- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01408121
African-American Pharmacogenetics (AA Genetic)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The investigators propose a pharmacogenetic cohort study of 100 African-American versus 100 Caucasian patients presenting with an acute coronary syndrome, receiving clopidogrel or prasugrel and undergoing PCI. The study will have four arms: African-American on clopidogrel; African-American on prasugrel; Caucasian on clopidogrel; and Caucasian on prasugrel. All patients will undergo genotyping and platelet reactivity testing with the VerifyNow P2Y12 assay, at least 6 hours after receiving a thienopyridine loading dose, but before hospital discharge. All patients will be treated with aspirin 325 mg/day as well.
Race determination will be based on a patient's self-report, but patients enrolled in the trial must also report that all four of their grandparents were of the same race as theirs. Other races (Asian, Native American, et al) will be excluded from this study.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
-
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District of Columbia
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Washington, District of Columbia, United States, 20010
- Washington Hospital Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients age 18 or older, of both genders
Presenting with an ACS, defined as at least two of the following:
- symptoms consistent with myocardial ischemia;
- ST segment elevation or depression of at least 1 mm in 2 or more contiguous leads on EKG;
- a cardiac troponin I level above upper limit of normal.
Self-reported African-american or Caucasian race
a. all 4 grandparents of same race
- No contraindications to prasugrel therapy.
- Patient is scheduled for, or has already undergone, PCI.
Exclusion Criteria:
- Known allergies to aspirin, clopidogrel, or prasugrel.
- Patient known to be pregnant or lactating.
- Patient with known history of bleeding diathesis or currently active bleeding.
- Platelet count <100,000/mm at the time of enrollment.
- Hematocrit <25% at the time of enrollment.
- On warfarin therapy at the time of PCI, or patient likely to require warfarin therapy post-PCI.
- Received fibrinolytics within the past 48 hours.
- Received a glycoprotein IIb/IIIa inhibitor within the past 48 hours, or if such a strategy for PCI involving a glycoprotein IIb/IIIa inhibitor is planned.
- Taking maintenance thienopyridine therapy in the previous 5 days.
- Known blood transfusion within the preceding 10 days.
- Patients treated with non-steroidal anti-inflammatory drugs (NSAIDS) within the previous 5 days.
- Patients with known chronic liver disease.
- Age greater than 75 years
- Body weight less than 60 kg
- History of stroke or transient ischemic attack
- Surgery planned within 1 month
- Patient likely to require coronary artery bypass grafting
- Any significant medical condition that, in the investigator's opinion, may interfere with the patient's optimal participation in the study.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
African-American on clopidogrel
|
All patients will undergo genotyping and platelet reactivity testing with the VerifyNow P2Y12 assay, at least 6 hours after receiving a thienopyridine loading dose but before hospital discharge.
|
African-American on prasugrel
|
All patients will undergo genotyping and platelet reactivity testing with the VerifyNow P2Y12 assay, at least 6 hours after receiving a thienopyridine loading dose but before hospital discharge.
|
Caucasian on clopidogrel
|
All patients will undergo genotyping and platelet reactivity testing with the VerifyNow P2Y12 assay, at least 6 hours after receiving a thienopyridine loading dose but before hospital discharge.
|
Caucasian on prasugrel
|
All patients will undergo genotyping and platelet reactivity testing with the VerifyNow P2Y12 assay, at least 6 hours after receiving a thienopyridine loading dose but before hospital discharge.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Distribution of CYP polymorphisms
Time Frame: During hospital stay; average hospital stay is less than 48 hours
|
CYP polymorphisms will be classified by their known effects upon enzyme function, using the consensus star-allele nomenclature.
More specifically, patients will be classified as a "poor metabolizer" if they possess at least one CYP allele known to be associated with reduced function of that particular CYP enzyme.
Allele frequencies will then be compared between African-american and Caucasian patients.
|
During hospital stay; average hospital stay is less than 48 hours
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Platelet reactivity
Time Frame: During hospital stay; average hospital stay is less than 48 hours
|
The secondary exploratory objective is to assess for associations between "poor metabolizer" CYP genotypes and the levels of post-thienopyridine platelet reactivity.
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During hospital stay; average hospital stay is less than 48 hours
|
Collaborators and Investigators
Investigators
- Principal Investigator: Ron Waksman, MD, MedStar Health Research Institute
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- AA Genetic
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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