EArly Discharge After Transradial Stenting of CoronarY Arteries in High-Risk Patients of Bleeding (EASY-B2B)
EArly Discharge After Transradial Stenting of CoronarY Arteries in High-Risk Patients of Bleeding: Bivalirudin to Reduce Bleeding EASY-B2B Study
RATIONALE:
Transradial coronary stenting is associated with less risk of access site complications and bleeding compared to femoral approach.
Major bleeding post-PCI is a strong independent predictor of mortality and MACE. Depending of the antithrombotic regimen and access-site used, bleeding related to access-site represents 50-80% of the cases. Whereas transradial approach minimizes the risks of access-site bleeding, it has no impact on non-access site bleeding.
Peri-procedural anemia is also an independent predictor of mortality and MACE.
With femoral approach, bivalirudin compared to heparin ± glycoproteins IIb-IIIa has been associated with a significant reduction in access-site and non-access site related bleeding.
In a post-hoc analysis of patients treated by transradial approach in ACUITY, there was a trend for non-access site bleeding (organ bleeding) with bivalirudin compared to heparin ± glycoproteins IIb-IIIa.
HYPOTHESES:
In patients at high-risk of peri-procedural bleeding, bivalirudin ± glycoproteins IIb-IIIa reduces the risk of bleeding compared to heparin ± glycoproteins IIb-IIIa.
In patients at high-risk of bleeding and undergoing transradial PCI, bivalirudin significantly reduces the incidence of non-access site bleeding and peri-procedural anemia.
研究概览
详细说明
OBJECTIVES:
The primary objective is to compare the incidence of major bleeding and anemia 24h post-PCI in patients at high-risk of bleeding after transradial PCI with heparin or bivalirudin.
研究类型
注册 (预期的)
阶段
- 第四阶段
联系人和位置
学习地点
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Quebec、加拿大、G1V 4G5
- 招聘中
- Quebec Heart-Lung Institute
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接触：
- Michele Jadin, MSc
- 电话号码：3007 418-6568711
- 邮箱：michele.jadin@crhl.ulaval.ca
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首席研究员：
- Olivier F Bertrand, MD, PhD
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- At least two of the following additional criteria
- At least 70 yrs old
- Female gender
- Diabetes
- Creatinine clearance <60mL/min
- History of gastro-intestinal or other organ bleeding
- Baseline anemia
- Current treatment with glycoproteins IIb-IIIa inhibitors
Exclusion Criteria:
- Intolerance or allergy to ASA, clopidogrel or ticlopidine precluding treatment for 12 months
- Concurrent participation in other investigational study
- Femoral sheath (artery)
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
有源比较器：Bivalirudin
Standard practice: 0.75mg/kg + infusion 1.75mg/kg/h
|
Standard practice: 0.75mg/kg + infusion 1.75mg/kg/h
其他名称：
|
|
有源比较器：Heparin
70 U/kg or standard practice
|
70 U/kg
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Major bleeding and Mace
大体时间：24h post-PCI and Discharge
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The primary end-points will be 1) the incidence of major bleeding (Replace-2 criteria) at hospital discharge and 2) the incidence of 24h post-PCI anemia (WHO criteria)
|
24h post-PCI and Discharge
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
EFFICACY and SAFETY PARAMETERS
大体时间：30 days
|
The composite of death, MI (def 1 : Tn-t > 0.1 and def 2 : CK-MB > 30μg/l), urgent revascularization and major bleeding at 30 days post-PCI. The incidence of ARC-defined stent thrombosis at 30 days. The incidence of access-site hematoma according to EASY scale. The incidence of radial artery occlusion at hospital discharge according to echo-doppler evaluation |
30 days
|
合作者和调查者
调查人员
- 首席研究员：Olivier F Bertrand, MD, PhD、Fondation IUCPQ
研究记录日期
研究主要日期
学习开始
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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