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WithdrawnNCT02723981COSTAUpdated Feb 20, 2017

COMBO-Stent in Patients on Chronic Anticoagulant Therapy (COSTA) COSTA-Bleed and COSTA-Outcome Trials

A Phase 4 interventional study of COMBO-Stent and Clopidogrel, Vitamin K Antagonist, Rivaroxaban, Dabigatran in Stable Angina, Unstable Angina and STEMI, sponsored by IHF GmbH - Institut für Herzinfarktforschung. Withdrawn at 10 sites in Germany. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2017-02-20.

Sponsored by IHF GmbH - Institut für Herzinfarktforschung · Phase 4, Interventional, and Treatment

Why this study was withdrawn
Regulatory authority approval for the initial study design could not be obtained
Phase
Phase 4
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
18 Years and older
Sex
All
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Study summary

Prospective, multi-centre, randomized, open-label, parallel comparisons to evaluate

  • the incidence of bleedings (COSTA-Bleed) and
  • the incidence of ischemic and bleeding events (COSTA-Outcome) following a therapy with the abluminal sirolimus coated bio-engineered stent (COMBO stent) in association with short-term single antiplatelet therapy as compared to a guidelines-based strategy in patients with coronary artery disease with an indication for chronic oral anticoagulant therapy.
Read the detailed description

The COSTA trials are investigator-initiated studies aimed at comparing the clinical outcome after percutaneous coronary intervention (PCI) using a COMBO-stent based strategy associated with short-term antiplatelet therapy with a guidelines-based therapy in patients with an indication for chronic oral anticoagulation. The study is organized as a national, multi-centre prospective, randomized trial. The duration of the follow-up is 15 months.

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Conditions studied

  • Stable Angina
  • Unstable Angina
  • STEMI
  • NSTEMI
  • Coronary Disease

Keywords

  • Stent , COMBO Stent, anticoagulation
03

In context

Angina Pectoris

519 studies on the registry are indexed under Angina Pectoris; 82 are open to participants now.

Browse Angina Pectoris studies →

Lead sponsor

IHF GmbH - Institut für Herzinfarktforschung is the lead sponsor of 16 studies on the registry; 4 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age 18 and older;
  • Willingness to comply with the study protocol; subject or a legally authorized representative must provide written informed consent prior to any study related procedure, in accordance with International Conference on harmonization of Good Clinical Practice (ICH-GCP) guidelines and per site requirements.
  • Patients on anticoagulant therapy or treatment-naive pa-tients with an indication to chronic anticoagulant therapy. Indications to oral anticoagulation may include atrial fibrillation, prosthetic valve disease, peripheral by-pass surgery, lung embolism or deep vein thrombosis or any other indication according to the Investigator´s opinion.
  • Single or multiple de novo lesion in a native coronary artery, all amenable to treatment with the COMBO stent;

Exclusion criteria

Exclusion Criteria:

  • Patients who, in the Investigator's opinion, should not be treated with (N)OAC. These may include, for instance: history of BARC 3-5 bleeding \<12 months; patients with a haemorrhagic disorder or bleeding diathesis (e.g. von Willebrand disease, haemophilia A or B or other hereditary bleeding disorder, history of spontaneous intra-articular bleeding, history of prolonged bleeding after surgery/intervention); patients with recent major surgery; history of intraocular, spinal, retroperitoneal, intra-articular or recent gastrointestinal bleeding unless the causative factor has been permanently eliminated or repaired; (reduction in the haemoglobin level of at least 2g/dL, transfusion of at least two units of blood, or symptomatic bleeding in a critical area or organ) including life-threatening bleeding episode (symptomatic intracranial bleeding, bleeding with a decrease in the haemoglobin level of at least 5g/dL or bleeding requiring transfusion of at least 4 units of blood or inotropic agents or necessitating surgery); Anaemia (haemoglobin \<10g/dL) or thrombocytopenia including heparin-induced thrombocytopenia (platelet count \<100E9/L) at screening;
  • Pregnant or nursing patients. Female patients of childbearing potential must have a negative pregnancy test done within 7 days prior to the index procedure per site standard test;
  • Other medical illness with a life expectancy \<2 years (e.g. known malignancy) or known history of substance abuse (alcohol, cocaine, heroin etc.) that may cause non-compliance with the protocol or confound the data in-terpretation or is associated with a limited life expectancy;
  • Patient has received an organ transplant or is on a wait-ing list for an organ transplant;
  • Known hypersensitivity or contraindication to antiplate-let or anticoagulant agents that does not allow guide-lines-compliant therapy and that cannot be adequately pre-medicated;
  • Previously received murine therapeutic antibodies and exhibited sensitization through the production of Human Anti-Murine Antibodies (HAMA);
  • Any significant medical condition which in the Investigator's opinion may interfere with the patient's optimal participation in the study;
  • Current participation in another investigational drug or device study except for non-interventional registries;
  • Patients not willing or able to comply with the protocol requirements or considered unreliable by the Investigator concerning the requirements for follow up during the study and/or compliance with study drug administration;

