The standard versus prolonged dual antiplatelet therapy after the XINSORB bioresorbable scaffold implantation (SPARTA) trial: study protocol for a randomized controlled trial

Trials. 2023 Jan 20;24(1):49. doi: 10.1186/s13063-022-07028-8.

Abstract

Background: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is the standard of care after coronary stenting, including coronary stenting involving bioresorbable scaffolds (BRSs). Current clinical guidelines recommend at least 12 months of DAPT after BRS implantation. However, the correlation between prolonged DAPT and net clinical benefits remains unknown.

Methods: The SPARTA trial is designed to be a prospective, randomized, parallel-group, clinical trial. It aims to compare the benefits and risks of DAPT applied for either 12 or 36 months after XINSORB BRS implantation. The primary endpoints are the incidence of the composite endpoint of major adverse cardiac events (MACEs), including all-cause death, any myocardial infarction (MI), and all revascularizations, as well as Bleeding Academic Research Consortium Definition (BARC) type 3 or 5 bleeding events. The secondary endpoints of the study include the device-oriented composite endpoint of target lesion failure (defined as cardiac death, target vessel-related MI, or ischemia-driven target lesion revascularization), target vessel failure (defined as cardiac death, MI, or ischemia-driven target vessel revascularization), scaffold thrombosis, and minor bleeding events. This trial will enroll 2106 subjects treated with the XINSORB BRS only. All subjects will receive DAPT after the index procedure for 12 (± 1) months. Subjects without MACEs or major bleeding will be randomized to receive either 24 additional months of DAPT or aspirin alone.

Discussion: This trial is designed to investigate the impact of extending the duration of DAPT up to 3 years after XINSORB BRS implantation by investigating the balance of risks and benefits in a broad population of treated patients.

Trial registration: ClinicalTrials.gov NCT04501900 . Registered on 6 August 2020.

Keywords: Bioresorbable scaffold; Coronary artery disease; Percutaneous coronary intervention; Scaffold thrombosis.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Absorbable Implants
  • Aspirin / adverse effects
  • Drug Therapy, Combination
  • Drug-Eluting Stents*
  • Hemorrhage / chemically induced
  • Hemorrhage / drug therapy
  • Hemorrhage / prevention & control
  • Humans
  • Myocardial Infarction* / drug therapy
  • Myocardial Infarction* / etiology
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / methods
  • Platelet Aggregation Inhibitors / adverse effects
  • Prospective Studies
  • Randomized Controlled Trials as Topic

Substances

  • Platelet Aggregation Inhibitors
  • Aspirin

Associated data

  • ClinicalTrials.gov/NCT04501900