coronary revascularization, major bleeding, and ST 12 months after stent implantation and who are compliant with 12 months of dual antiplatelet therapy following stent implantation and who are subsequently randomized to receive 18 months of thienopyridine treatment in addition to aspirin.

  • Placebo & AspirinDrug

    This population consists of subjects enrolled in the study who are free from death, MI, stroke, repeat coronary revascularization, major bleeding, and ST 12 months after stent implantation and who are compliant with 12 months of dual antiplatelet therapy following stent implantation and who are subsequently randomized to receive 18 months of placebo treatment in addition to aspirin.

Study groups in NCT00954707
Study groupRoleWhat they receive
12m DAPT GroupPlacebo comparatorNot described
Receives: Drug: Placebo & Aspirin
30m DAPT GroupActive comparatorNot described
Receives: Drug: Clopidogrel & Aspirin, Prasugrel & Aspirin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Phase I: the Rate of Target Lesion Failure (TLF)

    Target lesion failure (TLF) is defined as clinically-driven target lesion revascularization, target vessel myocardial infarction, or cardiac death that could not be clearly attributed to a vessel other than the target vessel at 12 months.

    Measured: 12 months

Secondary outcomes (12)
  1. Rate of Device Success

    A study device success is defined as achievement of a final residual diameter stenosis of < 50% (by QCA), using the assigned device only. If QCA is not available, the visual estimate of diameter stenosis is used.

    Measured: From post- procedure to hospital discharge, up to 39 days

  2. Rate of Lesion Success

    Lesion success is defined as the attainment of < 50% residual stenosis (by Quantitative coronary angiography (QCA)) using any percutaneous method.

    Measured: From post- procedure to hospital discharge, up to 39 days

  3. Rate of Procedure Success

    Procedure success is defined as the achievement of a final diameter stenosis of < 50% (by QCA) using any percutaneous method, without the occurrence of death, Myocardial infarction (MI), or repeat coronary revascularization of the target lesion during the hospital stay.

    Measured: From post- procedure to hospital discharge, up to 39 days

  4. Rate of Clinically-driven Target Lesion Revascularization (TVR)

    Defined as any "clinically-driven" repeat percutaneous intervention of the target lesion or bypass surgery of the target vessel. Clinically-driven revascularizations are those in which the subject has a positive functional study, ischemic ECG changes at rest in a distribution consistent with the target vessel, or ischemic symptoms, and an in-lesion diameter stenosis ≥50% by QCA.

    Measured: 12 Months

  5. Rate of Clinically Driven Target Vessel Revascularization (TVR)

    Defined as any clinically driven repeat percutaneous intervention of the target vessel or bypass surgery of the target vessel. Clinically-driven revascularizations are those in which the subject has a positive functional study, ischemic ECG changes at rest in a distribution consistent with the target vessel, or ischemic symptoms, and an in-lesion diameter stenosis ≥50% by QCA.

    Measured: 12 months

  6. Rate of Target Vessel Failure (TVF)

    Defined as target vessel revascularization, recurrent infarction, or cardiac death that could not be clearly attributed to a vessel other than the target vessel.

    Measured: 12 Months

  7. Rate of Major Adverse Cardiac Events (MACE)

    MACE includes Death, myocardial infarction, emergent bypass surgery, or target lesion revascularization at 12 months

    Measured: 12 Months

  8. Rate of Protocol Defined Stent Thrombosis (ST)

    Protocol defined ST includes early and late ST. Early thrombosis is defined as composite thirty-day ischemic endpoint including death, Q-wave myocardial infarction, or subabrupt closure requiring revascularization. Late thrombosis is defined as myocardial infarction occurring > 30 days after the index procedure and attributable to the target vessel with angiographic documentation (site reported or by qualitative coronary angiography) of thrombus or total occlusion at the target site and freedom from an interim revascularization of the target vessel.

    Measured: 12 Months

  9. Rate of Academic Research Consortium (ARC) Defined Stent Thrombosis (ST)

    ARC defined ST classifies ST by type - definite, probable, possible; by timing - acute, sub-acute, late, very late. Definite includes angiographic or pathologic confirmation; probable includes Any unexplained death within the first 30 days or Any MI (related to documented acute ischemia and without another obvious cause) in the territory of the stent; Possible includes Any unexplained death > 30 days. Acute includes those ≤ 24 hours post procedure; sub-acute includes those > 24 hours to ≤ 30 days post procedure; and late includes those > 30 days to ≤ 1 year post procedure; and very late includes those > 1 year post procedure.

    Measured: 12 Months

  10. Rate of Protocol Defined Major Bleeding Complications

    Defined by the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) classification, including severe and moderate bleeding combined.

    Measured: 12 Months

  11. Rate of Cardiac Death

    Include all deaths due to cardiac causes.

    Measured: 12 Months

  12. Rate of Non-cardiac Death

    Include all deaths due to non-cardiac causes.

    Measured: 12 Months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Aug 2009 (estimated)
  2. Study startAug 2009
  3. Primary completionJan 2012
  4. Study completionMar 2016 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
2,509 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00954707
Sponsor's protocol ID
P09-6301
Status last verified
Jan 2014
First submitted
6 Aug 2009
Last updated
7 Feb 2014
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Clopidogrel & Aspirin, Prasugrel & Aspirin in people with Coronary Artery Disease, run by Cordis US Corp. at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 7 Feb 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Oct 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Phase I: the Rate of Target Lesion Failure (TLF) (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Feb 2014.

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CYPRESS - CYPHER for Evaluating Sustained Safety | AzTrials