Timing of Endoscopy in Coronary Heart Disease Patients Taking Antiplatelet Drugs With Acute Non-variceal Upper Gastrointestinal Bleeding (PACT-UGIB)
A Prospective Randomized Controlled Study on the Timing of Endoscopy in Coronary Heart Disease Patients Taking Antiplatelet Drugs With Acute Non-variceal Upper Gastrointestinal Bleeding
This is a prospective randomized controlled trial (RCT) evaluating the optimal timing of endoscopy in patients with coronary heart disease who are taking antiplatelet drugs and present with acute non-variceal upper gastrointestinal bleeding.
Eligible patients will be randomly assigned to one of two groups: an urgent endoscopy group (undergoing endoscopy within 12 hours of hospital admission) or an early endoscopy group (undergoing endoscopy between 12 and 24 hours after admission). All patients will receive standard medical treatment for upper gastrointestinal bleeding and antiplatelet management in accordance with current clinical guidelines.
The primary outcome of this study is the incidence of major adverse cardiovascular events (MACE) within 30 days between the two groups. Secondary outcomes include further bleeding events, all-cause mortality, length of hospital stay, and the need for blood transfusion during the follow-up period.
This research aims to generate evidence-based clinical guidance on the safest and most effective endoscopy timing for this high-risk patient population.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Xue Chen, MD
- Phone Number: +86-15010049359
- Email: cx19890110@163.com
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 18 years
- Patients with coronary heart disease receiving antiplatelet therapy
- Patients who can tolerate general anesthesia and endoscopy after anesthesia evaluation
- Voluntary participation in the clinical trial and signed informed consent
Exclusion Criteria:
- Patients with unstable vital signs despite fluid resuscitation, blood transfusion, and other supportive treatments
- Presence of contraindications to endoscopy
- Patients with confirmed or suspected variceal upper gastrointestinal bleeding
- Gastrointestinal bleeding suspected to originate from the middle or lower gastrointestinal tract
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 |
|---|---|
|
Experimental: Urgent Endoscopy Group
Patients will undergo urgent endoscopy within 12 hours of hospital admission.
All patients will receive standard medical treatment for acute non-variceal upper gastrointestinal bleeding and antiplatelet management in accordance with clinical guidelines.
|
Urgent endoscopy performed within 12 hours after the patient is admitted to the hospital, used to diagnose and treat acute non-variceal upper gastrointestinal bleeding.
|
|
Experimental: Early Endoscopy Group
Patients will undergo early endoscopy between 12 and 24 hours after hospital admission.
All patients will receive standard medical treatment for acute non-variceal upper gastrointestinal bleeding and antiplatelet management in accordance with clinical guidelines.
|
Early endoscopy performed between 12 and 24 hours after the patient is admitted to the hospital, used to diagnose and treat acute non-variceal upper gastrointestinal bleeding.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
major adverse cardiovascular events (MACE)
Time Frame: Within 30 days after randomization
|
Incidence of MACE in the two groups
|
Within 30 days after randomization
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Further bleeding
Time Frame: Within 7 days after randomization
|
To compare the rate of further bleeding between the two groups
|
Within 7 days after randomization
|
|
All-cause mortality
Time Frame: Within 30 days after randomization
|
To compare all-cause mortality between the two groups.
|
Within 30 days after randomization
|
|
Length of hospital stay
Time Frame: From date of admission to date of discharge
|
To compare the length of hospital stay between the two groups.
|
From date of admission to date of discharge
|
|
Requirement for blood transfusion
Time Frame: Within 30 days after randomization
|
Proportion of patients requiring blood transfusion.
|
Within 30 days after randomization
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Xue Chen, MD, Beijing Anzhen Hospital
Study record dates
Study Major Dates
Study Start (Estimated)
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
Other Study ID Numbers
Other Study ID Numbers
- 2025AZC2007
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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