Ticagrelore Alone Post PCI (TICALONE)
A Single-center, Randomized, 6-month, Non-inferiority Study to Compare the Safety and Efficacy of TICAgreLor mONotherapy Versus Dual Antiplatelet Therapy in Chronic Coronary Syndrome Patients Post Percutaneous Coronary IntErvention (TICALONE)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
An interventional cardiologist will perform angiography with the supervision of a fellow interventional cardiologist. Patients who need revascularization will undergo PCI using DES (Drug-eluting stent). PCI will be performed using the radial or femoral approach to achieve complete revascularization of at least one stenosis with a diameter of ≥50%. All target lesions will be revascularized using the 4th generation DES.
Randomization (1:1) will take place after diagnostic angiography but before stent insertion (figure 1). Eligible patients will be divided into two groups: the reference group, which will get conventional DAPT with aspirin and Clopidogrel (80 mg aspirin once daily, and 75mg clopidogrel once daily), and the experimental group, which will receive ticagrelor monotherapy (90mg twice daily) following PCI for six months.
Antiplatelet therapy will start before or at the time of PCI. Patients will receive a loading dose of assigned drugs (325mg for aspirin, 300mg for clopidogrel, and 180mg for ticagrelor) before stent insertion unless they are already on pre-PCI maintenance therapy with the mentioned drugs.
Subjects are randomly assigned a treatment strategy by an interactive web response system.
The primary efficacy endpoint is a composite of cardiac death, target vessel MI, stent thrombosis, and the need for revascularization occurring within 6 months of PCI. The secondary endpoints are all-cause death, occurrence of MACE including stroke (ischemic, hemorrhagic, or unknown), MI, arrhythmia, and each component of the primary endpoint at 6 months.
Safety is the third outcome
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: javad UOM Kojuri, MD.MS
- Phone Number: 09171115083
- Email: kojurij@yahoo.com
Study Contact Backup
- Name: javad UOM Kojuri, MD.MS.
- Phone Number: 09171115083
- Email: kojurij@yahoo.com
Study Locations
-
-
-
Shiraz, Iran, Islamic Republic of, 7134814336
- Recruiting
- professor Kojuroi cardiology clinic
-
Contact:
- javad kojuri, MD.MS.
- Phone Number: 09171115083
- Email: kojurij@yahoo.com
-
Contact:
- javad kojuri, MD.MS.
- Phone Number: +989171115083
- Email: kojurij@yahoo.com
-
Principal Investigator:
- Javad kojuri, MD.MS
-
-
Fars
-
Shiraz, Fars, Iran, Islamic Republic of, 51318
- Recruiting
- Cardiology Ward Shiraz University of Medical Sciences
-
Contact:
- javad kojuri, M.D.
- Phone Number: 00987116318032
- Email: kojurij@yahoo.com
-
Principal Investigator:
- javad kojuri, M.D.
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male or female above 20 years of age undergoing PCI with a drug-eluting stent for chronic coronary syndrome
- The patient has provided written informed consent as approved by the ethics committee of the Shiraz University of Medical Sciences.
Exclusion Criteria:
- Contraindication to aspirin, clopidogrel, ticagrelor, or any other reason that study drug should not be administered (including hypersensitivity, moderate or severe liver disease, active bleeding, and major surgery within 30 days)
- Atrial fibrillation or other indication for oral anticoagulant therapy.
- Concomitant oral or IV therapy with strong CYP3A inhibitors, CYP3A substrates with narrow therapeutic indices (cyclosporine, and quinidine), or strong CYP3A inducers ( rifampin, rifampicin, phenytoin, and carbamazepine)
- Females of child-bearing age unless negative pregnancy test at screening and willing to use effective contraception for the duration of trial
- Females who are breastfeeding at the time of enrolment.
- Unsuccessful PCI or PCI without optimal stent placement; this decision is made by the supervising interventional cardiologist.
- patients with anatomical SYNTAX score ≥23 prior to PCI
- Patients with planned surgical intervention to treat any cardiac or non-cardiac condition.
- Previous PCI in the last 6 months.
- Current (same hospitalization) or previous (within 12 months) acute coronary syndrome.
- History of definite stent thrombosis.
- Concomitant cardiac valve disease requiring invasive therapy.
- Acute heart failure.
- Active myocarditis.
- Cardiomyopathy.
- Patient in hemodialysis.
- History of stroke or transient ischemic cerebrovascular accident.
- History of intracranial hemorrhage or other intracranial pathology associated with increased bleeding risk.
- Hemoglobin <10 g/dL
- Peptic ulceration documented by endoscopy within the last 3 months unless healing proven by repeat endoscopy.
- Any other condition deemed by the investigator to place the patient at excessive risk of bleeding with ticagrelor.
- Participation in another trial with an investigational drug or device.
- Assessment that the subject is not likely to comply with the study procedures or have complete follow-up.
- Known drug or alcohol dependence within the past 12 months as judged by the investigator.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Clopidogrel and aspirin
Patients post PCI randomized to Aspirin 80 mg and clopidogrel 75 mg daily
|
post PCI patients received these two drugs as dual antiplatelet regimen
|
|
Experimental: ticagrelor
Patients post PCI randomized to Ticagrelor 90 mg PO two times daily
|
Post PCI patients receive Ticagrelor 90 mg two times daily as single potent antiplatelet
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
stent thrombosis
Time Frame: 6 months
|
Post PCI till 6 months any confirmed or suspected episodes of stent thrombosis based on ARCH definition
|
6 months
|
|
Major adverse cardiovascular events
Time Frame: 6 months
|
Any episodes of myocardial infarction, acute coronary syndrome, revascularization, hospital admission and major vascular events will be recorded
|
6 months
|
|
Bleeding
Time Frame: 6 months
|
any major or minor bleeding based on HASBLED criteria
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Treatment related adverse reactions
Time Frame: 6 months
|
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
- Vascular Diseases
- Cardiovascular Diseases
- Heart Diseases
- Arteriosclerosis
- Arterial Occlusive Diseases
- Coronary Disease
- Myocardial Ischemia
- Coronary Artery Disease
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Inflammatory Agents
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Fibrin Modulating Agents
- Antirheumatic Agents
- Sensory System Agents
- Analgesics, Non-Narcotic
- Analgesics
- Antipyretics
- Neurotransmitter Agents
- Anti-Inflammatory Agents, Non-Steroidal
- Cyclooxygenase Inhibitors
- Fibrinolytic Agents
- Platelet Aggregation Inhibitors
- Purinergic P2Y Receptor Antagonists
- Purinergic P2 Receptor Antagonists
- Purinergic Antagonists
- Purinergic Agents
- Ticagrelor
- Clopidogrel
- Aspirin
Other Study ID Numbers
Other Study ID Numbers
- IR.SUMS.MED.REC.1403.150
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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