Sirolimus-eluting iron bioresorbable scaffold versus cobalt-chromium everolimus-eluting stents in patients with coronary artery disease: Rationale and design of the IRONMAN-II trial

Am Heart J. 2024 Sep:275:53-61. doi: 10.1016/j.ahj.2024.05.019. Epub 2024 Jun 4.

Abstract

Background: The previous first-in-human study established the preliminary safety and effectiveness of the novel thin-strut iron bioresorbable scaffold (IBS). The current study aims to directly compare the imaging and physiological efficacy, and clinical outcomes of IBS with contemporary metallic drug-eluting stents (DES).

Methods: A total of 518 patients were randomly allocated to treatment with IBS (257 patients) or metallic DES (261 patients) from 36 centers in China. The study is powered to test noninferiority of the IBS compared with the metallic everolimus-eluting stent in terms of the primary endpoint of in-segment late lumen loss at 2 years, and major secondary endpoints including 2-year quantitative flow ratio and cross-sectional mean flow area measured by optical coherence tomography (OCT) (limited to the OCT subgroup, 25 patients in each group).

Conclusion: This will be the first powered randomized trial investigating the safety and efficacy of the novel thin-strut IBS compared to a contemporary metallic DES. The findings will provide valuable evidence for future research of this kind and the application of metallic bioresorbable scaffolds.

Publication types

  • Clinical Trial Protocol
  • Comparative Study

MeSH terms

  • Absorbable Implants*
  • Coronary Artery Disease* / surgery
  • Coronary Artery Disease* / therapy
  • Drug-Eluting Stents*
  • Everolimus* / administration & dosage
  • Everolimus* / pharmacology
  • Female
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / pharmacology
  • Iron
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Percutaneous Coronary Intervention / methods
  • Prosthesis Design
  • Randomized Controlled Trials as Topic
  • Sirolimus* / administration & dosage
  • Sirolimus* / analogs & derivatives
  • Sirolimus* / pharmacology
  • Tissue Scaffolds
  • Tomography, Optical Coherence* / methods
  • Treatment Outcome

Substances

  • Everolimus
  • Immunosuppressive Agents
  • Iron
  • Sirolimus