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Coronary Heart DiseasePhase 4HOST-ASSURENCT01267734

Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis - SAfety & EffectiveneSS of Drug-ElUting Stents & Anti-platelet REgimen

A Phase 4 study testing Everolimus-eluting coronary stenting system (EECSS, Promus Element), Zotarolimus-eluting coronary stenting system (ZECSS, Endeavor Resolute) and Triple anti-platelet therapy (TAT) in people with Coronary Heart Disease, run by Seoul National University Hospital at 1 site in South Korea.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

Objectives 1. To compare the safety and long-term effectiveness of coronary stenting with the new platform Everolimus-Eluting coronary stenting system (EECSS, Promus Element) compared with the Zotarolimus-Eluting coronary stenting system (ZECSS, Endeavor Resolute) in patients with coronary heart disease (CHD) 2. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Coronary Heart Disease
What is being tested?
Everolimus-eluting coronary stenting system (EECSS, Promus Element), Zotarolimus-eluting coronary stenting system (ZECSS, Endeavor Resolute) and Triple anti-platelet therapy (TAT)
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
3,750 participants
Where
1 siteSouth Korea
Study dates
Jun 2010to Jun 2015
Phase
Phase 4
Are there results?
None posted in the registry

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

Who may be able to join

None listed.

Who cannot join

  • The patient has a known hypersensitivity or contraindication to any of the following medications: Heparin, Aspirin, Clopidogrel, Cilostazol, Everolimus, Zotarolimus, Contrast media (Patients with documented sensitivity to contrast media which can be effectively premedicated with steroids and diphenhydramine [e.g. rash] may be enrolled. Those with true anaphylaxis to prior contrast media, however, should not be enrolled.)
  • Systemic (intravenous) Everolimus or Zotarolimus use within 12 months.
  • Female of childbearing potential, unless a recent pregnancy test is negative, who possibly plan to become pregnant any time after enrollment into this study.
  • History of bleeding diathesis, known coagulopathy (including heparin-induced thrombocytopenia), abnormal hemogram (Hb<10g/dL or PLT count <100,000/μL) or will refuse blood transfusions
  • Patients with severe LV systolic dysfunction (LVEF<25%) or cardiogenic shock
  • Gastrointestinal or genitourinary bleeding within the prior 3 months, or major surgery within 2 months.
Show all 9Show fewer
  • Non-cardiac co-morbid conditions are present with life expectancy <1 year or that may result in protocol non-compliance (per site investigator's medical judgment).
  • Patients who are actively participating in another drug or device investigational study, which have not completed the primary endpoint follow-up period.
  • Symptomatic heart failure

Trial locations and contacts

1 site in 1 country.

Kyung Woo Park, MD, PhD contact

82-2-2072-0244

kwparkmd@snu.ac.kr

Hyo-Soo Kim, MD, PhD contact

82-2-2072-2226

hyosoo@snu.ac.kr

South Korea1 site, 1 recruiting
  • Seoul National University Hospital

    Seoul, 110-744

    Kyung Woo Park, MD, PhD, 82-2-2072-0244, kwparkmd@snu.ac.kr

    Hyo-Soo Kim, MD, PhD, 82-2-2072-2226, hyosoo@snu.ac.kr

    Recruiting

Other trials in South Korea

About this study

Official title: Comparison of the Efficacy and Safety of New Platform Everolimus-eluting Coronary Stent System (Promus Element) With Zotarolimus-eluting Coronary Stent System (Endeavor Resolute) and Triple Anti-platelet Therapy With Double-dose Clopidogrel Anti-platelet Therapy in Patients With Coronary Heart Disease

Objectives

  1. To compare the safety and long-term effectiveness of coronary stenting with the new platform Everolimus-Eluting coronary stenting system (EECSS, Promus Element) compared with the Zotarolimus-Eluting coronary stenting system (ZECSS, Endeavor Resolute) in patients with coronary heart disease (CHD)
  2. To determine the short-term efficacy and safety of triple anti-platelet therapy (TAT, Aspirin 100mg qd, Clopidogrel 75mg qd and Cilostazol 100mg bid) compared with double-dose clopidogrel dual anti-platelet therapy (DDAT, Aspirin 100mg qd and Clopidogrel 150mg qd) in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES)
Read more

Study design Prospective, open-label, 2-by-2 multifactorial, randomized, multicenter trial to test the following in CHD patients

  1. Non-inferiority of Promus Element stent compared with Endeavor Resolute stent in reducing target lesion failure (TLF)
  2. Non-inferiority of TAT compared with DDAT in reducing net clinical outcome Patients will be randomized in a 2-by-2 factorial manner according to the type of drug eluting stent (EECSS vs. ZECSS) and the type anti-platelet regimen (TAT vs. DDAT). Randomization will also be stratified per presence of DM.

