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PRasugrEl Monoterapi efter primær perkutan koronar intervention for ST-elevation myokardieinfarkt (PREMIUM)

6. november 2026 opdateret af: Kindai University

The aim of this study is to evaluate the safety of prasugrel monotherapy without aspirin versus 12-month dual antiplatelet therapy (DAPT) in patients with STEMI using platinum-chrome everolimus-eluting stent (PtCr-EES: SYNERGYTM).

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

In the STOPDAPT-2 ACS trial (NCT03462498), ischemic events (especially myocardial infarction) was significantly increased with 1-month DAPT followed by clopidogrel monotherapy, as compared to 12-month DAPT in patients with acute coronary syndrome (ACS). This was potentially attributable to clopidogrel, instead of prasugrel, which is more potent and has less individual difference in efficacy. On the other hand, previous studies including the STOPDAPT-2 ACS that evaluated the safety and efficacy of monotherapy with a P2Y12 inhibitor without aspirin consistently and significantly reduced the risk of bleeding, compared with standard DAPT. Consequently, there has been growing necessity to establish the safety with P2Y12 inhibitor monotherapy in terms of major adverse cardiovascular events. Therefore, we have planned to evaluate the non-inferiority of P2Y12 inhibitor monotherapy with prasugrel versus standard 12-month DAPT with prasugrel and aspirin in terms of the incidence of major cardiovascular events at 12 months after primary PCI in patients with STEMI using Platinum-Chromium Everolimus Eluting Stent (PtCr-EES; SYNERGYTM).

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

2268

Fase

  • Fase 4

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Osaka
      • Sayama, Osaka, Japan, 589-8511
        • Kindai University Faculty of Medicine

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Patients scheduled for primary PCI with everolimus-eluting stent (PtCr-EES, SYNERGYTM)
  • STEMI patients
  • Patients who can continue dual antiplatelet therapy with aspirin and a P2Y12 inhibitor for 12 months

Exclusion Criteria:

  • Patients taking anticoagulants
  • Patients under 18 years old
  • Patients with less than 1 year prognosis
  • Patients participating in other intervention studies

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: No aspirin (Prasugrel monotherapy)

To start prasugrel monotherapy before primary percutaneous coronary intervention (PCI).

12-month prasugrel monotherapy

Andre navne:
  • Eksperimentel arm
Aktiv komparator: 12-month DAPT

To start dual antiplatelet therapy with prasugrel and aspirin for 12 months before primary percutaneous coronary intervention (PCI).

12-month dual antiplatelet therapy with prasugrel and aspirin

Andre navne:
  • Referencearm

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Major adverse cardiovascular events
Tidsramme: 12 months

Composite of all-cause death, myocardial infarction, or stroke

12 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Major secondary bleeding endpoint: Type 3 or 5 bleeding in Bleeding Academic Research Consortium (BARC) criteria
Tidsramme: 12 months

Type 3 or 5 bleeding defined by BARC criteria

12 months
All-cause death
Tidsramme: 12 months

Death from any cause

12 months
Cardiovascular death
Tidsramme: 12 months

Death from cardiovascular cause

12 months
Non-cardiovascular death
Tidsramme: 12 months

Death from non-cardiovascular cause

12 months
Myocardial infarction (Periprocedual/ Spontaneous)
Tidsramme: 12 months

Defined by the Academic Research Consortium (ARC)-2

12 months
Stroke (Ischemic/ Haemorrhagic)
Tidsramme: 12 months

Including both ischemic and haemorrhagic stroke

12 months
Ischemic stroke
Tidsramme: 12 months

Ischemic stroke with symptom lasting over 24 hours

12 months
Hemorrhagic stroke
Tidsramme: 12 months

Intracerebral hemorrhage or subarachnoidal hemorrhage not associated with trauma

12 months
Stent thrombosis
Tidsramme: 12 months

Stent thrombosis defined by Academic Research Consortium (ARC)-2 definition

12 months
Target lesion failure
Tidsramme: 12 months

Cardiovascular death, target vessel myocardial infarction, clinically indicated target lesion revascularization

