이 페이지는 자동 번역되었으며 번역의 정확성을 보장하지 않습니다. 참조하십시오 영문판 원본 텍스트의 경우.

A Comparison of Antiplatelet Therapies in Asian Subjects With Acute Coronary Syndrome

2011년 9월 22일 업데이트: Eli Lilly and Company

A Comparison of Platelet Inhibition Following Prasugrel or Clopidogrel Administration in Asian Acute Coronary Syndrome Subjects Who Are to Undergo Percutaneous Coronary Intervention

The study will compare the safety and efficacy of prasugrel, administered at different doses with clopidogrel in the treatment of Asian participants with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention.

연구 개요

연구 유형

중재적

등록 (실제)

720

단계

  • 3단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

      • Taichung, 대만, 404
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Taichung City, 대만, 40201
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Taipei, 대만, 112
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Tao-Yuan, 대만, 333
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Daegu, 대한민국, 700-721
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Kwang Ju, 대한민국, 501-757
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Seongnam-Si, 대한민국, 463-707
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Seoul, 대한민국, 135 720
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Suwon-City, 대한민국, 442-721
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Beijing, 중국, 100853
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Guang Zhou, 중국, 510080
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Hangzhou, 중국, 310009
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Nanjing, 중국, 210008
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Shanghai, 중국, 200433
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Shenyang, 중국, 110016
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Wenzhou, 중국, 325027
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Xi'An, 중국, 710061
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Bangkok, 태국, 10400
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
      • Chiang Mai, 태국, 50200
        • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Inclusion Criteria:

  • A person who has been diagnosed with acute coronary syndrome (ACS) and is to undergo a percutaneous coronary intervention (PCI)
  • A person who is of East or Southeast Asian descent
  • A person who is of the legal age of 18 (or age 21 in Singapore) and is mentally competent to provide a signed written informed consent before entering the study
  • If a woman is of childbearing potential, she must test negative for pregnancy and agree to use a reliable method of birth control

Exclusion Criteria:

  • A person who has a severe cardiovascular condition such as cardiogenic shock at the time of randomization, ventricular arrhythmias or congestive heart failure
  • A person who is at an increased risk of bleeding (e.g. active internal bleeding, history of bleeding disorder, recent fibrinolytic therapy before randomization into the study)
  • A person who has prior history of any one of the following: ischemic or hemorrhagic stroke; intracranial neoplasm, arteriovenous malformation, or aneurysm; prior history of transient ischemic attack (TIA)
  • A person who needs to take other antiplatelet therapy other than Aspirin for the duration of the study
  • A person who receives daily treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) or cyclooxygenase-2 (COX2) inhibitors that cannot be discontinued
  • A person who has a severe liver disease, such as cirrhosis
  • A person who has a condition such as alcoholism, mental illness, or drug dependence

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 삼루타

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Prasugrel 60/10 Primary
Loading dose 60 mg followed by maintenance dose 10 mg/day
Oral, daily, 90 days
다른 이름들:
  • 효율적
  • LY640315
  • CS-747
  • 효율적인
실험적: Prasugrel 30/7.5 Primary
Loading dose 30 mg followed by maintenance dose 7.5 mg/day
Oral, daily, 90 days
다른 이름들:
  • 효율적
  • LY640315
  • CS-747
  • 효율적인
실험적: Prasugrel 30/5 Primary
Loading dose 30 mg followed by maintenance dose 5 mg/day
Oral, daily, 90 days
다른 이름들:
  • 효율적
  • LY640315
  • CS-747
  • 효율적인
활성 비교기: Clopidogrel 300/75 Primary
Loading dose 300 mg followed by maintenance dose 75 mg/day
Oral, daily, 90 days
다른 이름들:
  • 플라빅스
실험적: Prasugrel 30/5 Low Weight/Elderly
Loading dose 30 mg followed by maintenance dose 5 mg/day
Oral, daily, 90 days
다른 이름들:
  • 효율적
  • LY640315
  • CS-747
  • 효율적인
활성 비교기: Clopidogrel 300/75 Low Weight/Elderly
Loading dose 300 mg followed by maintenance dose 75 mg/day
Oral, daily, 90 days
다른 이름들:
  • 플라빅스

