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
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Studietype
Studietype
Fase
Fase
- Fase 4
Kontakter og plasseringer
Studiesteder
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Massachusetts
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Boston, Massachusetts, Forente stater, 02114
- Massachusetts General Hospital
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-
Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
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.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Enkelt
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / Behandling |
|---|---|
|
Aktiv komparator: 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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Aktiv komparator: Ticagrelor- Immediate Administration
Subjects receive 180 mg of ticagrelor immediately after study enrollment.
OCT is performed prior to and after coronary artery stenting.
|
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.
|
Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Total trombebelastning målt ved volumet av in-stent trombe kvantifisert ved planimetri.
Tidsramme: Trombebelastning vil bli målt ved slutten av koronararteriestentingprosedyren.
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Den totale trombebelastningen målt på OCT-bilder vil bli vurdert.
Volumet av in-stent trombe vil bli kvantifisert ved planimetri.
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Trombebelastning vil bli målt ved slutten av koronararteriestentingprosedyren.
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
PRI (platelet reactivity index) as measured bu the PLT-VASP assay.
Tidsramme: PRI iwill be measured at the time of OCT image acquisition.
|
The extent of platelet inhibition will be measured by PLT-VASP and VerifyNow P2Y12 assays.
|
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.
Tidsramme: P2Y12 will be measured at the time of OCT image acquisition.
|
The extent of platelet inhibition will be measured by PLT-VASP and VerifyNow P2Y12 assays.
|
P2Y12 will be measured at the time of OCT image acquisition.
|
Andre resultatmål
Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
PCI-related myocardial infarction (MI)
Tidsramme: 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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Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Samarbeidspartnere
Samarbeidspartnere
Studierekorddatoer
Studer hoveddatoer
Studiestart
Studiestart
Primær fullføring (Forventet)
Primær fullføring
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Patologiske prosesser
- Myokardiskemi
- Hjertesykdommer
- Kardiovaskulære sykdommer
- Vaskulære sykdommer
- Arteriosklerose
- Arterielle okklusive sykdommer
- Sykdom
- Koronar sykdom
- Koronararteriesykdom
- Syndrom
- Akutt koronarsyndrom
- Fysiologiske effekter av legemidler
- Nevrotransmittere agenter
- Molekylære mekanismer for farmakologisk virkning
- Blodplateaggregasjonshemmere
- Purinergiske P2Y-reseptorantagonister
- Purinergiske P2-reseptorantagonister
- Purinergiske antagonister
- Purinergiske midler
- Ticagrelor
Andre studie-ID-numre
Andre studie-ID-numre
- 2013P001322
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