Effect of Ticagrelor & Clopidogrel on Coronary Microcirculation in

Status Completed

Clinical Trial Summary

Of the patients diagnosed with ST-segment elevation myocardial infarction (STEMI) who underwent reperfusion therapy and have thrombolysis in myocardial infarction (TIMI) 3 flow, about 40% have flow alterations in the coronary microcirculation, which leads to worse remodeling of the left ventricle with a consequent increase in the mortality of this population. Clopidogrel is the only known antiplatelet medication that brings benefits to the coronary microcirculation. Ticagrelor is significantly superior to clopidogrel in terms of decreasing mortality.

The main objective of this study is to compare the effect of ticagrelor versus clopidogrel on the coronary microcirculation by the Myocardial Perfusion Score Index (MPSI) obtained using Microbubble Contrasted Echocardiography (MCE) in patients who have STEMI and treated with thrombolysis.

Clinical Trial Description

The present project should prospectively include patients participating in the TREAT study, who are including individuals with Acute Myocardial Infarction (AMI) treated with fibrinolytic and openly randomized to ticagrelor or clopidogrel within 24 hours of the onset of symptoms. Patients will be submitted to coronary angiography within 4 (± 2) days of the onset of symptoms, and those who, at the end of coronary angiography, present residual obstruction in the culprit vessel of less than 50% and have TIMI 3 flow, regardless of have undergone percutaneous coronary intervention will be included.

Following, on day 2 (± 1) days after coronary angiography (therefore 6 ± 3 days from the onset of symptoms), they will be submitted to microcirculation perfusion evaluation by means of MPSI (myocardial perfusion score index) obtained by MCE (Microbubble contrasted echocardiography) - blood collection for evaluation of Platelet aggregability will be performed immediately prior to the start of MCE. Finally, in order to evaluate left ventricular remodeling, patients will undergo a new Echocardiography within 90 (± 10) days after discharge. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT03104062
Study type	Interventional
Source	University of Sao Paulo General Hospital
Contact
Status	Completed
Phase	N/A
Start date	October 1, 2016
Completion date	February 1, 2018

View Details

See also
Status	Clinical Trial	Phase
Recruiting	`NCT06125392` - Multicenter Registry on Microvascular Dysfunction - Searching a New Ach Spasm Definition
Recruiting	`NCT05805462` - The Euro-CRAFT Registry
Terminated	`NCT04614467` - A Placebo-Controlled Trial of CLBS16 in Subjects With Coronary Microvascular Dysfunction	Phase 2
Recruiting	`NCT04598997` - Artificial Intelligence With DEep Learning on COROnary Microvascular Disease
Completed	`NCT04202172` - Functional Assessment of the Infart-related Artery With Bioactive and Polymer-free Coronary Stents (The FUNCOMBO Trial)	Phase 4
Not yet recruiting	`NCT05793567` - A Study of Microcirculatory Function in Type 2 Myocardial Infarction (T2MI)
Completed	`NCT03523624` - Factor XIII and Other Biomarkers in ST Segment Elevation Myocardial Infarction
Completed	`NCT02045459` - Microvascular Disease Exercise Trial	N/A
Recruiting	`NCT05825339` - Absolute Flow for Ischemia With No Obstructive Coronary Arteries
Recruiting	`NCT05178914` - Personalized Medicine Using Coronary Microvascular Function Measured in Patient With Percutaneous Coronary Intervention in Angina	N/A
Active, not recruiting	`NCT04005963` - The Value of PET Quantitative Analysis of Coronary Physiology in Coronary Microvascular Disease
Recruiting	`NCT05743140` - A Clinical Study of Fundus OCTA for the Identification of CMD
Recruiting	`NCT03064295` - Whole-Heart Myocardial Blood Flow Quantification Using MRI
Recruiting	`NCT03537586` - A Single Center Diagnostic, Cross-sectional Study of Coronary Microvascular Dysfunction	N/A
Recruiting	`NCT04960371` - Effects of Anxiety on Coronary Microcirculatory Function in Hypertensive Patients
Enrolling by invitation	`NCT05913999` - Serial PET MPI in Patients Undergoing Cancer Treatment
Recruiting	`NCT05810051` - Exercise and Coronary Microvascular Disease	N/A
Completed	`NCT05471739` - Simultaneous Assessment of Coronary Microvascular Dysfunction and Ischemia With Non-obstructed Coronary Arteries With Intracoronary Electrocardiogram and Intracoronary Doppler
Recruiting	`NCT04440761` - Barts-MINOCA Registry
Completed	`NCT04685941` - Treatment of Slow-flow After Primary Percutaneous Coronary Intervention With Flow-mediated Hyperemia	N/A

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

Effect of Ticagrelor and Clopidogrel on Coronary Microcirculation in Patients With Acute Myocardial Infarction

Clinical Trial Summary

Clinical Trial Description

Study Design

Related Conditions & MeSH terms