COMPARE STEMI ONE- Comparison Of reduced DAPT followed by P2Y12 inhibitor Monotherapy with Prasugrel vs tAndard Regimen in STEMI patients treated with OCT-guided vs aNgio-guided completE revascularization. - RM21

Research Maatschap Cardiologen Rotterdam Zuid0 个研究点目标入组 1,200 人开始时间: 2024年6月26日最近更新: 2024年8月21日

适应症

试验速览

阶段: 1 期
状态: 进行中（未招募）
发起方
入组人数: 1,200

研究概览入排标准研究者记录与标识符相似试验

研究概览

简要总结

暂无简介。

研究设计

研究类型: Interventional

入排标准

年龄范围: 18 至 65+（—）
性别: All

入选标准

•Eligibility at index procedure All STEMI patients who are planned to be treated with PCI: ST segment elevation myocardial infarction Chest discomfort suggestive of cardiac ischemia =20 min at rest with 1 of the following ECG features: ? ST segment elevation =2 contiguous ECG leads ? new or presumably new left bundle branch block In patients with multivessel disease, treatment only of the culprit lesion / target vessel during primary PCI is recommended., Eligibility at 30-45 days ? All patients who have provided informed consent Compliance to DAPT with no regimen modifications (Non-adherence Academic Research Consortium 0; see section 6.4.4) ? No occurrence of significant event (such as MI, unplanned revascularisation, stent thrombosis, stroke, major vascular complication/bleeding BARC Types 3 or greater). ? Successful revascularization: - Successful delivery and deployment of the Study device(s), with final residual stenosis of <30% (visually) for all target lesions. ? Complete revascularization performed when more than 1 significant lesion, in staged procedure(s) occurring within 15 days from the index procedure. Physiologic assessment highly recommended for lesions with stenosis between 50% and 90%.

排除标准

•Patients on oral anticoagulation - Contraindication to P2Y12 inhibitors and/or to Cardioaspirin or to any of the excipients (hypersensitivity, history of any stroke or transient ischemic attack within the last 12 months, active bleeding or haemorrhagic diathesis, fibrin-specific fibrinolytic therapy less than 24 h before randomization, severe hepatic dysfunction (Child-Pugh C), history of asthma induced by the administration of salicylates or substances with a similar action, notably non-steroidal anti-inflammatory medicines, history of gastrointestinal perforation or acute gastrointestinal ulcers, severe cardiac failure (NYHA grade III or IV), combination with methotrexate at doses of 15 mg/week or more). - Patients who have received P2Y12 inhibitors other than Prasugrel in the ambulance (Ticagrelor or Clopidogrel loading dose) or are already on P2Y12 inhibitors, may be enrolled in the protocol, provided that the Prasugrel loading dose is administered at admission, according to current guidelines recommendations (see section 5.2.2). - Concomitant oral or i.v. therapy with strong CYP3A inhibitors (e.g., ketoconazole, itraconazole, voriconazole, telithromycin, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir, grapefruit juice >1L/day), CYP3A substrates with narrow therapeutic indices (e.g., cyclosporine, quinidine), or strong CYP3A inducers (e.g., rifampin) - rifampicin, phenytoin, carbamazepine, dexamethason, phenobarbital - Platelet count <100.000/µL at the time of screening - Anemia (hemoglobin <10 g/dL) at the time of screening - Comorbidities associated with life expectancy <1 year - Pregnancy, giving birth within the last 90 days, or lactation (see appendix III for women of childbearing potential) - PCI indication for stent thrombosis or previous history of definite stent thrombosis - Non-deferrable major surgery on DAPT after PCI - Cardiogenic shock - Out of hospital cardiac arrest (OHCA) unless survivors of ventricular arrythmia with prompt return of spontaneous circulation (ROSC) - Patients with severe renal impairment: creatinine clearance =30 ml/min/1.73 m2 (as calculated by MDRD formula for estimated GFR). - Patients participating in another interventional (device of drug trial) within the previous 12 months or patients to whom an investigational drug was administered in the 30 days prior to screening, or 5 half-lives of the study drug, whichever is longer. - No informed consent

研究者

发起方

Research Maatschap Cardiologen Rotterdam Zuid

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