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Bioflow-DAPT Study

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT04137510
Recruitment Status : Active, not recruiting
First Posted : October 24, 2019
Last Update Posted : April 12, 2023
Information provided by (Responsible Party):
Biotronik AG

Brief Summary:

BIOFLOW-DAPT is a prospective, multi-center, international, two-arm randomized controlled clinical study.

A total of 1'948 subjects will be randomized 1:1 to receive either Orsiro Mission or Resolute Onyx. After index procedure, all patients will receive DAPT (ASA + P2Y12 inhibitor) for 30 days, followed by monotherapy with either P2Y12 inhibitor or ASA only until the end of the study.

Clinical follow-up visits will be scheduled at 1, 6 and 12 months post-procedure.

Condition or disease Intervention/treatment Phase
Coronary Artery Disease Device: Percutaneous coronary intervention Phase 4

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 1948 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Prospective, multi-center, international, two-arm randomized controlled clinical study.
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Prospective, Randomized, Multi-center Study to Assess the Safety of the Orsiro Mission Stent Compared to the Resolute Onyx Stent in Subjects at High Risk for Bleeding in Combination With 1-month Dual Antiplatelet Therapy (DAPT)
Actual Study Start Date : February 24, 2020
Actual Primary Completion Date : January 1, 2023
Estimated Study Completion Date : February 19, 2027

Arm Intervention/treatment
Experimental: Orsiro Device: Percutaneous coronary intervention
It's a non-surgical procedure that uses a catheter to place a stent into a coronary blood vessel in order to open up the vessel.

Active Comparator: Resolute Onyx Device: Percutaneous coronary intervention
It's a non-surgical procedure that uses a catheter to place a stent into a coronary blood vessel in order to open up the vessel.

Primary Outcome Measures :
  1. Composite of cardiac death, myocardial infarction (MI) and definite or probable stent thrombosis at 12 months [ Time Frame: 12 months post-procedure ]

Secondary Outcome Measures :
  1. Rate of definite/probable stent thrombosis according to the ARC definition [ Time Frame: until 12 months post-procedure ]
  2. Rate of MACCE [ Time Frame: until 12 months post-procedure ]
    composite of all-cause death, MI, and stroke

  3. Rate of MACE [ Time Frame: until 12 months post-procedure ]
    composite of cardiac death, MI, and Target Vessel Revascularization (TVR)

  4. Rate of cardiac death or MI [ Time Frame: until 12 months post-procedure ]
    all, target vessel related MI, Q-wave and non Q-wave, ST-related and non ST-related

  5. Rate of all-cause death, cardiac, non-cardiac [ Time Frame: until 12 months post-procedure ]
  6. Rate of stroke, ischemic and hemorrhagic [ Time Frame: until 12 months post-procedure ]
  7. Rate of clinically-indicated TVR [ Time Frame: until 12 months post-procedure ]
  8. Rate of clinically-indicated Target Lesion Revascularization (TLR) [ Time Frame: until 12 months post-procedure ]
  9. Rate of Target Vessel Failure (TVF) [ Time Frame: until 12 months post-procedure ]
    Composite of clinically-driven TVR, cardiac death or target-vessel related MI

  10. Rate of target lesion failure (TLF) [ Time Frame: until 12 months post-procedure ]
    Composite of clinically driven TLR, cardiac death or target vessel related MI

  11. Rate of bleeding according to BARC definition [ Time Frame: until 12 months post-procedure ]
  12. Rate of bleeding according to GUSTO definition [ Time Frame: until 12 months post-procedure ]
  13. Rate of bleeding according to TIMI definition [ Time Frame: until 12 months post-procedure ]
  14. Rate of Device success [ Time Frame: until 12 months post-procedure ]
    Attainment of less than 30% residual stenosis of the target lesion using assigned stent only

  15. Rate of Procedure success [ Time Frame: until 12 months post-procedure ]
    Attainment of less than 30% residual stenosis of the target lesion using assigned stent only without occurrence of in-hospital major adverse cardiac events

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Subject is acceptable candidate for treatment with a DES
  2. Subject is considered at high bleeding risk (HBR), defined as meeting one or more of the following criteria at the time of enrollment:

