A randomized multicenter trial comparing the XIENCE everolimus eluting stent with the CYPHER sirolimus eluting stent in the treatment of female patients with de novo coronary artery lesions: The SPIRIT WOMEN study.

<h4>Background</h4>The comparative performance of different drug-eluting stents (DES) among female patients has not been assessed in a randomized manner.<h4>Objectives</h4>The SPIRIT Women Clinical Evaluation trial compared the durable polymer everolimus-eluting XIENCE stent...

Full description

Saved in:
Bibliographic Details
Main Authors: Anna Franzone, Serge Zaugg, Raffaele Piccolo, Maria Grazia Modena, Ghada W Mikhail, Josepa Mauri Ferré, Ruth Strasser, Liliana Grinfeld, Dik Heg, Peter Jüni, Stephan Windecker, Marie-Claude Morice
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182632&type=printable
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850230400617545728
author Anna Franzone
Serge Zaugg
Raffaele Piccolo
Maria Grazia Modena
Ghada W Mikhail
Josepa Mauri Ferré
Ruth Strasser
Liliana Grinfeld
Dik Heg
Peter Jüni
Stephan Windecker
Marie-Claude Morice
author_facet Anna Franzone
Serge Zaugg
Raffaele Piccolo
Maria Grazia Modena
Ghada W Mikhail
Josepa Mauri Ferré
Ruth Strasser
Liliana Grinfeld
Dik Heg
Peter Jüni
Stephan Windecker
Marie-Claude Morice
author_sort Anna Franzone
collection DOAJ
description <h4>Background</h4>The comparative performance of different drug-eluting stents (DES) among female patients has not been assessed in a randomized manner.<h4>Objectives</h4>The SPIRIT Women Clinical Evaluation trial compared the durable polymer everolimus-eluting XIENCE stent (DP-EES) with the durable polymer sirolimus-eluting Cypher stent (DP-SES) in women undergoing percutaneous coronary intervention (PCI).<h4>Methods</h4>A total of 455 female patients with stable CAD were randomly assigned to receive DP-EES (n = 304) or DP-SES (n = 151). The powered angiographic outcome of the trial was in-stent late lumen loss (LLL) at 9 months after the index procedure. Secondary angiographic end points included in-segment LLL, in-stent and in-segment binary restenosis and percent diameter stenosis. The primary clinical outcome was a composite of all-cause death, myocardial infarction (MI) or target vessel revascularization (TVR).<h4>Results</h4>At 9-month follow-up, in-stent LLL was 0.19±0.38 mm and 0.11±0.37 mm in patients assigned to DP-EES and DP-SES, respectively. The one-sided upper 95% CI of the difference in in-stent LLL between the groups of 0.08 mm was 0.15 and therefore within the pre-specified non-inferiority margin of 0.17 mm (p for non-inferiority = 0.013). However, the test for superiority showed a borderline significant difference in terms of LLL between DP-EES and DP-SES (p for superiority = 0.044). There were no significant differences in binary restenosis (2.0% vs. 0.72%, p = 0.44) and percent diameter stenosis (14.97±12.17 vs. 13.36±10.82, p = 0.19). The rate of definite stent thrombosis at 12 months was lower in patients treated with DP-EES (0% vs. 2.0%, p = 0.036).<h4>Conclusions</h4>Among women undergoing PCI, DP-EES was associated with a small but probably clinically relevant increase in in-stent LLL at 9 months as compared to DP-SES and with a lower risk of definite stent thrombosis at 12 months.<h4>Trial registration</h4>ClinicalTrials.gov NCT01182428. https://clinicaltrials.gov/.
format Article
id doaj-art-df70fd5756ee4b3e92001be0af014666
institution OA Journals
issn 1932-6203
language English
publishDate 2017-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-df70fd5756ee4b3e92001be0af0146662025-08-20T02:03:53ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01128e018263210.1371/journal.pone.0182632A randomized multicenter trial comparing the XIENCE everolimus eluting stent with the CYPHER sirolimus eluting stent in the treatment of female patients with de novo coronary artery lesions: The SPIRIT WOMEN study.Anna FranzoneSerge ZauggRaffaele PiccoloMaria Grazia ModenaGhada W MikhailJosepa Mauri FerréRuth StrasserLiliana GrinfeldDik HegPeter JüniStephan WindeckerMarie-Claude Morice<h4>Background</h4>The comparative performance of different drug-eluting stents (DES) among female patients has not been assessed in a randomized manner.<h4>Objectives</h4>The SPIRIT Women Clinical Evaluation trial compared the durable polymer everolimus-eluting XIENCE stent (DP-EES) with the durable polymer sirolimus-eluting Cypher stent (DP-SES) in women undergoing percutaneous coronary intervention (PCI).<h4>Methods</h4>A total of 455 female patients with stable CAD were randomly assigned to receive DP-EES (n = 304) or DP-SES (n = 151). The powered angiographic outcome of the trial was in-stent late lumen loss (LLL) at 9 months after the index procedure. Secondary angiographic end points included in-segment LLL, in-stent and in-segment binary restenosis and percent diameter stenosis. The primary clinical outcome was a composite of all-cause death, myocardial infarction (MI) or target vessel revascularization (TVR).