Acute Coronary Syndrome Clinical Trial
— VERDIOfficial title:
A Randomized Study With Loading Dose of Prasugrel Opposed to the Standard Dose of Clopidogrel in Type 2 Diabetic Patients in Acute Coronary Syndrome, Revascularized Through Drug-eluting Stent.
The purpose of this study is to determine if, in type 2 diabetic patients undergoing treatment with PCI and a stent, who fail to respond to normal doses of clopidogrel, a loading dose of 60 mg of prasugrel followed by 10 mg once daily is superior to the standard dose of 75 mg of clopidogrel in achieving greater than 50% inhibition of platelet aggregation at 24-36 hours of treatment.
Status | Completed |
Enrollment | 65 |
Est. completion date | October 2013 |
Est. primary completion date | October 2013 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years to 80 Years |
Eligibility |
Inclusion Criteria: 1. Type 2 diabetic patients with acute coronary syndrome with non-ST segment elevation who are undergoing a percutaneous coronary intervention (PCI) with a coronary stent. 2. Patients who are non-responsive on the platelet anti-aggregation test with standard doses of clopidogrel will be randomized. 3. Participants must sign an informed consent document. Exclusion Criteria: 1. Age <18 years or >80 years. 2. Patients with acute coronary syndrome with ST segment elevation. 3. Pregnancy previous to or during the study. 4. The use of oral anticoagulants in the last 10 days with an INR >1.5 or who plan to use them during the follow-up period (1 year). 5. Antithrombotic treatment with GP IIb/IIIa inhibitors. 6. Contraindication for the use of prasugrel and/or clopidogrel and/or aspirin: - Antecedents of pharmacologic allergy to thienopyridine derivatives or aspirin. - Antecedents of clinically significant or persistent thrombocytopenia or neutropenia. 7. Active bleeding or significant increase of risk of hemorrhage such as severe hepatic insufficiency, peptic ulcer present, proliferative diabetic retinopathy, antecedents of severe systemic bleeding, gastrointestinal bleeding, macrohematuria, intraocular hemorrhage, hemorrhagic stroke, or intracranial bleeding), or other antecedents of bleeding diathesis or coagulopathy. 8. Patients with previous TIA or CVA. 9. Patients weighing <60 Kg. 10. Hemoglobin <10.5 g/dl, or Hematocrit <30%. 11. Severe left ventricular systolic dysfunction, EF <35%. 12. Renal insufficiency with creatinine levels >2 mg/dl. 13. Previous inclusion of the patient in another study. 14. Treatment in research (medication or device) in the last 30 days prior. 15. Medical, geographical, or social factors that would make participation in the study impractical, such as the incapacity to provide written informed consent and to understand the complete meaning of informed consent, or the refusal of the patient to participate in the study. |
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Spain | Hospital Universitario Virgen del Rocío | Seville |
Lead Sponsor | Collaborator |
---|---|
Fundación Pública Andaluza para la gestión de la Investigación en Sevilla | Andaluz Health Service |
Spain,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of patients who achieve inhibition of platelet aggregation greater that 50% | The principal objective is to determine whether in type 2 diabetic patients who are non-responsive to clopidogrel at habitual doses and who receive treatment through percutaneous coronary intervention (PCI) with a stent, a treatment plan with a loading dose of prasugrel (60 mg) followed by 1 cp (10 mg) once a day, is superior to a standard dose of 75 mg clopidogrel in achieving greater than 50% inhibition of platelet aggregation at 24-36 hours of treatment. | 24 to 36 hours post-PCI | No |
Secondary | Number of participants with adverse events as a measure of safety and tolerability | To evaluate the safety of treatment with prasugrel in comparison with the standard treatment with clopidogrel in terms of the appearance of secondary effects (severe bleeding, thrombocytopenia, neutropenia, gastrointestinal changes, thrombotic thrombocytopenic purpura). | 30 days | Yes |
Secondary | Number of patients who die or present the combined endpoint of cardiovascular death, MI or recurrent ischemia as a measure of efficacy. | To assess the results in different sub-groups and analyze the combined endpoint of cardiovascular death, MI or recurrent ischemia at 30 days. | 30 days. | Yes |
Secondary | Number of participants who are non-responsiveness to antiaggregation therapy as a measure of efficacy | To analyze the characteristics of patients who are non-responsive to anti-aggregation therapy. | 30 days. | No |
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