Vol. 21 No. 3 (2017)
INTERVENTIONAL CARDIOLOGY

Prospective rAndomized, single-blind, mulTicenter study of sirolimus-eluting coRonary stent “Calypso” vs everolimus-eluting cOronary stenT “XiencePrime”: results of the PATRIOT trial

A. Prokhorikhin
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
Bio
V. Baystrukov
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
I. Grazhdankin
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
D. Ponomarev
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
V. Verin
Primorsky Regional Clinical Hospital No. 1, Vladivostok, Russian Federation
A. Osiev
Moscow Regional Research and Clinical Institute, Moscow, Russian Federation
V. Ganyukov
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
A. Protopopov
Regional Clinical Hospital, Krasnoyarsk, Russian Federation
V. Dyomin
Orenburg Regional Clinical Hospital, Orenburg, Russian Federation
S. Abugov
Petrovsky Russian Research Center of Surgery, Ministry of Health of Russian Federation, Moscow, Russian Federation
A. Boykov
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
D. Malaev
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
A. Karaskov
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
E. Pokushalov
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
E. Kretov
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation

Published 2017-11-22

Keywords

  • coronary stent,
  • randomized trial,
  • “Calypso”,
  • ischemic heart disease

How to Cite

Prokhorikhin, A., Baystrukov, V., Grazhdankin, I., Ponomarev, D., Verin, V., Osiev, A., Ganyukov, V., Protopopov, A., Dyomin, V., Abugov, S., Boykov, A., Malaev, D., Karaskov, A., Pokushalov, E., & Kretov, E. (2017). Prospective rAndomized, single-blind, mulTicenter study of sirolimus-eluting coRonary stent “Calypso” vs everolimus-eluting cOronary stenT “XiencePrime”: results of the PATRIOT trial. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 21(3), 76–85. https://doi.org/10.21688/1681-3472-2017-3-76-85

Abstract

Aim. This trial was aimed at comparing the efficacy and safety of sirolimus-eluting coronary stent “Calypso” (Angioline) and everolimus-eluting coronary stent “XiencePrime” (Abbott Vascular) when used for treatment of ischemic heart disease patients.
Methods. The trial included patients suitable for coronary revascularization with coronary stenting. They underwent a standard revascularization procedure and were randomized in 2:1 ratio to receive “Calypso” coronary stent (Angioline) (n = 407) or “XiencePrime” coronary stent (AbbottVascular) (n = 203). The follow-up period was 12 months. In order to detect restenosis (secondary endpoint), angiographic follow-up was performed in 20% of cases at 12 months. The trial protocol had no limitations regarding the length of lesions, number of target lesions and number of implanted stents. The main exclusion criterion was STEMI. The composite primary endpoint included one-year target lesion-related complications determined as cardiogenic death, target vessel myocardial infarction, clinically indicated target lesion revascularization. The primary endpoint data were evaluated by an independent committee.
Results. In the trial, 55% of patients had acute coronary syndrome with ST elevation and type C lesions were detected in 46% of cases. In “Calypso” and “XiencePrime” groups, TLF occurred in 5.4% and 6.4% respectively (absolute risk difference in TLF accounted for 1%, 95% CI [---;2.1%]; p non-inferiority = 0.017). Thus, the hypothesis of non-inferiority of “Calypso” as compared to “XiencePrime” was confirmed. The incidence of stent thrombosis (definite and probable) was relatively low and had no significant differences between “Calypso” and “XiencePrime” groups (0.73% and 0%; p>0.05). Definite stent thrombosis was noted in two cases in the “Calypso” group (0.49%), in one case the cause of thrombosis turned out to be incomplete stent expansion after implantation.
Conclusion. “Calypso” sirolimus eluting stent was not inferior to “XiencePrime” everolimus-eluting stent in treating patients with coronary heart disease.

Received 7 November 2017. Revised 13 November 2017. Accepted 20 November 2017.

