Individualizing Dual Antiplatelet Therapy After Percutaneous Coronary Intervention - The IDEAL-PCI Registry
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Purpose
The purpose of this study is to determine the efficacy and safety of a routine individualized antiplatelet therapy after coronary stent implantation by evaluating "on-treatment" platelet reactivity with Multiple Electrode Aggregometry (MEA, Multiplate® Analyzer).
| Condition | Intervention | Phase |
|---|---|---|
|
Platelet Inhibition Coronary Stent Implantation |
Drug: prasugrel or ticagrelor Drug: Clopidogrel |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Individualizing Dual Antiplatelet Therapy After Percutaneous Coronary Intervention - The IDEAL-PCI Registry |
- Definite Stent Thrombosis [ Time Frame: 30 days ] [ Designated as safety issue: No ]The angiographic or pathological confirmation of stent thrombosis is called "definite stent thrombosis"
- Any Bleeding Event [ Time Frame: 30days ] [ Designated as safety issue: Yes ]
Bleeding classified by the TIMI hemorrhage classification scheme:
Minor: any clinically overt sign of hemorrhage (including imaging) that is associated with a fall in hemoglobin of 3 to < 5 g/dL
Major: (1) if it is intracranial, or (2) clinically significant overt signs of hemorrhage associated with a drop inhemoglobin of > 5 g/dL
- Probable Stent Thrombosis [ Time Frame: 30days ] [ Designated as safety issue: No ]
Probable stent thrombosis is considered to have occurred in case of
- any unexplained death within the first 30 days.
- any MI that is related to documented acute ischemia in the territory of the implanted stent without angiographic confirmation of stent thrombosis and in the absence of any other obvious cause, irrespective of the time after the index procedure
| Enrollment: | 1008 |
| Study Start Date: | July 2011 |
| Study Completion Date: | January 2013 |
| Primary Completion Date: | January 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: standard therapy
standard dual antiplatelet therapy after PCI for all patient populations (stable CVD and ACS)
|
Drug: Clopidogrel
clopidogrel 75mg od for 12 month
Other Name: Plavix
|
|
Experimental: individualized therapy
dual antiplatelet therapy modified according to clopidogrel on-treatment platelet reactivity measured by Multiplate Analyzer
|
Drug: prasugrel or ticagrelor
prasugrel 10mg od for 12 month ticagrelor 90mg td for 12 month
Other Names:
|
Detailed Description:
Depending on the clinical presentation patients are treated according to standard operating procedures in our department. The earliest, 12 hours after an initial clopidogrel-loading dose (600mg)"on-treatment" platelet reactivity will be determined by Multiple Electrode Aggregometry (MEA, Multiplate® Analyzer), a point of care assay. In case of high residual platelet reactivity (i.e. ≥ 50U), patients are switched according to a therapeutic algorithm to either prasugrel (Efient®), or in case of contraindication (i.e. stroke) to ticagrelor (Brilique®), or in case of contraindication (intracranial hemorrhage) reloaded with clopidogrel.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- all consecutive PCI patients with stent implantation of our institution
Exclusion Criteria:
- pregnancy
Contacts and Locations
More Information
Additional Information:
Publications:
| Responsible Party: | Prof. Dr. Guenter Christ, Univ. Prof. Dr., Kaiser Franz Josef Hospital |
| ClinicalTrials.gov Identifier: | NCT01515345 History of Changes |
| Other Study ID Numbers: | IDEAL-PCI protocol 1.0 |
| Study First Received: | January 18, 2012 |
| Results First Received: | February 3, 2013 |
| Last Updated: | May 13, 2013 |
| Health Authority: | Austria: Ethikkommission |
Keywords provided by Kaiser Franz Josef Hospital:
|
clopidogrel-nonresponder stent thrombosis |
Additional relevant MeSH terms:
|
Clopidogrel Prasugrel Ticagrelor Platelet Aggregation Inhibitors Hematologic Agents Therapeutic Uses Pharmacologic Actions |
Purinergic P2Y Receptor Antagonists Purinergic P2 Receptor Antagonists Purinergic Antagonists Purinergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 23, 2013