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Selatogrel Outcome Study in Suspected Acute Myocardial Infarction

Phase 3
Conditions
Acute Myocardial Infarction
Registration Number
NCT04957719
Lead Sponsor
Viatris Innovation GmbH
Brief Summary

This study will randomize patients recently discharged from the hospital with a confirmed diagnosis of type 1 acute myocardial infarction (Thygesen et al. 2018) and having additional cardiovascular risk factors.

Detailed Description

The purpose of this study is to assess the clinical efficacy of selatogrel when self-administered upon occurrence of symptoms suggestive of an acute myocardial infarction (AMI) in participants at risk of having a recurrent AMI.

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
14000
Inclusion Criteria
  • Confirmed diagnosis of symptomatic type 1 acute myocardial infarction (AMI) ST-Elevation Myocardial Infarction (STEMI) or Non-ST-Elevation Myocardial Infarction (NSTEMI), no longer than 4 weeks prior to randomization.

  • Diagnosis of multivessel coronary artery disease defined as ≥ 50% stenosis on 2 or more coronary artery territories, including the left main artery, during a prior cardiac catheterization or cardiac catheterization during the qualifying AMI event and presence of at least 1 of the following risk factors:

    • Second prior AMI,
    • Diabetes mellitus defined by ongoing glucose lowering treatment,
    • Chronic kidney disease defined as estimated glomerular filtration rate less than 60 mL/min/1.73 m2 and either known history of chronic kidney disease or a biomarker of chronic kidney damage,
    • Peripheral artery disease at any time prior to randomization,
    • Absence of, or unsuccessful coronary revascularization of the qualifying AMI.
  • Successful self-administered placebo according to the autoinjector instruction for use training during screening.

Main

Exclusion Criteria
  • Increased risk of serious bleeding including any of the following:

    • History of intracranial bleed at any time.
    • Known uncorrected intracranial vascular abnormality.
    • Gastrointestinal bleed requiring hospitalization or transfusion within 1 year prior to screening.
    • Already on oral triple antithrombotic therapy (i.e., Dual antiplatelet therapy and oral anticoagulant).
    • Known liver impairment significantly affecting the hepatic function.
    • Current dialysis.
    • Ischemic stroke or transient ischemic attack within 3 months of screening.
  • Chronic anemia with hemoglobin < 10 g/dL.

  • Chronic thrombocytopenia with platelet count < 100,000/mm3.

  • Known hypersensitivity to selatogrel, any of its excipients, or drugs of the P2Y12 class.

  • Previous exposure to an investigational drug within 3 months prior to randomization.

  • Participation in another clinical trial with an investigational product or device within 3 months prior to randomization.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Clinical status as assessed by a 6-point ordinal scaleTotal duration: up to 7 days

The clinical status will be assessed using a 6-point ordinal scale after any study treatment self-administration. Only the worst clinical outcome will be retained as the primary efficacy outcome. The 6 mutually exclusive outcomes ranked from worst to best are:

1. Death (all causes), within 7 days after study treatment administration.

2. Acute myocardial infarction with compromised electro-hemodynamics, within 2 days after study treatment administration.

3. ST-Elevation Myocardial Infarction (STEMI), within 2 days after study treatment administration.

4. High-risk Non-ST-Elevation Myocardial Infarction (NSTEMI), within 2 days after study treatment administration.

5. NSTEMI with peak cardiac troponin greater than 10 times upper limit of normal, within 2 days after study drug administration.

6. None of the above

Occurrence of Type 3 or 5 treatment-emergent bleeding events according to the Bleeding Academic Research Consortium (BARC) definitionTotal duration: up to 2 days

The number of:

* Type 3 treatment-emergent bleeding events and

* Type 5 treatment-emergent bleeding events

will be assessed according to the Bleeding Academic Research Consortium (BARC) definition (Mehran et al. 2011), within 2 days after study treatment administration.

The Bleeding Academic Research Consortium (BARC) definitions are:

* Type 3, bleeding is divided into 3 categories, a through c, and includes clinical, laboratory, and/or imaging evidence of bleeding with specific healthcare provider responses.

* Type 5, bleeding is fatal.

Secondary Outcome Measures
NameTimeMethod
Occurrence of death, non-fatal acute myocardial infarction, hospitalization or unplanned emergency department visit for heart failure (Composite endpoint)Total duration: up to 30 days

Occurrence death, non-fatal acute myocardial infarction, hospitalization or unplanned emergency department visit for heart failure within 30 days after any self-administration.

Trial Locations

Locations (558)

Advanced Cardiovascular, LLC

🇺🇸

Alexander City, Alabama, United States

Birmingham VA Health Care System

🇺🇸

Birmingham, Alabama, United States

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Cardiovascular Associates of the Southeast

🇺🇸

Birmingham, Alabama, United States

Grandview Medical Center and Affinity Cardiovascular Specialists, LCC

🇺🇸

Birmingham, Alabama, United States

Heart Center Research, LLC

🇺🇸

Huntsville, Alabama, United States

Dignity Health Mercy Gilbert Medical Center

🇺🇸

Gilbert, Arizona, United States

Mayo Clinic Arizona

🇺🇸

Phoenix, Arizona, United States

University of Arizona - Sarver Heart Center

🇺🇸

Tucson, Arizona, United States

Northeast Arkansas Charitable Foundation, Inc.- NEA Baptist Clinic

🇺🇸

Jonesboro, Arkansas, United States

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Advanced Cardiovascular, LLC
🇺🇸Alexander City, Alabama, United States

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