- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05292846
Uninterrupted Direct-acting Oral Anticoagulation in Patients Undergoing Transradial Percutaneous Coronary Procedures (DOAC-NOSTOP)
Up to 20-30% of patients who are candidates for direct oral anticoagulation (DOAC) present with concomitant ischemic heart disease and often require coronary angiography with or without percutaneous coronary intervention (PCI). The decision whether to continue the DOAC throughout periprocedural period or interrupt DOAC before planned procedure represents a substantial challenge in daily clinical practice.
The objective of this study is to evaluate the safety of uninterrupted direct-acting oral anticoagulation in patients undergoing trans-radial percutaneous coronary procedures.
Study Overview
Status
Intervention / Treatment
Detailed Description
The study design is an investigator-initiated, single-arm, open-label, pilot study in patients treated with DOAC undergoing trans-radial percutaneous coronary procedures.
Because of the exploratory nature of this study, no formal sample size calculations are required. On the basis of previous pilot studies with similar designs, a sample of 200 patients is planned; with a safety stopping rule based on the occurrence of BARC type 3 or 5 bleeding. In the present trial, if during the enrollment period more than 3 cases of BARC 3 or 5 bleeding occur up to 30-day follow-up, patient recruitment will be terminated. This number is based on the reported 1.6% BARC type 3 or 5 bleeding in patients undergoing transradial percutaneous coronary procedures.
Study Type
Enrollment (Estimated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Jorge Sanz Sanchez, MD, PhD
- Phone Number: 440087
- Email: sjorge4@gmx.com
Study Locations
-
-
Milan
-
Rozzano, Milan, Italy, 20089
- Not yet recruiting
- Humanitas Research Hospital
-
Principal Investigator:
- Giulio Stefanini, Prof
-
Contact:
- Giulio Stefanini, Prof
- Phone Number: 0282247384
- Email: giulio.stefanini@gmail.com
-
Sub-Investigator:
- Mauro Chiarito, MD
-
-
-
-
-
Barcelona, Spain
- Recruiting
- Hospital del Mar
-
Contact:
- Beatriz Vaquerizo Montilla
-
Madrid, Spain
- Recruiting
- Hospital La Paz
-
Contact:
- Alfonso Jurado Román
-
Valencia, Spain, 46026
- Recruiting
- Hospital Universitario y Politecnico La Fe
-
Contact:
- Jorge Sanz Sanchez, MD, PhD
- Phone Number: 440087
- Email: sjorge4@gmx.com
-
Sub-Investigator:
- Jose Luis Diez Gil, MD, PhD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients under anticoagulation with DOAC and any indication for diagnostic or therapeutic trans-radial percutaneous coronary procedures. At least 25% of the population undergoing PCI will be included.