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Adenosine Diphosphate (ADP)-Induced P2Y12 Receptor-mediated Platelet Aggregation (P2Y12 Reaction Units; PRU) Using the Accumetrics VerifyNow (VN) P2Y12 Assay at 4 Hours Post-Loading Dose (LD) in Primary Cohort (≥60 kg and <75 Years)
기간: At 4 hours following LD administration

ADP-induced PRU represents the rate and extent of ADP-stimulated platelet aggregation and serves as a biomarker of clinical efficacy, with lower values indicating greater P2Y12 platelet inhibition.

Observed PRU values are presented with statistical comparisons of difference in least squares mean (LS mean) PRU values between prasugrel and clopidogrel.

Efficacy analyses are analyzed and presented separately for the LD and maintenance dose (MD) phase.

At 4 hours following LD administration
Adenosine Diphosphate (ADP)-Induced P2Y12 Reaction Units (PRU) Using the Accumetrics VerifyNow (VN) P2Y12 Assay at 30 Days During Maintenance Dose (MD) Administration in Primary Cohort
기간: At 30 days during MD therapy

Efficacy analyses are analyzed and presented separately for the loading dose (LD) and MD phase. This primary outcome analysis compares PRU for the 3 prasugrel MDs (10 mg, 7.5 mg, and 5 mg) with the clopidogrel 75-mg MD at 30 days post-MD in the primary cohort (participants who weighed ≥60 kg and were <75 years).

ADP-induced PRU serves as a biomarker of clinical efficacy, with lower values indicating greater P2Y12 platelet inhibition.

Observed PRU values are presented with statistical comparisons of LS mean difference between prasugrel and clopidogrel.

At 30 days during MD therapy

2차 결과 측정

결과 측정
측정값 설명
기간
Adenosine Diphosphate (ADP)-Induced P2Y12 Reaction Units (PRU) Using the Accumetrics VerifyNow (VN) P2Y12 Assay at 30 Minutes, 2 and 4 Hours Post-Loading Dose (LD) in Primary (≥60 kg and <75 Years) and Low Weight/Elderly (<60 kg or ≥75 Years) Cohorts.
기간: At 30 minutes, 2 hours, and 4 hours following LD administration

Efficacy analyses analyzed and presented separately for LD and maintenance dose (MD) phase. Analysis compares PRU for prasugrel LDs (30 mg and 60 mg) with clopidogrel 300-mg LD at 30 minutes post-LD.

Data for Primary Cohort at 4 hours post-LD, already presented in first Primary Outcome Measure, are also presented here.

ADP-induced PRU serves as biomarker of clinical efficacy, with lower values indicating greater P2Y12 platelet inhibition.

Observed PRU values presented with statistical comparisons of least-squares mean (LS mean) difference between prasugrel and clopidogrel.

At 30 minutes, 2 hours, and 4 hours following LD administration
Adenosine Diphosphate (ADP)-Induced P2Y12 Reaction Units (PRU) Using the Accumetrics VerifyNow (VN) P2Y12 Assay at During Maintenance Dose (MD) Phase at 30 Days and 90 Days in Primary Cohort and Low Weight/Elderly Cohort
기간: At 30 Days and 90 days during MD therapy

Efficacy analyses analyzed and presented separately for loading dose (LD) and MD phase. Analysis compares PRU for 3 prasugrel MDs (10 mg, 7.5 mg, and 5 mg) with clopidogrel 75-mg MD at 30 days post-MD.

Data for Primary Cohort at 30 days post-LD, already presented in second Primary Outcome Measure, are also presented here.

ADP-induced PRU serves as a biomarker of clinical efficacy, with lower values indicating greater P2Y12 platelet inhibition.

Observed PRU values are presented with statistical comparisons of least squares (LS) mean difference between prasugrel and clopidogrel.