Angiographic exclusion criteria:

  • Vessel diameter \<2 und > 5mm;
  • Target lesion with characteristics that make it unsuitable for stent delivery and deployment;
  • Planned use of a stent or another coronary device in the same or another session (target vessel or non-target vessel), precluding a COMBO-only strategy.
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
0 participants (actual)

Study arms

  • Experimental
    COMBO-Stent

    Implantation of COMBO-Stent and medication with (N)OAC and clopidogrel for 3 months followed by (N)OAC alone

    Device: COMBO-Stent · Drug: Clopidogrel, Vitamin K Antagonist, Rivaroxaban, Dabigatran

  • Active comparator
    Any Drug eluting or bare metal stent

    Implantation of any drug eluting oder bare metal stent combined with anticoagulant medication according to ESC guidelines

    Device: Any drug eluting stent oder bare metal sent · Drug: ASA, Clopidogrel, Vitamin K Antagonist, Rivaroxaban, Dabigatran

Interventions

  • DeviceCOMBO-Stent

    The OrbusNeich COMBO Bio-engineered Sirolimus Eluting Stent (COMBO Stent) consists of a 316L stainless steel alloy abluminally coated with a biocompatible, biodegradable poly-mer containing sirolimus. Covalently attached to the surface of the stent is a layer of murine, monoclonal, anti-human CD34 antibody. The antibody specifically targets circulatory CD34+ cells (endothelial progenitor cells) thus favoring endothelialization.

  • DrugClopidogrel, Vitamin K Antagonist, Rivaroxaban, Dabigatran

    Anticoagulant medication after stent Implantation: (N)OAC and clopidogrel for 3 months followed by (N)OAC

    Also known as: Plavix, Marcumar, Xarelto, Pradaxa

  • DeviceAny drug eluting stent oder bare metal sent

    Implantation of traditional bare metal stents and/or drug eluting stents (any device approved on the market, implanted according to CE marking and IFU) and medication regimen in accordance with ESC Guidelines

    Also known as: Cypher, Taxus, CoStar, Janus, Endeavor, Xience, Promus, Multi Link, Coroflex, Veriflex, Integrity, Driver

  • DrugASA, Clopidogrel, Vitamin K Antagonist, Rivaroxaban, Dabigatran

    A combination of antiplatelet and anticoagulant therapy according to ESC guidelines (2014)

    Also known as: Anticoagulant medication according to ESC guidelines

06

What researchers measure

Primary outcomes

  1. Number of patients with bleedings

    any BARC (bleeding academic research consortium) bleeding at 6 weeks - superiority.

    Time frame: 6 weeks

  2. Number of patients with safety events

    Strategy oriented composite safety endpoint, including death (unless proven not to be connected to the other endpoints), any MI, stroke or systemic embolism, definite or probable stent thrombosis, BARC 3-4 bleeding at 15 months post PCI - non-inferiority with reflex to superiority testing. Hierarchical testing: Endpoint II is only tested if null hypothesis of no difference in bleeding incidence can be rejected at final analysis.

    Time frame: 15 months

07

Study locations

10 sites
  • MVZ am Kuechwald GmbH
    Chemnitz, Germany
  • Elisabeth Krankenhaus
    Essen, Germany
  • Universitaetsmedizin Mainz
    Mainz, Germany
  • Theresienkrankenhaus und St. Hedwig GmbH
    Mannheim, Germany
  • Universitaetsmedizin Mannheim
    Mannheim, Germany
  • St. Franziskus, Kliniken Maria Hilf GmbH
    Moenchengladbach, Germany
  • Evangelisches Krankenhuas Muehlheim a.d. Ruhr GmbH
    Muehlheim an der Ruhr, Germany
  • Diakonissen-Stiftungs-Krankenhaus
    Speyer, Germany
  • Herzklinik Ulm GbR
    Ulm, Germany
  • Schwarzwald-Baar-Klinikum
    Villingen-Schwenningen, Germany
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References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 20, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02723981
Lead sponsor
IHF GmbH - Institut für Herzinfarktforschung
Collaborators
OrbusNeich
Responsible party
Sponsor
First posted
Mar 31, 2016
Start date
Apr 2016
Primary completion
May 2018 (estimated)
Completion
Dec 2018 (estimated)
Last update
Feb 20, 2017

Study contacts

Tommasso Gori
principal investigator · Universitaetsmedizin Mainz
Ibrahim Akin
principal investigator · Universitaetsmedizin Mannheim

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is withdrawn, as verified in Feb 2017. You cannot join it, but the record below documents what was studied.

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