Coronary Artery Disease Clinical Trial
Official title:
Anticoagulant Treatments Evaluation During Percutaneous Coronary Angioplasty in Stable Patients
The purpose of this study is to determine whether adjunction of intravenous anticoagulant therapy (enoxaparin, HNF, bivalirudin) to antiaggregation with clopidogrel and aspirin improves in-hospital results of percutaneous transluminal coronary angioplasty (ptca) in selected patients.
- Background : We don't know if using IV anticoagulant therapy is necessary for
percutaneous coronary angioplasty in stable patients.
- Purpose : to compare efficacy and security of use or not of different anticoagulant
treatments during percutaneous coronary angioplasty in patients with double
antiaggregant therapy.
- Abstract : In stable patients pretreated with double antiaggregant therapy use of IV
anticoagulants has not been yet evaluated during angioplasty. In this prospective
randomized trial we want to compare in such patients the efficacy and security of the
administration of IV heparin, IV enoxaparin, IV bivalirudin and no use of anticoagulant
during coronary angioplasty. We will evaluate in each group ischaemic events (clinic,
ECG and biology) and haemorrhagic events (clinic, biology) with a one month follow up.
- Primary outcome: ischaemic events via troponin Ic measurements during 24 hours post
procedure.
- Secondary outcomes: haemorrhagic events : clinical and biological evaluation (Hb, Ht,
TIMI score)
- Study design : monocentric randomized clinical trial type therapeutic equivalence phase
IV.
- Interventions : In patients prepared with therapeutic association (aspirin clopidogrel)
comparison between use or no of anticoagulant (IV heparin, IV enoxaparin or IV
bivalirudin).
- Number of subjects : 120 per group (total of 480).
- Statistical analysis : multivariate analysis with logistic regression models : each end
point (troponin Ic increase, haemoglobin decrease, …) will be explicated with treatment
group and other covariates (sex, age, creatinine, …).
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