VerifyNow to Optimise Platelet Inhibition in Coronary Acute Syndrome clinical trials begins in Spain
Photo by Robina Weermeijer
Fundación EPIC is enrolling patients into the clinical trial investigating VerifyNow to Optimise Platelet Inhibition in Coronary Acute Syndrome (VERONICA).
The objective of the study is to establish a de-scaling strategy of P2Y12 inhibitors (P2Y12 i) with a decrease in hemorrhagic events without increasing ischemic complications based on a Platelet Function Test (PFT).
Clinical practice guidelines recommend the use of double anti-aggregation with acetylsalicylic acid and a P2Y12 receptor inhibitor (P2Y12 i) in acute coronary syndrome (ACS) and in the choice of the latter it is very important to consider two opposing risks, Ischemia and hemorrhage. In the era of clopidogrel, platelet function tests (PFT) attempted to determine which patients were at risk of thrombotic events, but after the publication of 3 randomized studies, the absence of benefit from the use of PFT was proven except in very selected cases. The TOPIC trial opened the door to the descaling strategy of P2Y12 i with a decrease in hemorrhagic events without increasing ischemic complications. In that study, where the randomization was not based on PFT, it was demonstrated that there is a subgroup of patients who with prasugrel and ticagrelor pose an excessive level of antiaggregation and carry a high rate of complications, as high as 33 % in the net clinical end-point of ischemia and bleeding BARC ≥ 2 at 1 year. Based on that data, the recently published guidelines of the non-ST acute coronary syndrome of the European Society of Cardiology recommend with class IIB that de-escalation of P2Y12 i maybe considered an alternative strategy, especially in ACS patients deemed unsuitable for potent platelet inhibition.
The trial is designed to enroll male and female 18 years and older and is being conducted in the Hospital Universitario de Cabueñes, Gijón, Spain and Hospital de León, León, Spain.
The study start date is May 1, 2021.
This page provides a more detailed overview of this clinical trial: https://ichgcp.net/clinical-trials-registry/NCT04654052