Funding: The study was funded by “Angioline Interventional Devices” (Novosibirsk, Russian Federation). The supporting source had no involvement in study design; collection, analysis and interpretation of data; writing of the report; and in the decision to submit the article for publication.

Conflict of interest: The authors declare no conflict of interest.

References

  1. Morice M.C., Serruys P.W., Sousa J.E., Fajadet J., Ban Hayashi E., Perin M., Colombo A., Schuler G., Barragan P., Guagliumi G., Molnàr F., Falotico R.; RAVEL Study Group. Randomized Study with the Sirolimus-Coated Bx Velocity Balloon-Expandable Stent in the Treatment of Patients with de Novo Native Coronary Artery Lesions. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002;346(23):1773-80. PMID: 12050336 http://dx.doi.org/10.1056/NEJMoa012843
  2. Moses J.W., Leon M.B., Popma J.J., Fitzgerald P.J., Holmes D.R., O'Shaughnessy C., Caputo R.P., Kereiakes D.J., Williams D.O., Teirstein P.S., Jaeger J.L., Kuntz R.E.; SIRIUS Investigators.Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med. 2003;349(14):1315-23. PMID: 14523139 http://dx.doi.org/10.1056/NEJMoa035071
  3. Kastrati A., Mehilli J., Pache J., Kaiser C., Valgimigli M., Kelbaek H., Menichelli M., Sabaté M., Suttorp M.J., Baumgart D., Seyfarth M., Pfisterer M.E., Schömig A. Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med. 2007;356(10):1030-9. PMID: 17296823 http://dx.doi.org/10.1056/NEJMoa067484
  4. Daemen J., Wenaweser P., Tsuchida K., Abrecht L., Vaina S., Morger C., Kukreja N., Jüni P., Sianos G., Hellige G., van Domburg R.T., Hess O.M., Boersma E., Meier B., Windecker S., Serruys PW. Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study. Lancet. 2007;369(9562):667-78. PMID: 17321312 http://dx.doi.org/10.1016/S0140-6736(07)60314-6
  5. Serruys P.W., Ruygrok P., Neuzner J., Piek J.J., Seth A., Schofer J.J., Richardt G., Wiemer M., Carrié D., Thuesen L., Boone E., Miquel-Herbert K., Daemen J. A randomised comparison of an everolimus-eluting coronary stent with a paclitaxel-eluting coronary stent: the SPIRIT II trial. EuroIntervention. 2006;2(3):286-94. PMID: 19755303
  6. Tsuchida K., Piek J.J., Neumann F.J., van der Giessen W.J., Wiemer M., Zeiher A.M., Grube E., Haase J., Thuesen L., Hamm C.W., Veldhof S., Dorange C., Serruys P.W. One-year results of a durable polymer everolimus-eluting stent in de novo coronary narrowings (The SPIRIT FIRST Trial). EuroIntervention. 2005;1(3):266-72. PMID: 19758915
  7. Воробьев В.Л., Семенихин А.А., Грачев Н.И., Верин В.В. Проспективное исследование однолетних клинических результатов использования коронарного стента «Калипсо» у пациентов с острым коронарным синдромом. Патология кровообращения и кардиохирургия. 2017;21(1):44-49. http://dx.doi.org/10.21688/1681-3472-2017-1-44-49 [Vorobev V.L., Semenihin A.A., Grachev N.I., Verin V.V. Prospective study one-year clinical outcomes of the Calypso coronary stent in patients presenting with acute coronary syndrome. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2017;21(1):44-49. (In Russ.). http://dx.doi.org/10.21688/1681-3472-2017-1-44-49]