    1. ≥ 75 years of age
    2. Moderate (estimated GFR 30-59 ml/min) or severe (estimated GFR < 30 ml/min) chronic kidney disease or failure (dialysis dependent)
    3. Advanced liver disease, defined as having cirrhosis with or without portal hypertension and with or without gastroesophageal varices.
    4. Cancer (excluding non-melanoma skin cancer) diagnosed or treated within the previous 12 months or actively treated
    5. Anemia with hemoglobin < 11.0 g/dL or requiring transfusion within 4 weeks prior to randomization
    6. Baseline thrombocytopenia defined as a platelet count <100,000/mm3
    7. History of stroke (ischemic or hemorrhagic), previous intracerebral hemorrhage (ICH) (spontaneous at any time or traumatic within the past 12 months) or presence of a brain arteriovenous malformation
    8. History of hospitalization for bleeding within the previous 12 months
    9. Chronic clinically significant bleeding diathesis
    10. Clinical indication for chronic or lifelong oral anticoagulation (OAC) (with a vitamin K antagonist or non-vitamin K OAC)
    11. Clinical indication for chronic or lifelong steroid or oral nonsteroidal anti-inflammatory drug(s) (NSAIDs), other than aspirin
    12. Nondeferrable major surgery on DAPT
    13. Recent major surgery or major trauma within 30 days before PCI
    14. Precise DAPT score ≥ 25
  3. Subject is ≥ 18 years or the minimum age required for legal adult consent in the country of enrollment
  4. Subject is capable (no legally authorized representative allowed) to provide written informed consent as approved by the Institutional Review Board (IRB)/Ethics Committee (EC) of the respective clinical site prior to any study related procedure
  5. Subject is willing to comply with all protocol and follow-up requirements, including agreement to discontinue DAPT at 1 month
  6. Subject is eligible for dual antiplatelet therapy treatment with aspirin plus a P2Y12 inhibitor agent for 1-month post index procedure

Exclusion Criteria:

  1. Subject who previously experienced a stent or scaffold thrombosis in any coronary vessel
  2. Subject has a known allergy to all types of P2Y12 inhibitor (Clopidogrel, Ticagrelor, Prasugrel, Ticlopidine and Cangrelor; thus preventing the use of the appropriate P2Y12 inhibitor), aspirin, both heparin and bivalirudin, L-605 cobalt-chromium (Co-Cr) alloy or one of its major elements (cobalt, chromium, tungsten, nickel), molybdenum, platinum and irridium, silicon carbide, PLLA,polymers, mTOR inhibiting drugs such as zotarolimus or sirolimus, or contrast media
  3. Revascularization of any target vessel within 9 months prior to the index procedure or previous PCI of any non-target vessel within 72 hours prior to or during the index procedure
  4. 4. Subject with documented left ventricular ejection fraction (LVEF) <30% as evaluated by the most recent imaging exam (i.e. echocardiogram, ventriculogram, MUGA, etc.), but within 90 days pre/procedure or during the index procedure
  5. Subject judged by physician as inappropriate for discontinuation from DAPT at 1 month following index procedure, due to another condition requiring chronic DAPT
  6. Subject with planned surgery or procedure necessitating discontinuation of P2Y12 inhibitor and/or aspirin within the first month post-index procedure Note - planned staged procedure at the time of index procedure is not allowed
  7. Active bleeding at the time of inclusion
  8. Subject with a current medical condition with a life expectancy of less than 12 months
  9. Subject is currently participating or intends to participate in another investigational drug or device trial within 12 months following the index procedure or any other clinical trial that may interfere with the treatment or protocol of this study
  10. Subject is pregnant and/or breastfeeding or intends to become pregnant during the duration of the study
  11. In the investigator's opinion, subject will not be able to comply with the follow-up requirements
  12. Subjects who need an impartial witness to give an informed consent

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT04137510

Show Show 53 study locations
Sponsors and Collaborators
Biotronik AG
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Principal Investigator: Marco Valgimigli, Prof. Dr. Cardiocentro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Biotronik AG Identifier: NCT04137510    
Other Study ID Numbers: C1703
First Posted: October 24, 2019    Key Record Dates
Last Update Posted: April 12, 2023
Last Verified: April 2023
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Biotronik AG:
Dual antiplatelet therapy
high bleeding risk
Coronary artery disease
Percutaneous coronary intervention
Additional relevant MeSH terms:
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Coronary Artery Disease
Myocardial Ischemia
Coronary Disease
Heart Diseases
Cardiovascular Diseases
Arterial Occlusive Diseases
Vascular Diseases