Tailored Antiplatelet Therapy During Percutaneous Coronary Intervention in Patients With Diabetes Mellitus
The Effect of Point-of-care Platelet Function Assay Guided Antiplatelet Therapy on the Periprocedural Increase of Cardiac Enzymes.
The researchers aimed to investigate the effect of point-of-care platelet function assay on the periprocedural cardiac enzyme elevation in patients with diabetes mellitus.
All patients who are supposed to undergo coronary angiography were loaded with clopidogrel (300mg) and aspirin (300mg) at D-1. If patients were determined to implant coronary stent after diagnostic coronary angiography, their platelet function is assayed with Verifynow-ADP (Accumetrics). If patients have >270 unit in the assay, they are randomized to abciximab or control group. After successful stent implantation, cardiac enzymes (CK-MB, Troponin-I) are followed at 8hr, 16hr and 24hr. Clinical outcomes including bleeding complications are assessed at 1 month.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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-
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Seongnam, Korea, Republic of
- Seoul National University Bundang Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients who were determined to implant drug-eluting coronary stent
- Diabetes mellitus (type 1 or 2)
Exclusion Criteria:
- Age <18 years or >80years
- Patients with acute myocardial infarction
- Patients with history of cerebral hemorrhage ever or ischemic infarction within 2 years
- Patients with history of major surgery (abdominal, thoracic, intraocular) within 6 months
- Patients who have have allergy to antiplatelet medications (aspirin, clopidogrel, abciximab)
- Patients who are on anticoagulation therapy
- Serum creatinine >2.0mg/dl or ALT/AST > 3 times of upper normal limit (120 U/L)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: control
|
Patients,who showed PRU >270 unit and were randomized to control group,were treated with conventional antiplatelet therapy (aspirin+clopidogrel) during PCI and follow up periods. Aspirin : D-1 300mg, D0-30 100mg qd Clopidogrel : D-1 300mg, D0-30 75mg qd
Other Names:
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Experimental: abciximab
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Patients, who showed PRU >270 unit and were randomized to abciximab group,were treated with abciximab in addition to conventional antiplatelet treatment (aspirin+clopidogrel).
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Peak cardiac enzyme level (CK-MB,troponin-I)
Time Frame: within 24 hrs
|
The investigators will check cardiac enzymes at 8hrs, 16hrs and 24hrs after percutaneous coronary intervention.
We will take the highest value among those measured at three time points as a patient's peak cardiac enzyme level.
The primary outcome of this study is to compare the peak cardiac enzyme level between two groups.
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within 24 hrs
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
major adverse cardiovascular events (MACE): a composite of cardiac death, myocardial infarction, ischemic stroke
Time Frame: 1 month
|
1 month
|
|
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Bleeding complications (cerebrovascular, intraocular, bleeding which needs transfusion more than 2 pints)
Time Frame: 1 month
|
1 month
|
|
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The rate of periprocedural myocardial infarction
Time Frame: 8hr, 16hr, 24hrs
|
The definition of periprocedural myocardial infarction : cardiac enzyme increase more than three times of upper normal limit
|
8hr, 16hr, 24hrs
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Glucose Metabolism Disorders
- Metabolic Diseases
- Endocrine System Diseases
- Diabetes Mellitus
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Platelet Aggregation Inhibitors
- Purinergic P2Y Receptor Antagonists
- Purinergic P2 Receptor Antagonists
- Purinergic Antagonists
- Purinergic Agents
- Anticoagulants
- Clopidogrel
- Abciximab
Other Study ID Numbers
Other Study ID Numbers
- DM-Verifynow
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