12 months
Target vessel failure
Tidsramme: 12 months

Cardiovascular death, target vessel myocardial infarction, clinically indicated target vessel revascularization

12 months
Patient-Oriented Composite Endpoint
Tidsramme: 12 months

All-cause death, stroke, myocardial infarction, and all revascularization, defined by the Academic Research Consortium (ARC)-2

12 months
Any target lesion revascularization
Tidsramme: 12 months

Revascularization to the target lesions (including 5mm of both ends of the stent[s]) regardless of PCI or CABG

12 months
Clinically-driven target lesion revascularization
Tidsramme: 12 months

Target lesion revascularization with the anginal symptoms or the positive test for ischemia

12 months
Non-target lesion revascularization
Tidsramme: 12 months

Revascularization to non-target lesions regardless PCI or CABG

12 months
Coronary artery bypass grafting
Tidsramme: 12 months

Any coronary artery bypass grafting

12 months
Any target vessel revascularization
Tidsramme: 12 months

Revascularization to the target vessel

12 months
Any coronary revascularization
Tidsramme: 12 months

Revascularization regardless of PCI or CABG

12 months
Type 2 bleeding in Bleeding Academic Research Consortium (BARC) criteria
Tidsramme: 12 months

Type 2 bleeding defined by BARC criteria

12 months
Type 3 bleeding in Bleeding Academic Research Consortium (BARC) criteria
Tidsramme: 12 months

Type 3 bleeding defined by BARC criteria

12 months
Type 4 bleeding in Bleeding Academic Research Consortium (BARC) criteria
Tidsramme: 12 months

Type 4 bleeding defined by BARC criteria

12 months
Type 5 bleeding in Bleeding Academic Research Consortium (BARC) criteria
Tidsramme: 12 months

Type 5 bleeding defined by BARC criteria

12 months
Type 2, 3, or 5 bleeding in Bleeding Academic Research Consortium (BARC) criteria
Tidsramme: 12 months

Type 2, 3, or 5 bleeding defined by BARC criteria

12 months
Major bleeding in Thrombolysis in Myocardial Infarction (TIMI) criteria
Tidsramme: 12 months

Major bleeding defined by TIMI criteria

12 months
Minor bleeding in Thrombolysis in Myocardial Infarction (TIMI) criteria
Tidsramme: 12 months

Minor bleeding defined by TIMI criteria

12 months
Major or minor bleeding in Thrombolysis in Myocardial Infarction (TIMI) criteria
Tidsramme: 12 months

Major or minor defined by TIMI criteria

12 months
Severe bleeding in Global utilization of streptokinase and tPA for occluded arteries (GUSTO) criteria
Tidsramme: 12 months

Severe bleeding defined by GUSTO criteria

12 months
Moderate bleeding in Global utilization of streptokinase and tPA for occluded arteries (GUSTO) criteria
Tidsramme: 12 months

Moderate bleeding defined by GUSTO criteria

12 months
Moderate or severe bleeding in Global utilization of streptokinase and tPA for occluded arteries (GUSTO) criteria
Tidsramme: 12 months

Moderate or severe bleeding defined by GUSTO criteria

12 months
Intracranial bleeding
Tidsramme: 12 months

Intracranial bleeding regardless of spontaneous or trauma

12 months
Gastrointestinal bleeding
Tidsramme: 12 months

Bleeding from gastrointestinal tract regardless of severity

12 months
Gastrointestinal complaints
Tidsramme: 12 months

Requirement of upper gastric fiberscopy to examine the gastrointestinal complaints

12 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Gaku Nakazawa, MD, PhD, Kindai University Faculty of Medicine

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

7. april 2023

Primær færdiggørelse (Faktiske)

12. februar 2026

Studieafslutning (Faktiske)

27. april 2026

Datoer for studieregistrering

Først indsendt

19. januar 2023

Først indsendt, der opfyldte QC-kriterier

1. februar 2023

Først opslået (Faktiske)

2. februar 2023

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

9. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

6. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • Y0140

Plan for individuelle deltagerdata (IPD)

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