Drug-Eluting Stenting Followed by Cilostazol tREAtment Reduces SErious Adverse Cardiac Events (DECREASE-PCI)

Phase 4

Terminated

• Conditions: Coronary Artery Disease
• Interventions: Drug: Placebo; Drug: Cilostazol

• Registration Number: NCT01346865
• Lead Sponsor: Seung-Jung Park

Brief Summary

The DECREASE-PCI trial is a prospective, randomized, placebo controlled, double-blind, phase 4 study to evaluate efficacy and safety of triple anti-platelet therapy compared with dual antiplatelet therapy in patients treated with DES for Coronary Artery Disease.

The primary objective of this study is to compare the safety and efficacy of triple antiplatelet therapy versus dual (standard) antiplatelet therapy in patients treated with drug-eluting stent (DES) implantation for the treatment of coronary artery disease.

Detailed Description

Use of drug-eluting stent (DES) has reduced the incidence of restenosis rate and the need for repeat revascularization compared to using bare metal stents (BMS). Therefore, DES implantation has been default strategy in the treatment of coronary artery disease. However, despite use of DES, the restenosis, subsequent repeat revascularization, and associated cardiac events (stent thrombosis, myocardial infarction) remain significant clinical problem in routine practice, especially complex lesion subsets.

2110 patients who received successful dug eluting stent implantation will be enrolled at 21 centers in Korea. Patients meeting inclusion criteria without any exclusion criteria and agree to participate in this trial will be randomized 1:1 to a) triple therapy (Aspirin+Clopidogrel +Cilostazol) or b) dual therapy group (Aspirin+ Clopidogrel +Placebo). All patients will be blindly assigned to cilostazol 100mg (1tablet bid) or matching placebo (1tablet bid) as 1:1 ratio and are prescribed for 1 year.

Study Timeline

• Study First Submitted: 2011-04-22
• Study Start: 2011-05
• Study First Submitted QC: 2011-05-02
• Study First Posted: 2011-05-03
• Primary Completion: 2015-02
• Study Completion: 2015-02
• Status Verified: 2015-11
• Last Update Submitted: 2015-11-13
• Last Update Posted: 2015-11-16

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 402

Inclusion Criteria

1. Clinical

2. Patients with angina and documented ischemia or patients with documented silent ischemia

3. Patients who are eligible and has been successfully applied for DES implantation

4. Age >18 years

5. Signed written informed consent form prior to study entry

6. Angiographic

7. De novo lesion or restenotic lesions

8. Percent diameter stenosis ≥50%

9. Reference vessel size 2.5 mm by visual estimation

Read More

Exclusion Criteria

1. History of bleeding diathesis or coagulopathy (e.g. current use of NSAIDs, Upper GI bleeding during the recent 6 months)
2. Pregnancy or lactation (women who have child-bearing potential)
3. Known hypersensitivity or contra-indication to contrast agent, heparin, eluted-drug of stent
4. Limited life-expectancy (less than 1 year) due to combined serious disease
5. Characteristics of lesion 1)Left main disease 2)Graft vessels
6. Hematological disease (Neutropenia <3000/mm3, Thrombocytopenia <100,000/mm3)
7. Hepatic dysfunction, liver enzyme (ALT and AST) elevation 3 times normal
8. Renal dysfunction, creatinine 2.0mg/dL
9. Contraindication to aspirin, clopidogrel or cilostazol
10. Stroke (ischemic or hemorrhagic) or transient ischemic attack (TIA) within 6 months.
11. Planned major surgery within the next 6 months with the need to discontinue antiplatelet therapy

Read More

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
dual therapy group	Placebo	Placebo
cilostazol	Cilostazol	cilostazol 100mg

Primary Outcome Measures

Name	Time	Method
Major Adverse Cardiac and Cerebrovascular Ischemic Events (MACCE)	At 1-year time point after PCI	composite of any death, myocardial infarction, ischemic stroke, target vessel revascularization

Secondary Outcome Measures

Name	Time	Method
Major Adverse Cardiac Events (MACE)	At 1-year time point and yearly up to 3 years after PCI	1. Composite of major cardiac adverse events (MACE) including death, Q-MI, Non Q- MI, and target lesion or vessel revascularization; 2. Target vessel revascularization; 3. Target lesion revascularization; 4. Stent thrombosis (definite/probable); 5. Ischemic stroke; 6. Myocardial infarction; 7. Adverse Events during study periods

Trial Locations

Locations (12)

Sejong General Hospital; 🇰🇷 Bucheon, Korea, Republic of

Chungnam National University Hospital; 🇰🇷 Daejeon, Korea, Republic of

Soon Chun Hyang University Hospital Cheonan; 🇰🇷 Cheonan, Korea, Republic of

Keimyung University Dongsan Medical Center; 🇰🇷 Daegu, Korea, Republic of

Soonchunhyang Univ. Bucheon Hospital; 🇰🇷 Bucheon, Korea, Republic of

The Catholic University of Korea, Daejeon ST. Mary's Hospital; 🇰🇷 Daejeon, Korea, Republic of

Gangnam Severance Hospital; 🇰🇷 Seoul, Korea, Republic of

Gangneung Asan Hospital; 🇰🇷 Gangneung, Korea, Republic of

Pusan National University Yangsan Hospital; 🇰🇷 Pusan, Korea, Republic of

Department of Medicine, Asan Medical Center University of Ulsan College of Medicine; 🇰🇷 Seoul, Korea, Republic of

SMA-SNU Boramae Medical Center; 🇰🇷 Seoul, Korea, Republic of

St.carollo Hospital; 🇰🇷 Suncheon, Korea, Republic of