Patients Undergoing Percutaneous Coronary Intervention (PCI) Through Optimal Platelet Inhibition
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Purpose
The purpose of this study is to assess the the 1-year rates of ischemic and bleeding complications in patients whose dual antiplatelet therapy regimen post-PCI has been determined with the use of a clinical algorithm that includes both clinical risks and platelet reactivity while on chronic clopidogrel therapy.
| Condition |
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Percutaneous Coronary Intervention Dual Antiplatelet Therapy Aspirin Clopidogrel |
| Study Type: | Observational |
| Study Design: | Observational Model: Case-Only Time Perspective: Prospective |
| Official Title: | TRIAGE: Patients Undergoing Percutaneous Coronary Interventions to Improve Clinical Outcomes Through Optimal Platelet Inhibition |
- MACE [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]Major adverse cardiac events (all-cause death, myocardial infarction and stent thrombosis)
- Rates of major bleeding [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]The rates of major bleeding in patients treated with a thienopyridine based on the clinical algorithm.
| Estimated Enrollment: | 1000 |
| Study Start Date: | March 2012 |
| Estimated Study Completion Date: | February 2014 |
| Estimated Primary Completion Date: | February 2014 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
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SA + 5mg prasugrel
Prasugrel 5 mg group: Patients with Intermediate or high bleeding risks and PRU ≥ 230 are Prescribed 5mg of prasugrel daily along with aspirin.
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ASA + 10 mg prasugrel
Prasugrel 10 mg group: Patients with Low bleeding risk and high ischemia risk and PRU ≥ 230 are prescribed 10 mg of prasugrel daily along with aspirin.
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ASA + 75 mg clopidogrel daily
Clopidogrel 75 mg group (control): PRU ≤ 230; high bleeding risk or high ischemic risk; patients with active malignancy, age >75; Wt< 60kg with previous CVA or TA are prescribed 75 mg of clopidogrel daily along with aspirin.
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Detailed Description:
Prospective multicenter registry. Patients already on chronic dual antiplatelet therapy with aspirin and clopidogrel will be assessed for (1) clinical risks factors for future bleeding and ischemic complications, and (2) on-treatment platelet reactivity as measured by the VerifyNow P2Y12 assay (Accumetrics, Inc., San Diego, CA, USA). These will be considered by utilization of a clinical algorithm to determine the dual antiplatelet regimen post-PCI (aspirin in combination with 1. clopidogrel, 2. prasugrel 5mg daily, or 3. prasugrel 10mg daily).
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Subjects in any of the participating sites who are on chronic clopidogrel treatment and return for PCI will be considered for this study.
Inclusion Criteria:
- The subject has provided informed written.
- The subject must be ≥ 18 years of age (or minimum age as required by local regulations) at the time of enrollment.
- Patient is established on chronic clopidogrel therapy when he/she returns for PCI, and the components of DAPT are determined by the clinical decision algorithm as local standard of care.
- The subject is willing and able to cooperate with the study procedures and required follow-ups.
Exclusion Criteria:
- Patients with cardiogenic shock will be excluded.
- The subject is participating in an investigational device or drug study. Subject must have completed the follow up phase of any previous study at least 30 days prior to enrolment in this study.
- Pregnant women.
Contacts and Locations| Contact: Roxana Mehran, MD | 212-659-9649 | roxana.mehran@mountsinai.org |
| United States, New York | |
| Mount Sinai Medical Center | Recruiting |
| New York, New York, United States, 10029 | |
| Principal Investigator: George Dangas, MD | |
| Principal Investigator: | George Dangas, MD | Mount Sinai School of Medicine |
More Information
No publications provided
| Responsible Party: | Mount Sinai School of Medicine |
| ClinicalTrials.gov Identifier: | NCT01582217 History of Changes |
| Other Study ID Numbers: | GCO 12-0028, FWA # 00005656 and 00005651 |
| Study First Received: | April 18, 2012 |
| Last Updated: | April 19, 2012 |
| Health Authority: | United States: Institutional Review Board United States: Food and Drug Administration Germany: Federal Institute for Drugs and Medical Devices Australia: Department of Health and Ageing Therapeutic Goods Administration Brazil: Ministry of Health |
Keywords provided by Mount Sinai School of Medicine:
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Bleeding Risk Score Outcomes Prasugrel |
Additional relevant MeSH terms:
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Prasugrel Purinergic P2Y Receptor Antagonists Purinergic P2 Receptor Antagonists Purinergic Antagonists Purinergic Agents |
Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 19, 2013