Incidence of Major Cardiovascular Events in Diabetic Patients With ACS Undergoing Coronary Angioplasty and Treated With Clopidogrel 150 mg Versus 75 mg (IDASCOP 1)
Incidence Des évènements cArdiovasculaires majeurS Chez Les Patients COronariens diabétiques Subissant Une angioPlastie Coronaire et traités Par Clopidogrel à la Dose 150 mg Versus 75 mg
Acute Coronary Syndrome (ACS) is triggered by the rupture of an atherosclerotic plaque that results in a platelet aggregation reaction in the coronary artery. The administration of antiplatelet agents starting from the acute phase of the disease has helped reduce the risk of ischemic relapse both during initial and long-term hospitalization.
Management of clopidogrel following an ischemic event has been the subject of several treatment regimens ranging from a single continuous dose to a sequential double dose of between 7 and 30 days. The CURRENT-OASIS 7 therapeutic trial showed a benefit of clopidogrel double dose in reducing the risk of myocardial intervention (MI) and the composite outcome: cardiovascular mortality, MI, or stroke (CVA/TIA) at 30 days. However, the study protocol was interested in all ACSs, regardless of the Type 2 Diabetes Mellitus (T2DM) status in selected patients. Also, doubling of clopidogrel dose was maintained over 7 days after angioplasty. The literature describes an increased cardiovascular risk in type II diabetics in secondary prevention. No previous study has evaluated the effect of clopidogrel double dose given for 1 month on the reduction of this risk in the long-term in diabetic patients.
Thus, the objective of this study is to evaluate the efficacy and safety of clopidogrel double dose, given for 1 month in ACS in the diabetic patient.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
Studietype
Studietype
Inschrijving (Werkelijk)
Inschrijving
Fase
Fase
- Fase 4
Contacten en locaties
Studie Locaties
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Ben Arous, Tunesië
- HMPIT
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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:
- Male or female aged between 18 to 75 years old.
- Proven ACS requiring PTCA within 1 week of inclusion. The ACS should be without ST-segment elevation (presence of chest pain with ST-segment or T-wave changes without sustained ST segment elevation) with elevation of cardiac biomarkers of MI (positive troponins).
- Coronary angiography showing at least one coronary lesion, whether mono, bi or multi-truncate
- Type 2 diabetes confirmed for at least one year
- Patient candidate for treatment with Clopidogrel
- Informed consent of patients
Non-Inclusion Criteria:
- Non-consenting patient and/or participating in another clinical study
- ACS with ST segment elevation (STEMI)
- History of digestive or cerebral bleeding with antiplatelet agents or anticoagulants
- Insulin-dependent diabetes mellitus (IDDM)
- Diabetic requiring insulin
- Patient in cardiogenic shock
- Patient under treatment with anti-glycoprotein IIb/IIIa or stopped less than 72 hours prior to inclusion
- Previously treated with clopidogrel or thrombolytics
- Patients programmed for surgery in less than 6 months
- Ischemic stroke less than 6 weeks old
- History of haemorrhagic stroke (regardless of time)
- Patients under or candidates for Vitamin K antagonist (VKA)
- Patients under another antiplatelet agent (Ticlopidine, Prasugrel)
- Patients with a contraindication to clopidogrel (hypersensitivity to the active substance or to any of the excipients, severe hepatic impairment, progressive hemorrhagic lesion such as peptic ulcer or intracranial hemorrhage)
- Under omeprazole treatment, or considered during the study
- Anemia (Hb <12g/dl)
- Thrombocytopenia with less than 100000 cells/mm3
- Serum creatinine greater than 200 μmol/l
- Pregnancy and/or breast-feeding
- Severe renal impairment
Exclusion criteria:
- Non-compliance with treatment (treatment compliance <80%)
- AE/SAE requiring cessation of treatment
- Planning a CABG
- Occurrence of pregnancy during the study
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
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Actieve vergelijker: Arm 1 (single dose)
Will receive a clopidogrel loading dose of 600 mg PO, then a daily dose of clopidogrel 75 mg PO until the angioplasty is performed.
After coronary intervention, a daily dose of clopidogrel 150 mg PO for 7 days will be given, followed by a daily single dose of clopidogrel (75 mg PO) for 21 days.
Maintenance therapy will be clopidogrel daily dose of 75 mg PO thereafter, until the end of the study.
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COPIGREL® - clopidogrel dosed at 75 mg per tablet
Andere namen:
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Actieve vergelijker: Arm 2 (double dose)
Will receive a clopidogrel loading dose of 600 mg PO, then a daily dose of clopidogrel 75 mg PO until the angioplasty is performed.
After coronary intervention, a daily dose of clopidogrel 150 mg PO for 7 days will be given, followed by a daily double dose of clopidogrel (150 mg PO) for 21 days.
Maintenance therapy will be clopidogrel daily dose of 75 mg PO thereafter, until the end of the study.
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COPIGREL® - clopidogrel dosed at 75 mg per tablet
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Major Cardiovascular Events (MACE)
Tijdsspanne: 1 year after coronary intervention
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Incidence of major cardiovascular events including cardiac death, MI, cerebrovascular accident (CVA), revascularization (PTCA, GABG), stent thrombosis.
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1 year after coronary intervention
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Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Bleeding Events
Tijdsspanne: At 1, 3, 6, 9 and 12 months from patient enrollment
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All bleeding events (digestive, cerebral, other locations)
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At 1, 3, 6, 9 and 12 months from patient enrollment
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Heart Failure Readmission
Tijdsspanne: At 1, 3, 6, 9 and 12 months from patient enrollment
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Incidence of heart failure hospital readmissions
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At 1, 3, 6, 9 and 12 months from patient enrollment
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Global Death
Tijdsspanne: At 1, 3, 6, 9 and 12 months from patient enrollment
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Incidence of death of all causes (death of cardiovascular origin and death of non-cardiovascular origin)
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At 1, 3, 6, 9 and 12 months from patient enrollment
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Incidence of Adverse Events
Tijdsspanne: At 1, 3, 6, 9 and 12 months from patient enrollment
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Incidence of Adverse Events (AE) including Serious Adverse Events (SAE)
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At 1, 3, 6, 9 and 12 months from patient enrollment
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Medewerkers en onderzoekers
Sponsor
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Werkelijk)
Primaire voltooiing
Studie voltooiing (Werkelijk)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
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
Aanvullende relevante MeSH-voorwaarden
- Glucosemetabolismestoornissen
- Metabole ziekten
- Endocriene systeemziekten
- Suikerziekte
- Diabetes mellitus, type 2
- Fysiologische effecten van medicijnen
- Neurotransmitter agenten
- Moleculaire mechanismen van farmacologische werking
- Bloedplaatjesaggregatieremmers
- Purinerge P2Y-receptorantagonisten
- Purinerge P2-receptorantagonisten
- Purinerge antagonisten
- Purinerge middelen
- Clopidogrel
Andere studie-ID-nummers
Andere studie-ID-nummers
- TERIAK-001
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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