Exclusion Criteria:
- Aged < 18 years
- Cardiogenic shock
- Major active bleeding at the time of the procedure
- Use of mechanical circulatory support
- Chronic total occlusions
- Pre-planned vascular access different from radial artery access (i.e. femoral, brachial, ulnar)
- Inability to provide informed consent
- Unable to understand and follow study-related instructions or unable to comply with study protocol
- Currently participating in another trial
- Pregnant women
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Uninterruped direct-acting oral anticoagulation
Uninterrupted direct-acting oral anticoagulation in patients undergoing trans-radial percutaneous coronary procedures
|
Apixaban Dabigatran Edoxaban Rivaroxaban
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Rate of Bleeding Academic Research Consortium (BARC) type 2, 3 or 5
Time Frame: 30-day follow-up
|
30-day follow-up
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Rate of BARC type 3, or 5
Time Frame: 30-day follow-up
|
30-day follow-up
|
Rate of all-cause death
Time Frame: 30-day follow-up
|
30-day follow-up
|
Rate of cardiac death
Time Frame: 30-day follow-up
|
30-day follow-up
|
Rate of stroke
Time Frame: 30-day follow-up
|
30-day follow-up
|
Rate of myocardial infarction
Time Frame: 30-day follow-up
|
30-day follow-up
|
Rate of definite/probable stent thrombosis
Time Frame: 30-day follow-up
|
30-day follow-up
|
Rate of definite stent thrombosis
Time Frame: 30-day follow-up
|
30-day follow-up
|
Rate of target-lesion revascularization
Time Frame: 30-day follow-up
|
30-day follow-up
|
Rate of target-vessel revascularization
Time Frame: 30-day follow-up
|
30-day follow-up
|
Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- Valgimigli M, Frigoli E, Leonardi S, Rothenbuhler M, Gagnor A, Calabro P, Garducci S, Rubartelli P, Briguori C, Ando G, Repetto A, Limbruno U, Garbo R, Sganzerla P, Russo F, Lupi A, Cortese B, Ausiello A, Ierna S, Esposito G, Presbitero P, Santarelli A, Sardella G, Varbella F, Tresoldi S, de Cesare N, Rigattieri S, Zingarelli A, Tosi P, van 't Hof A, Boccuzzi G, Omerovic E, Sabate M, Heg D, Juni P, Vranckx P; MATRIX Investigators. Bivalirudin or Unfractionated Heparin in Acute Coronary Syndromes. N Engl J Med. 2015 Sep 10;373(11):997-1009. doi: 10.1056/NEJMoa1507854. Epub 2015 Sep 1.
- Lip GY, Huber K, Andreotti F, Arnesen H, Airaksinen KJ, Cuisset T, Kirchhof P, Marin F; European Society of Cardiology Working Group on Thrombosis. Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary intervention/ stenting. Thromb Haemost. 2010 Jan;103(1):13-28. doi: 10.1160/TH09-08-0580. Epub 2009 Sep 30. Erratum In: Thromb Haemost. 2010 Sep;104(3):653. Dosage error in article text.
- Kogame N, Guimaraes PO, Modolo R, De Martino F, Tinoco J, Ribeiro EE, Kawashima H, Ono M, Hara H, Wang R, Cavalcante R, Moulin B, Falcao BAA, Leite RS, de Almeida Sampaio FB, Morais GR, Meireles GC, Campos CM, Onuma Y, Serruys PW, Lemos PA. Aspirin-Free Prasugrel Monotherapy Following Coronary Artery Stenting in Patients With Stable CAD: The ASET Pilot Study. JACC Cardiovasc Interv. 2020 Oct 12;13(19):2251-2262. doi: 10.1016/j.jcin.2020.06.023. Epub 2020 Sep 16.
- Serruys PW, van Hout B, Bonnier H, Legrand V, Garcia E, Macaya C, Sousa E, van der Giessen W, Colombo A, Seabra-Gomes R, Kiemeneij F, Ruygrok P, Ormiston J, Emanuelsson H, Fajadet J, Haude M, Klugmann S, Morel MA. Randomised comparison of implantation of heparin-coated stents with balloon angioplasty in selected patients with coronary artery disease (Benestent II). Lancet. 1998 Aug 29;352(9129):673-81. doi: 10.1016/s0140-6736(97)11128-x. Erratum In: Lancet 1998 Oct 31;352(9138):1478.
- Lip GYH, Collet JP, Haude M, Byrne R, Chung EH, Fauchier L, Halvorsen S, Lau D, Lopez-Cabanillas N, Lettino M, Marin F, Obel I, Rubboli A, Storey RF, Valgimigli M, Huber K; ESC Scientific Document Group. 2018 Joint European consensus document on the management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous cardiovascular interventions: a joint consensus document of the European Heart Rhythm Association (EHRA), European Society of Cardiology Working Group on Thrombosis, European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA). Europace. 2019 Feb 1;21(2):192-193. doi: 10.1093/europace/euy174.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 515
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
product manufactured in and exported from the U.S.
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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