  8. Лопотовский П.Ю., Пархоменко М.В., Коков Л.С. Предварительные результаты Регистра ретроспективного исследования практики применения российских стентов «Синус» и «Калипсо». Вестник Росздравнадзора. 2015;(5):44-49. [Lopotovskiy P.Y., Parkhomenko M.V., Kokov L.S. Preliminary results of a retrospective study register for the use of Russian stents «Sinus» and «Calypso». Vestnik Roszdravnadzora. 2015;(5):44-49. (in Russ.)]
  9. Прохорихин А.А., Верин В.В., Осиев А.Г., Ганюков В.И., Протопопов А.В., Демин В.В., Абугов С.А., Байструков В.И., Гражданкин И.О., Пономарев Д.Н., Кретов Е.И. Простое слепое проспективное рАндомизированное мультиценТровое исследование эффективности и безопасности сиролимус-доставляющего коРонарного стента «КалИпсО» по сравнению с эверолимус-доставляющим сТентом XiencePrime. Патология кровообращения и кардиохирургия. 2016;20(4):96-101. http://dx.doi.org/ 10.21688/1681-3472-2016-4-96-101 [Prokhorikhin A.A., Verin V.V., Osiev A.G., Ganyukov V.I., Protopopov A.V., Dyomin V.V., Abugov S.A., Baystrukov V.I., Grazhdankin I.O., Ponomaryov D.N., Kretov E.I. Prospective rAndomized, single-blind, mulTicenter control clinical study of sirolimus-eluting coRonary stent “Calypso” vs everolimus-elutIng cOronary stenT “XiencePrime”: design and rationale for “PATRIOT” trial. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2016;20(4):96-101. (In Russ.). http://dx.doi.org/10.21688/1681-3472-2016-4-96-101]
  10. Tunes da Silva G., Logan B.R., Klein J.P. Methods for equivalence and noninferiority testing. Biol Blood Marrow Transplant. 2009;15(1 Suppl):120-7. PMID: 19147090 PMCID: PMC2701110 http://dx.doi.org/10.1016/j.bbmt.2008.10.004
  11. Pilgrim T., Heg D., Roffi M., Tüller D., Muller O., Vuilliomenet A., Cook S., Weilenmann D., Kaiser C., Jamshidi P., Fahrni T., Moschovitis A., Noble S., Eberli F.R., Wenaweser P., Jüni P., Windecker S. Ultrathin strut biodegradable polymer sirolimus-eluting stent versus durable polymer everolimus-eluting stent for percutaneous coronary revascularisation (BIOSCIENCE): a randomised, single-blind, non-inferiority trial. Lancet. 2014;384(9960):2111-22. PMID: 25189359 http://dx.doi.org/10.1016/S0140-6736(14)61038-2
  12. Windecker S., Haude M., Neumann F.J., Stangl K., Witzenbichler B., Slagboom T., Sabaté M., Goicolea J., Barragan P., Cook S., Piot C., Richardt G., Merkely B., Schneider H., Bilger J., Erne P., Waksman R., Zaugg S., Jüni P., Lefèvre T. Comparison of a novel biodegradable polymer sirolimus-eluting stent with a durable polymer everolimus-eluting stent: results of the randomized BIOFLOW-II trial. Circ Cardiovasc Interv. 2015;8(2):e001441. PMID: 25634905 http://dx.doi.org/10.1161/CIRCINTERVENTIONS.114.001441
  13. Iqbal J., Serruys P.W., Silber S., Kelbaek H., Richardt G., Morel M.A., Negoita M., Buszman P.E., Windecker S. Comparison of zotarolimus- and everolimus-eluting coronary stents: final 5-year report of the RESOLUTE all-comers trial. Circ Cardiovasc Interv. 2015;8(6):e002230. http://dx.doi.org/10.1161/CIRCINTERVENTIONS.114.002230
  14. Serruys P.W., Silber S., Garg S., van Geuns R.J., Richardt G., Buszman P.E., Kelbaek H., van Boven A.J., Hofma S.H., Linke A., Klauss V., Wijns W., Macaya C., Garot P., DiMario C., Manoharan G., Kornowski R., Ischinger T., Bartorelli A., Ronden J., Bressers M., Gobbens P., Negoita M., van Leeuwen F., Windecker S. Comparison of zotarolimus-eluting and everolimus-eluting coronary stents. N Engl J Med. 2010;363(2):136-46. PMID: 20554978 http://dx.doi.org/10.1056/NEJMoa1004130