At 30 Days and 90 days during MD therapy
Percent Inhibition of Adenosine Diphosphate (ADP)-Induced P2Y12 Reaction Units (PRU) at 30 Minutes, 2 Hours, and 4 Hours Post-Loading Dose (LD) in Primary in Primary Cohort and Low Weight/Elderly Cohort
기간: 30 minutes, 2 hours, and 4 hours following LD administration
A higher percentage (percent inhibition least squares mean [LS mean]) represents greater platelet inhibition.
30 minutes, 2 hours, and 4 hours following LD administration
Percent Inhibition of Adenosine Diphosphate (ADP)-Induced P2Y12 Reaction Units (PRU) During the Maintenance Dose (MD) Phase at 30 Days and 90 Days in Primary Cohort and Low Weight/Elderly Cohort
기간: 30 days and at 90 days during MD therapy
A higher percentage (percent inhibition least squares mean [LS mean]) represents greater platelet inhibition.
30 days and at 90 days during MD therapy
Summary of Myocardial Infarction (MI), Stroke, Stent Thrombosis and Urgent Target Vessel Revascularization (UTVR) in Primary Cohort and Low Weight/Elderly Cohort
기간: Randomization through end of study (90 days)

Nonfatal MI: American College of Cardiology (ACC) definition Nonfatal stroke: rapid onset of new, persistent neurologic deficit lasting >24 hours; classified as either ischemic or hemorrhagic based on imaging data, if available, or uncertain cause if imaging data was not available.

Stent thrombosis: defined as definite, probable, or possible, based on Academic Research Consortium definitions.

UTVR: percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) for recurrent ischemia. Revascularization must have included the vessel(s) dilated at the initial procedure

Randomization through end of study (90 days)
Risk of Cardiovascular (CV) Death, Nonfatal Myocardial Infarction (MI), or Non-fatal Stroke
기간: 30 days and 90 days

Risk was defined as the number of participants with events of CV death, nonfatal MI, or nonfatal stroke.

CV death: death caused by CV event or not clearly attributable to non-CV causes.

Nonfatal MI: per adapted American College of Cardiology definition.

Nonfatal stroke: rapid onset of new, persistent neurologic deficit lasting more than 24 hours; either ischemic or hemorrhagic based on imaging data, if available, or uncertain cause if imaging data was not available.

As a consequence of the overall low number of reported clinical events, composite endpoints were not analyzed.

30 days and 90 days
Risk of Cardiovascular (CV) Death, Nonfatal Myocardial Infarction (MI), or Urgent Target Vessel Revascularization (UTVR)
기간: 30 days and 90 days

Risk was defined as the number of participants with events of CV death, nonfatal MI, or UTVR.

UTVR: percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) for recurrent ischemia. Revascularization must have included the vessel(s) dilated at the initial procedure.

As a consequence of the overall low number of reported clinical events, composite endpoints were not analyzed.

30 days and 90 days
Risk of Cardiovascular (CV) Death, Nonfatal Myocardial Infarction (MI), Nonfatal Stroke, or Recurrent Myocardial Ischemia Requiring Hospitalization
기간: 30 days and 90 days

Risk was defined as the number of events of CV death, nonfatal MI, nonfatal stroke or recurrent myocardial ischemia requiring hospitalization.

Recurrent myocardial ischemia requiring hospitalization: rehospitalization for symptoms of myocardial ischemia at rest with either new ST-segment deviation ≥1 mm, or performance of a coronary revascularization procedure percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) during the same hospital stay.

As a consequence of the overall low number of reported clinical events, composite endpoints were not analyzed.

30 days and 90 days
Risk of Cardiovascular (CV) Death, Nonfatal Myocardial Infarction (MI), Nonfatal Stroke, Urgent Target Vessel Revascularization (UTVR), or Recurrent Myocardial Ischemia Requiring Hospitalization (Analyzed Individually)
기간: 30 days and 90 days
Risk was defined as the number of participants with events of CV death, nonfatal MI, nonfatal stroke, UTVR, or recurrent myocardial ischemia requiring hospitalization.
30 days and 90 days
Risk of Definite or Probable Stent Thrombosis Per ARC (Academic Research Consortium) Definition
기간: 30 days and 90 days

Risk was defined as the number of participants with events of definite or probable stent thrombosis.

