Atherosclerosis Clinical Trial
Official title:
Aspirin Non-responsiveness and Clopidogrel Endpoint Trial.
In the ASCET study, 1000 patients with documented coronary heart disease will be randomized to either continued treatment with aspirin 160 mg/d or change to clopidogrel 75mg/d. Clinical endpoints will be recorded for at least 2 years and related to the initial aspirin response, assessed by the PFA-100® method, to investigate whether aspirin non-responders have higher composite event rate than responders or whether Clopidogrel treatment in patients non-responsive to aspirin will reduce their risk of future clinical events. The clinical events are the composite of unstable angina, myocardial infarction, stroke or death.
Background: Aspirin is widely used as an antiplatelet drug in patients with coronary heart
disease. Despite documented clinical benefit, many patients on aspirin still experience
severe cardiovascular events. Several laboratory reports have shown lack of platelet
inhibition in 5-40% of aspirin-treated patients, and the term aspirin resistance has been
introduced. The clinical relevance of these laboratory findings is, however, still unknown.
New antiplatelet drugs have been developed, and the adenosin diphosphate (ADP) receptor
inhibitor clopidogrel has at least the same efficacy as aspirin with an acceptable safety
profile. Laboratory methods for determination of platelet reactivity and treatment efficacy
have been complicated and time consuming. New methodologies, like the PFA-100® system, have
made such analyses more suitable for clinical use.
Design: In the ASCET study, 1000 patients with documented coronary heart disease will be
randomized to either continued treatment with aspirin 160 mg/d or change to clopidogrel
75mg/d after initial determination of their platelet reactivity while on aspirin treatment.
Clinical endpoints will be recorded for at least 2 years and related to the initial aspirin
response.
Scand Cardiovasc J. 2004 Dec;38(6):353-6.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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