Patient enrollment 3750 patients enrolled at 50 centers in Republic of Korea

Patient follow-up Clinical follow-up will occur at 1, 3, 12, 24, 36 months after the procedure. Angiographical follow-up will be recommended to all participants at 13 months after the procedure. Investigator or designee may conduct follow-up as telephone contacts or office visits.

Primary endpoint

  1. Target lesion failure (TLF), defined as a composite of cardiac death, target vessel-related myocardial infarction (MI) and ischemia-driven target lesion revascularization (TLR) up to 12 months for the stent arm
  2. Net clinical outcome, defined as a composite of cardiac death, nonfatal MI, CVA and major bleeding by PLATO criteria at 1 month for the anti-platelet arm
Read the detailed description

Secondary endpoint

  1. Clinical and laboratory endpoint at 1 month All death and cardiac death Myocardial infarction (q wave and non-q wave) Stent thrombosis (definite and possible) CVA (hemorrhagic and non-hemorrhagic) Bleeding (major and minor) VerifyNow ASA and VerifyNow P2Y12
  2. Clinical endpoint at 12 months All death and cardiac death Target vessel-related MI and all MI (q wave and non-q wave) Target vessel/lesion revascularization (ischemia-driven and all) Stent thrombosis (definite/possible/probable) Net clinical outcome including bleeding (major and minor) Acute success of procedure (device, lesion and procedure)
  3. Angiographic (including IVUS or OCT) endpoint at 13 months In-stent \& In-segment late loss In-stent \& In-segment % diameter stenosis Angiographic pattern of restenosis Neointimal volume, % neointimal volume and % volume obstruction on IVUS or OCT Degree of stent strut endothelialization on OCT
Being tested
Everolimus-eluting coronary stenting system (EECSS, Promus Element), Zotarolimus-eluting coronary stenting system (ZECSS, Endeavor Resolute), Triple anti-platelet therapy (TAT), Double-dose clopidogrel anti-platelet therapy (DDAT)
Keywords
Everolimus, Zotarolimus, Cilostazol, Clopidogrel
Medical subject headings
Coronary Disease

What participants receive

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

  • Everolimus-eluting coronary stenting system (EECSS, Promus Element)Device

    Also called Promus Element

    Everolimus-eluting stent

  • Zotarolimus-eluting coronary stenting system (ZECSS, Endeavor Resolute)Device

    Also called Endeavor Resolute

    Zotarolimus-eluting stent

  • Triple anti-platelet therapy (TAT)Drug

    100mg Aspirin QD + 75mg Clopidogrel QD + 100mg Cilostazol BID for 1 month

  • Double-dose clopidogrel anti-platelet therapy (DDAT)Drug

    100mg Aspirin QD + 150mg Clopidogrel QD for 1 month

Study groups in NCT01267734
Study groupRoleWhat they receive
EECSS + DDATExperimentalPromus Element stent + double-dose clopidogrel anti-platelet therapy
Receives: Device: Everolimus-eluting coronary stenting system (EECSS, Promus Element); Drug: Double-dose clopidogrel anti-platelet therapy (DDAT)
ZECSS + DDATActive comparatorEndeavor Resolute stent + double-dose clopidogrel anti-platelet therapy
Receives: Device: Zotarolimus-eluting coronary stenting system (ZECSS, Endeavor Resolute); Drug: Double-dose clopidogrel anti-platelet therapy (DDAT)
EECSS + TATExperimentalPromus Element stent + triple anti-platelet therapy
Receives: Device: Everolimus-eluting coronary stenting system (EECSS, Promus Element); Drug: Triple anti-platelet therapy (TAT)
ZECSS + TATActive comparatorEndeavor Resolute stent + triple anti-platele therapy
Receives: Device: Zotarolimus-eluting coronary stenting system (ZECSS, Endeavor Resolute); Drug: Triple anti-platelet therapy (TAT)