As a consequence of the overall low number of reported clinical events, composite endpoints were not analyzed.

30 days and 90 days
Risk of Definite, Probable, or Possible Stent Thrombosis Per Academic Research Consortium (ARC) Definition
기간: 90 days

Risk was defined as the number of participants with events of definite, probable, or possible stent thrombosis.

As a consequence of the overall low number of reported clinical events, composite endpoints were not analyzed.

90 days
Risk of All-cause Death in Primary Cohort and Low Weight/Elderly Cohort
기간: Randomization through end of study (90 days)
Risk was defined as the number of participants with events of all-cause death.
Randomization through end of study (90 days)
Incidence of Non-coronary Artery Bypass Graft (CABG) Related Thrombolysis in Myocardial Infarction (TIMI) Life-threatening (a Subset of Non-CABG-related TIMI Major Bleeding), Major, Minor, and Minimal Bleeding
기간: Randomization through end of study (90 days)

Bleeding events were classified and analyzed in accordance with the TIMI criteria definitions.

Major bleeding: any intracranial hemorrhage (ICR) OR any clinically overt bleeding (including bleeding evident on imaging studies) associated with a fall in hemoglobin (Hgb) of ≥5 grams/deciliter (gm/dL) from baseline.

Minor bleeding: any clinically overt bleeding associated with a fall in Hgb of ≥3 but <5 gm/dL from baseline.

Insignificant bleeding: any bleeding event that does not meet criteria for a Major or Minor bleed.

Randomization through end of study (90 days)
Incidence of CABG-related TIMI Major or Minor Bleeding.
기간: Randomization through end of study (90 days)
Randomization through end of study (90 days)
Inpatient Healthcare Resource Utilization
기간: Initial hospitalization, 30 days, 90 days
Healthcare resource utilization data were modeled from historical analyses to determine initial hospitalization costs, total 30-day medical care costs, and total 90-day medical care costs.
Initial hospitalization, 30 days, 90 days
Genetic Variation Related to Drug Metabolism and Transport Substudy Result Summary
기간: Baseline to 4 hours post-loading dose (LD), 30 days and 90 days during maintenance dose (MD) phase

The primary hypothesis for the genetics substudy was that CYP2C19 genetic variation has a significant effect on pharmacodynamic (PD) response to clopidogrel but not on PD response to prasugrel per change in PRU as measured by the Accumetrics VerifyNow P2Y12 device.

Participants were classified by CYP2C19 genotype into predicted metabolic phenotypes according to literature-based functional predictions. These classifications were clustered into 2 groups: extensive metabolizer (EM) and reduced metabolizer (RM).

A higher value for change in PRU indicates a greater level of platelet inhibition.

Baseline to 4 hours post-loading dose (LD), 30 days and 90 days during maintenance dose (MD) phase
Risk of CV Death, Nonfatal MI, Nonfatal Stroke, UTVR, or Recurrent Myocardial Ischemia Requiring Hospitalization (Analyzed Individually)
기간: 30 days and 90 days
Risk of Cardiovascular (CV) Death, Nonfatal Myocardial Infarction (MI), Nonfatal Stroke, Urgent Target Vessel Revascularization (UTVR), or Recurrent Myocardial Ischemia Requiring Hospitalization (Analyzed Individually)
30 days and 90 days

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작

2009년 2월 1일

기본 완료 (실제)

2010년 6월 1일

연구 완료 (실제)

2010년 6월 1일

연구 등록 날짜

최초 제출

2009년 1월 27일

QC 기준을 충족하는 최초 제출

2009년 1월 27일

처음 게시됨 (추정)

2009년 1월 28일

연구 기록 업데이트

마지막 업데이트 게시됨 (추정)

2011년 11월 2일

QC 기준을 충족하는 마지막 업데이트 제출

2011년 9월 22일

마지막으로 확인됨

2011년 9월 1일

추가 정보

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

급성관상동맥증후군에 대한 임상 시험

Prasugrel에 대한 임상 시험

3
구독하다