Coronary Artery Disease Clinical Trial
— TARGET-FIRSTOfficial title:
Evaluation of a Modified Anti-Platelet Therapy Associated With Low-dose DES Firehawk in Acute Myocardial Infarction Patients Treated With Complete Revascularization Strategy
Verified date | March 2024 |
Source | MicroPort CRM |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The study aims to evaluate a modified antiplatelet therapy associated with Firehawk low-dose rapamycin DES in acute myocardial infarction patients treated with complete revascularization strategy. The modified antiplatelet therapy consists of a reduced duration of Dual Antiplatelet Therapy post procedure (ie. 1 month duration) followed by P2Y12 inhibitor monotherapy for the next 11 months. It is hypothesized that in the setting of clinically stable, low to moderate complexity acute Myocardial Infarction patients, a modern approach combining a stent with high biocompatibility feature, complete revascularization strategy and modified antiplatelet therapy may be associated with similar outcomes, or even a significant benefit compared with guidelines-recommended 12-month DAPT. This benefit could be driven by a reduced risk in significant bleeding events, while keeping a comparable protection against ischemic risk. Enrolled subjects will be randomized in a 1:1 ratio to either cessation of aspirin at 1 months, either continuation of DAPT. Selection of the P2Y12 inhibitor agent is left to investigator judgment but has to be in line with the current ESC guidelines. Subjects treated with the Firehawk or Firehawk Liberty coronary stent will be included in this study.
Status | Active, not recruiting |
Enrollment | 2248 |
Est. completion date | April 30, 2025 |
Est. primary completion date | April 30, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria (General): - Troponin-positive Non-ST-Elevation MI, requiring early invasive treatment (PCI), or ST-Elevation MI requiring primary PCI, and PCI occurred within the last 7 days - Subject is eligible for per-protocol antiplatelet treatments - Written informed consent Inclusion Criteria (Procedural/angiographic): - Successful revascularization - All treated lesions: - In native coronary arteries only - In vessels with visual reference diameter =2.25 mm and = 4.00 mm - Implanted with the study device - Maximum 3 lesions treated (*) - Maximum total stent length = 80 mm - Complete revascularization performed when more than 1 significant lesion, during the index procedure or in staged procedure(s) occurring within 7 days from the index procedure. Exclusion Criteria (General): - Subjects with prior STEMI or prior PCI within 12 months before index admission - Prior Coronary Artery Bypass Graft (CABG) Surgery - Cardiogenic shock - Secondary PCI - Fibrinolysis - Prior stent thrombosis - Planned PCI, CABG, or surgery within 12 months - Need for Oral Anti-Coagulation therapy - Ischemic stroke or ICH within 12 months - eGFR <30 mL/min/1.73 m2 or dialysis - Active bleeding at time of inclusion or high risk for major bleeding - History of bleeding diathesis or coagulopathy or subject refuse blood transfusions - Stage B or C liver cirrhosis or active cancer within 12 months - Baseline haemoglobin <13 g/dL (12g/dL for women) or anaemia requiring transfusion in the 4 weeks prior to index procedure - Moderate or severe thrombocytopenia - Expected non-adherence to protocol or estimated life expectancy =12 months - Known hypersensitivity or contraindication to any medication used in the study or any of the study stent's components/compounds - Participation in another interventional clinical trial - Woman who is pregnant, nursing or with known intention to procreate Exclusion Criteria (Procedural/Angiographic): - In-stent restenosis or thrombosis - Chronic total occlusion - Severe calcification - True bifurcation disease and side branch diameter = 2mm, or bifurcation treated with 2 stents - Left main coronary artery lesion - Residual untreated dissection = C - Implantation of a non-study stent - Subject is deemed to receive preferentially CABG within 1 year |
Country | Name | City | State |
---|---|---|---|
Austria | Universitätsklinikum | St Pölten | |
France | CHU Annecy | Annecy | |
France | Clinique Roseraie | Aubervilliers | |
France | CH Bastia | Bastia | |
France | CHU Caen | Caen | |
France | CH Chartres | Chartres | |
France | CH Cherbourg | Cherbourg | |
France | CHU Clermont-Ferrand | Clermont-Ferrand | |
France | CHU Dijon | Dijon | |
France | CH Haguenau | Haguenau | |
France | CHU Lille | Lille | |
France | CH St Joseph/St Luc | Lyon | |
France | CHU La Timone | Marseille | |
France | Hôpital Jacques Cartier | Massy | |
France | CHU Montpellier | Montpellier | |
France | Clinique Millénaire | Montpellier | |
France | CHU Nîmes | Nîmes | |
France | CHU Reims | Reims | |
France | Clinique St Hilaire | Rouen | |
France | CHU Toulouse | Toulouse | |
France | Clinique Pasteur | Toulouse | |
Italy | Humanitas - Gavazzeni | Bergamo | |
Italy | Clinica Montevergine | Mercogliano | |
Italy | Niguarda | Milan | |
Italy | AOU Federico II | Napoli | |
Italy | Policlinico Universitario | Padova | |
Italy | Giovanni Paolo II | Ragusa | |
Netherlands | Tergooi MC | Blaricum | |
Netherlands | Jeroen Bosch Ziekenhuis | Den Bosch | |
Netherlands | Albert Schweitzer Ziekenhuis | Dordrecht | |
Netherlands | Maastad University Hospital | Rotterdam | |
Netherlands | Haga Ziekenhuis | The Hague | |
Portugal | Hospital Santa Maria | Lisbon | |
Spain | Hospital General Universitario | Alicante | |
Spain | Clinic Hospital Barcelona | Barcelona | |
Spain | Hospital del Mar | Barcelona | |
Spain | Puerta del mar | Cadiz | |
Spain | Hospital Universitario de Bellvitge | L'Hospitalet De Llobregat | |
Spain | Hosp. Doctor Lucus Augusti | Lugo | |
Spain | Hospital Universitario La Princesa | Madrid |
Lead Sponsor | Collaborator |
---|---|
MicroPort CRM | European Cardiovascular Research Center |
Austria, France, Italy, Netherlands, Portugal, Spain,
Tarantini G, Smits PC, Lhermusier T, Honton B, Range G, Piot C, Lemesle G, Ruiz Nodar JM, Godin M, Madera Cambero M, Motreff P, Cuisset T, Bouchez D, Poezevara Y, Cayla G. A prospective study comparing short versus standard dual antiplatelet therapy in patients with acute myocardial infarction: design and rationale of the TARGET-FIRST trial. EuroIntervention. 2023 Jun 19;19(3):240-247. doi: 10.4244/EIJ-D-22-01006. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Net Adverse Clinical and Cerebral Events (NACCE) | (Number of participants with first occurrence of) NACCE, defined as a composite of all cause death, non-fatal myocardial infarction, definite/probable stent thrombosis, stroke, or bleeding events (BARC type 3 or 5) | 11 months post randomization | |
Primary | Bleeding events | (Number of participants with first occurrence of) bleeding events (BARC 2,3 or 5) | 11 months post randomization |
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