Unstable Angina Clinical Trial
Official title:
Optimization of Antiplatelet Therapy With Clopidogrel on the Basis of the Extent of Platelet Inhibition in Patients With Acute Coronary Syndromes on Dual Antiplatelet Therapy Undergoing PCI With Stent Implantation
The purpose of this study is to evaluate the efficacy (reduction of major ischemic events at 6 and 12 months of follow-up) of a tailored clopidogrel therapy in patients with UA/NSTEMI undergoing PCI with stent implantation and wiht a documented residual platelet reactivity assessed by a point of care system (VerifyNow P2Y12).
Several studies documented the presence of a high variability in the individual response to
antiplatelet therapies in terms of extent of platelet function inhibition. This laboratory
finding is the so-called aspirin or clopidogrel resistance which we prefer to define
residual platelet reactivity (RPR) on antiplatelet therapy.
A growing body of evidence is demonstrating the clinical relevance of this laboratory
parameter, i.e. patients with RPR are at higher risk of a subsequent adverse cardiovascular
event.
In particular, it has been demonstrated that RPR measured by light transmittance
aggregometry induced by ADP or by the point of care assay VerifyNow P2Y12 identifies
patients which, after coronary revascularization with stent implantation, at higher risk of
a potentially catastrophic event such as stent thrombosis.
No randomized trials are available in the literature on the efficacy and safety of an
antiplatelet therapy tailored on the extent of platelet function inhibition.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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