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What is the Optimal antiplatElet and Anticoagulant Therapy in Patients With Oral Anticoagulation Undergoing revasculariSaTion 2. (WOEST 2)

9. mars 2020 oppdatert av: R&D Cardiologie

An International Prospective Registry on Concomitant Use of Oral Anticoagulants and P2Y12 Inhibitors in Patients With Atrial Fibrillation or Heart Valve Prosthesis Undergoing Coronary Revascularisation.

The optimal antithrombotic therapy for patients with atrial fibrillation (AF) with a CHA2DS2-VASc score ≥1 with concomitant acute coronary syndrome (ACS) or revascularisation by percutaneous coronary intervention (PCI) with stenting, is still unknown. For these patients current North American and European guidelines recommend a triple therapy strategy, including vitamin K antagonists (VKA), aspirin and clopidogrel. A major drawback of this triple therapy strategy is a significant increase in the risk of major bleeding. Furthermore, the ommitance of aspirin and the introduction of more potent P2Y12 inhibitors as well as the non-vitamin K oral anticoagulants (NOAC), created numerous new antithrombotic treatment strategies for these patients with overlapping conditions. To date, evidence on the risks and benefits of these new antithrombotic treatment strategies is lacking.

The WOEST 2 Registry aims to improve medical care for patients with AF and/or a heart valve prosthesis ánd undergoing coronary revascularisation through a better understanding of their demographics, antithrombotic management and related in-hospital and long-term outcomes. The WOEST 2 Registry will provide data to support benchmarking of antithrombotic treatment patterns and patient outcomes.

Objective: To assess the different management patterns and related in-hospital and long-term safety and efficacy outcomes of combined use of chronic oral anticoagulation and a P2Y12 inhibitor in patients with atrial fibrillation and/or a heart valve prosthesis undergoing coronary revascularisation.

Studieoversikt

Status

Ukjent

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

The WOEST 2 Registry is a prospective, international, multi-centre, non-interventional, cohort study designed to recruit an unselected cohort of patients with atrial fibrillation and/or a heart valve prosthesis undergoing coronary revascularisation.

Trial overview

Name : WOEST 2 REGISTRY

Target for enrollment : 2200 patients

Time frame for inclusion : within 72 hours after index PCI or coronary artery bypass grafting (CABG)

Follow-up : 24 months

Visits : 30 days, 12 and 24 months after index PCI or CABG

Studietype

Observasjonsmessig

Registrering (Forventet)

2200

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Belgia
      • Aalst, Belgia
        • Aktiv, ikke rekrutterende
        • Onze Lieve Vrouw Ziekenhuis
      • Antwerpen, Belgia
        • Aktiv, ikke rekrutterende
        • Universitair Ziekenhuis Antwerpen
      • Bonheiden, Belgia
        • Rekruttering
        • Imelda Ziekenhuis
      • Genk, Belgia
        • Rekruttering
        • Ziekenhuis Oost-Limburg
      • Leuven, Belgia
        • Aktiv, ikke rekrutterende
        • Universitair Ziekenhuis Leuven
  • Nederland
      • Amsterdam, Nederland
        • Aktiv, ikke rekrutterende
        • Onze Lieve Vrouwe Gasthuis
      • Breda, Nederland
        • Aktiv, ikke rekrutterende
        • Amphia Ziekenhuis
      • Nieuwegein, Nederland
      • Tilburg, Nederland
        • Aktiv, ikke rekrutterende
        • Elizabeth-Tweesteden Ziekenhuis

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Sannsynlighetsprøve

Studiepopulasjon

WOEST2 Registry is designed to recruit an unselected cohort of patients with AF and/or a heart valve prosthesis undergoing coronary revascularisation (PCI/CABG) within at least three European countries (Netherlands, Belgium, United Kingdom). The three international cohorts of patients reflect the spectrum of our study population within the geographic catchment regions. At least 15 hospitals of varying size and characteristics will participate in this study.

Beskrivelse

Inclusion Criteria:

In order to be eligible to be included in this registry, a subject must meet ALL of the following criteria:

  1. Patient is ≥ 18 years of age;
  2. Patients with a diagnosis of atrial fibrillation (prior to hospitalisation ór during hospitalisation within 72h after coronary revascularisation) and/or with a heart valve prosthesis (aortic/mitral);
  3. Chronic treatment with OAC or NOAC therapy at inclusion or the intention to start chronic treatment with OAC or NOAC within 72h after coronary revascularisation AND with intended duration of treatment for at least one year after inclusion in the registry;
  4. Indication for coronary revascularisation by CABG or PCI (with deployment of at least 1 coronary stent);
  5. Prescription of a P2Y12 inhibitor (clopidogrel, ticagrelor or prasugrel) because of CABG following acute coronary syndrome* and /or because of PCI (with deployment of at least 1 coronary stent).
  6. Patient has provided written informed consent.

Exclusion Criteria:

A potential subject who meets ANY of the following criteria will be excluded from participation in this study:

  1. Patients unable to sign informed consent (including mental disabled patients);
  2. Patients with life expectancy < 1 year;
  3. Allergy or intolerance to P2Y12 inhibitors.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
Patients with chronic oral anticoagulation and P2Y12 inhibitor
Patients with chronic indication for chronic oral anticoagulation (OAC) because of a heart valve prosthesis and/or atrial fibrillation undergoing coronary revascularisation (by PCI or CABG) and requiring concomitant treatment with P2Y12 inhibitors.
Legemiddel: Combination of chronic oral anticoagulation and a P2Y12 inhibitor with or without aspirin.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Composite of the rate of non-fatal myocardial infarction, non-fatal ischemic stroke (including transient ischemic attack), non-central nervous system systemic embolization and cardiovascular death [the primary efficacy outcome].
Tidsramme: 1 year
1 year
The occurrence of any bleeding episode requiring in-hospital medical attention and/or a switch of antithrombotic medication [the primary safety outcome].
Tidsramme: 1 year
Bleeding will be classified by the Bleeding Academic Research Consortium (BARC) 2, 3, 4 and 5 bleeding criteria and by the Thrombolysis in Myocardial Infarction (TIMI) minor and major bleeding criteria.
1 year

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

R&D Cardiologie

Samarbeidspartnere

St. Antonius Hospital

Etterforskere

  • Hovedetterforsker: Jurriën M ten Berg, MD, PhD, St. Antonius Hospital Nieuwegein, the Netherlands
  • Hovedetterforsker: Willem JM Dewilde, MD, PhD, Imelda Hospital Bonheiden, Belgium

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Hjelpsomme linker

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. juni 2014

Primær fullføring (Forventet)

1. januar 2021

Studiet fullført (Forventet)

1. januar 2022

Datoer for studieregistrering

Først innsendt

10. desember 2015

Først innsendt som oppfylte QC-kriteriene

15. desember 2015

Først lagt ut (Anslag)

18. desember 2015

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

11. mars 2020

Siste oppdatering sendt inn som oppfylte QC-kriteriene

9. mars 2020

Sist bekreftet

1. september 2019

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • R&D/Z14.016/WOEST2
  • WOEST2-004 (Annen identifikator: WOEST 2 Study Team)
  • V.21483/W14.007 (Annen identifikator: Medical research Ethics Committees United - St. Antonius Hospital, the Netherlands)

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