<h4>Results</h4>At 9-month follow-up, in-stent LLL was 0.19±0.38 mm and 0.11±0.37 mm in patients assigned to DP-EES and DP-SES, respectively. The one-sided upper 95% CI of the difference in in-stent LLL between the groups of 0.08 mm was 0.15 and therefore within the pre-specified non-inferiority margin of 0.17 mm (p for non-inferiority = 0.013). However, the test for superiority showed a borderline significant difference in terms of LLL between DP-EES and DP-SES (p for superiority = 0.044). There were no significant differences in binary restenosis (2.0% vs. 0.72%, p = 0.44) and percent diameter stenosis (14.97±12.17 vs. 13.36±10.82, p = 0.19). The rate of definite stent thrombosis at 12 months was lower in patients treated with DP-EES (0% vs. 2.0%, p = 0.036).<h4>Conclusions</h4>Among women undergoing PCI, DP-EES was associated with a small but probably clinically relevant increase in in-stent LLL at 9 months as compared to DP-SES and with a lower risk of definite stent thrombosis at 12 months.<h4>Trial registration</h4>ClinicalTrials.gov NCT01182428. https://clinicaltrials.gov/.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182632&type=printable
spellingShingle Anna Franzone
Serge Zaugg
Raffaele Piccolo
Maria Grazia Modena
Ghada W Mikhail
Josepa Mauri Ferré
Ruth Strasser
Liliana Grinfeld
Dik Heg
Peter Jüni
Stephan Windecker
Marie-Claude Morice
A randomized multicenter trial comparing the XIENCE everolimus eluting stent with the CYPHER sirolimus eluting stent in the treatment of female patients with de novo coronary artery lesions: The SPIRIT WOMEN study.
PLoS ONE
title A randomized multicenter trial comparing the XIENCE everolimus eluting stent with the CYPHER sirolimus eluting stent in the treatment of female patients with de novo coronary artery lesions: The SPIRIT WOMEN study.
title_full A randomized multicenter trial comparing the XIENCE everolimus eluting stent with the CYPHER sirolimus eluting stent in the treatment of female patients with de novo coronary artery lesions: The SPIRIT WOMEN study.
title_fullStr A randomized multicenter trial comparing the XIENCE everolimus eluting stent with the CYPHER sirolimus eluting stent in the treatment of female patients with de novo coronary artery lesions: The SPIRIT WOMEN study.
title_full_unstemmed A randomized multicenter trial comparing the XIENCE everolimus eluting stent with the CYPHER sirolimus eluting stent in the treatment of female patients with de novo coronary artery lesions: The SPIRIT WOMEN study.
title_short A randomized multicenter trial comparing the XIENCE everolimus eluting stent with the CYPHER sirolimus eluting stent in the treatment of female patients with de novo coronary artery lesions: The SPIRIT WOMEN study.
title_sort randomized multicenter trial comparing the xience everolimus eluting stent with the cypher sirolimus eluting stent in the treatment of female patients with de novo coronary artery lesions the spirit women study
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182632&type=printable
work_keys_str_mv AT annafranzone arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT sergezaugg arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT raffaelepiccolo arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT mariagraziamodena arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT ghadawmikhail arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT josepamauriferre arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT ruthstrasser arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT lilianagrinfeld arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT dikheg arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT peterjuni arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT stephanwindecker arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT marieclaudemorice arandomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT annafranzone randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT sergezaugg randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT raffaelepiccolo randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT mariagraziamodena randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT ghadawmikhail randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT josepamauriferre randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT ruthstrasser randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT lilianagrinfeld randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT dikheg randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT peterjuni randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT stephanwindecker randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy
AT marieclaudemorice randomizedmulticentertrialcomparingthexienceeverolimuselutingstentwiththecyphersirolimuselutingstentinthetreatmentoffemalepatientswithdenovocoronaryarterylesionsthespiritwomenstudy