What is being measured

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

  1. Target lesion failure (TLF)

    Composite of cardiac death, target vessel-related myocardial infarction (MI) and ischemia-driven target lesion revascularization (TLR)

    Measured: 12 months

  2. Net clinical outcome

    Composite of cardiac death, nonfatal MI, CVA and major bleeding by PLATO criteria

    Measured: 1 month

Timeline

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

  1. First posted28 Dec 2010 (estimated)
  2. Study startJun 2010
  3. Primary completionDec 2011
  4. Study completionJun 2015 (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
None (open label)
Enrolment
3,750 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01267734
Sponsor's protocol ID
HOST-ASSURE
Acronym
HOST-ASSURE
Status last verified
Dec 2013
First submitted
27 Dec 2010
Last updated
17 Dec 2013
Results posted
No
Data monitoring committee
Yes

Publications

  • Park KW, Kang SH, Kang HJ, Koo BK, Park BE, Cha KS, Rhew JY, Jeon HK, Shin ES, Oh JH, Jeong MH, Kim S, Hwang KK, Yoon JH, Lee SY, Park TH, Moon KW, Kwon HM, Hur SH, Ryu JK, Lee BR, Park YW, Chae IH, Kim HS; HOST-ASSURE Investigators. A randomized comparison of platinum chromium-based everolimus-eluting stents versus cobalt chromium-based Zotarolimus-Eluting stents in all-comers receiving percutaneous coronary intervention: HOST-ASSURE (harmonizing optimal strategy for treatment of coronary artery stenosis-safety & effectiveness of drug-eluting stents & anti-platelet regimen), a randomized, controlled, noninferiority trial. J Am Coll Cardiol. 2014 Jul 1;63(25 Pt A):2805-16. doi: 10.1016/j.jacc.2014.04.013. Epub 2014 May 7.

    PubMed 24814486
  • Park KW, Kang SH, Park JJ, Yang HM, Kang HJ, Koo BK, Park BE, Cha KS, Rhew JY, Jeon HK, Shin ES, Oh JH, Jeong MH, Kim S, Hwang KK, Yoon JH, Lee SY, Park TH, Moon KW, Kwon HM, Chae IH, Kim HS. Adjunctive cilostazol versus double-dose clopidogrel after drug-eluting stent implantation: the HOST-ASSURE randomized trial (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-Safety & Effectiveness of Drug-Eluting Stents & Anti-platelet Regimen). JACC Cardiovasc Interv. 2013 Sep;6(9):932-42. doi: 10.1016/j.jcin.2013.04.022.

    PubMed 24050860
  • Park KW, Park BE, Kang SH, Park JJ, Lee SP, Cha KS, Rhew JY, Jeon HK, Shin ES, Oh JH, Jeong MH, Kim S, Hwang KK, Yoon JH, Lee SY, Park TH, Moon KW, Kwon HM, Chae IH, Kim HS; HOST investigators. The 'Harmonizing Optimal Strategy for Treatment of coronary artery stenosis - sAfety & effectiveneSS of drug-elUting stents & antiplatelet REgimen' (HOST-ASSURE) trial: study protocol for a randomized controlled trial. Trials. 2012 Mar 31;13:29. doi: 10.1186/1745-6215-13-29.

    PubMed 22463698

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Everolimus-eluting coronary stenting system (EECSS, Promus Element), Zotarolimus-eluting coronary stenting system (ZECSS, Endeavor Resolute) and Triple anti-platelet therapy (TAT) in people with Coronary Heart Disease, run by Seoul National University Hospital at 1 site in South Korea.

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

Who may be eligible to take part?

The sponsor lists 0 inclusion and 9 exclusion criteria. 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 17 Dec 2013. 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 South Korea. 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. 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?

Results are not available in the source record.

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

Contact Kyung Woo Park, MD, PhD (82-2-2072-0244, kwparkmd@snu.ac.kr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Target lesion failure (TLF) (time frame: 12 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01267734, which also lists 3 linked publications.

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 17 Dec 2013.

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