Effect of Pretreatment With Ticagrelor on Residual Thrombus After PCI in Patients Presenting With ACS in Comparison With Delayed Treatment at the Time of PCI: an OCT Study
Effect of Pretreatment With Ticagrelor on Residual Thrombus After Percutaneous Coronary Intervention (PCI) in Patients Presenting With Acute Coronary Syndrome in Comparison With Delayed Treatment at the Time of PCI: an Optical Coherence Tomography Study
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Studietype
Studietype
Fase
Fase
- Fase 4
Contacten en locaties
Studie Locaties
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Massachusetts
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Boston, Massachusetts, Verenigde Staten, 02114
- Massachusetts General Hospital
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
Patient Characteristics:
- Males and non-pregnant females > or equal to 18 and < or equal to 79 years of age presenting with suspected acute coronary syndrome (unstable angina or NSTEMI)
- Patients likely to be scheduled to undergo coronary angiography with possible percutaneous coronary intervention (PCI)
Lesion Characteristics on Diagnostic Coronary Angiography:
- De novo lesions in native coronary arteries found by diagnostic coronary angiography
- Angiographic stenosis <100%
- Reference vessel diameter 2.5 mm - 4.0 mm by visual estimation
Exclusion Criteria:
Patient Specific Exclusion Criteria:
- Subjects who are unable or unwilling to sign the informed consent form.
- Subjects being treated with anti-platelet medications other than aspirin prior to diagnostic catheterization including glycoprotein IIb/IIIa inhibitors.
- Subjects with serious co-morbid conditions that in judgment of the investigator preclude inclusion in this study
- Subjects with NYHA class III or IV heart failure or known left ventricular ejection fraction < 30%.
- Subjects with an ST elevation myocardial infarction.
- Subjects with hemodynamic or electrical instability (including shock).
- Subjects diagnosed with severe, non-catheter-related coronary artery spasm.
- Subjects who are or may be pregnant.
- Subjects with known allergies to contrast media.
- Subjects with eGFR < 60 ml/min/1.73m2.
- Subjects currently taking oral anticoagulants with an absolute contraindication to discontinuation of anticoagulation.
- History of TIA or stroke < 6 months.
- History of hemorrhagic stroke.
- Hepatic insufficiency defined as liver cirrhosis, AST/ALT/Alkaline Phosphatase greater than 3 times the upper limit of normal or hyperbilirubinemia.
- Cardiac catheterization scheduled within 4 hours of randomization or more then 72 hours after randomization.
Lesion Specific Exclusion Criteria. These exclusion criteria apply to the target lesion to be imaged by OCT.
- Lesions located in the left main coronary artery
- Lesions that are heavily calcified
- Lesions where OCT cannot be performed due to technical difficulties
- Other lesions that the investigator deems inappropriate for the procedure such as sites with excessive tortuosity or low flow by TIMI grade.
- Lesions in saphenous vein grafts or arterial conduits.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
|
Actieve vergelijker: Ticagrelor- Delayed Administration
Subjects receive 180 mg of ticagrelor during cardiac catheterization after diagnostic angiography and prior to stenting.
OCT is performed prior to and after coronary artery stenting.
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Subjects are randomized to receive ticagrelor immediately after enrollment versus at the time of cardiac catheterization.
OCT is performed prior to and after coronary artery stenting.
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Actieve vergelijker: Ticagrelor- Immediate Administration
Subjects receive 180 mg of ticagrelor immediately after study enrollment.
OCT is performed prior to and after coronary artery stenting.
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Subjects are randomized to receive ticagrelor immediately after enrollment versus at the time of cardiac catheterization.
OCT is performed prior to and after coronary artery stenting.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Totale trombusbelasting zoals gemeten door het volume van in-stent trombus gekwantificeerd door planimetrie.
Tijdsspanne: De trombusbelasting wordt gemeten aan het einde van de stentprocedure van de kransslagader.
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De totale trombusbelasting gemeten op OCT-beelden zal worden beoordeeld.
Het volume van de trombus in de stent zal worden gekwantificeerd door middel van planimetrie.
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De trombusbelasting wordt gemeten aan het einde van de stentprocedure van de kransslagader.
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Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
PRI (platelet reactivity index) as measured bu the PLT-VASP assay.
Tijdsspanne: PRI iwill be measured at the time of OCT image acquisition.
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The extent of platelet inhibition will be measured by PLT-VASP and VerifyNow P2Y12 assays.
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PRI iwill be measured at the time of OCT image acquisition.
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P2Y12 Reaction Units as measured by the VerifyNow P2Y12 assay.
Tijdsspanne: P2Y12 will be measured at the time of OCT image acquisition.
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The extent of platelet inhibition will be measured by PLT-VASP and VerifyNow P2Y12 assays.
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P2Y12 will be measured at the time of OCT image acquisition.
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Andere uitkomstmaten
Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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PCI-related myocardial infarction (MI)
Tijdsspanne: PCI-related MI will be assesed within 24 hours after the end of the coronary artery stenting procedure.
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PCI related myocardial infarction is defined by the third Universal definition of myocardial infarction.
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PCI-related MI will be assesed within 24 hours after the end of the coronary artery stenting procedure.
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Medewerkers en onderzoekers
Sponsor
Sponsor
Medewerkers
Medewerkers
Studie record data
Bestudeer belangrijke data
Studie start
Studie start
Primaire voltooiing (Verwacht)
Primaire voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Pathologische processen
- Myocardiale ischemie
- Hartziekten
- Hart-en vaatziekten
- Vaatziekten
- Arteriosclerose
- Arteriële occlusieve ziekten
- Ziekte
- Hart-en vaatziekte
- Coronaire hartziekte
- Syndroom
- Acute kransslagader syndroom
- Fysiologische effecten van medicijnen
- Neurotransmitter agenten
- Moleculaire mechanismen van farmacologische werking
- Bloedplaatjesaggregatieremmers
- Purinerge P2Y-receptorantagonisten
- Purinerge P2-receptorantagonisten
- Purinerge antagonisten
- Purinerge middelen
- Ticagrelor
Andere studie-ID-nummers
Andere studie-ID-nummers
- 2013P001322
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