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Bivalirudin With Prolonged Full Dose Infusion Versus Heparin Alone During Emergency PCI

Not Applicable
Conditions
ST Elevation Myocardial Infarction
Interventions
Registration Number
NCT03822975
Lead Sponsor
Shenyang Northern Hospital
Brief Summary

This study is aimed to investigate if the bivaliruding with prolonged full dose infusion after PCI is superior to heparin alone in reducing 30-day mortality or major bleeding for patients with STEMI treated with emergency PCI. A total of 6000 STEMI patients will be enrolled and randomly assigned to receive bivalirudin or heparin during emergency PCI in a 1:1 ratio. This study will provide key evidence for peri-operative anticoagulant therapy decisions in STEMI patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
6016
Inclusion Criteria
  • Any age;
  • STEMI patients undergoing primary PCI with ST elevation≥1mm in≥2 contiguous leads or new LBBB with symptom onset 48h;
  • Patients requiring staged revascularization of non-culprit vessels within 30 days may be enrolled. In such cases the same antithrombotic agents and PCI procedures must be used in the staged procedure consistent with the index procedure PCI, in particular the assigned antithrombin agent heparin vs. bivalirudin);
  • Dual antiplatelet drugs must be administrated according to guidelines before PCI (loading doses and maintenance doses of aspirin and clopidogrel or ticagrelor);
  • The subject or legal representative has been informed of the nature of the study, understood the provisions of the protocol, was able to ensure adherence, and signed informed consent.
Exclusion Criteria
  • Not suitable for emergency primary PCI;
  • STEMI treated by thrombolysis;
  • Patients received heparin, LMWH, fondaparinux, bivalirudin, or GPI within 48 hours before the index PCI;
  • Mechanical complications (such as ventricular septal rupture, papillary muscle rupture with acute mitral regurgitation, etc.);
  • Known allergy or contraindications to heparin, bivalirudin, aspirin, or both clopidogrel and ticagrelor
  • Patients in whom the investigators consider inappropriate to participate in this study (eg, have participated in another drug/instrument study or undergoing another drug/instrument study).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Heparinunfractionated HeparinHeparin alone during primary PCI
BivalirudinBivalirudinBivalirudin with prolonged full dose infusion during primary PCI
Primary Outcome Measures
NameTimeMethod
Composite of all-cause death or BARC type 3~5 bleeding30 days

BARC=Bleeding academic research consortium

Secondary Outcome Measures
NameTimeMethod
BARC type 2-5 bleeding30 days

BARC=Bleeding academic research consortium

Stent thrombosis30 days

Definite or probable stent thrombosis according to Academic Research Consortium

Thrombocytopenia30 days

defined as platelet counts less than 150\*10\^9/L after treatment

All cause mortality1 years
BARC type 3-5 bleeding30 days

BARC=Bleeding academic research consortium

Major adverse cardiac and cerebral events (MACE)30 days

MACE is defined as a composite of all cause death, recurrent myocardial infarction, stroke or ischemic driven target vessel revascuarlization

Net adverse clinical events (NACE)30 days

NACE is defined as a composite of MACE or BARC type 3-5 bleeding

Composite of all-cause death or BARC type 2-5 bleeding30 days

BARC=Bleeding academic research consortium

Trial Locations

Locations (85)

Bengbu Second People's Hospital

🇨🇳

Bengbu, Anhui, China

Fu Yang People'S Hospital

🇨🇳

Fuyang, Anhui, China

Linquan County Peoples Hospital

🇨🇳

Fuyang, Anhui, China

NO.2 People's Hospital of Fuyang City

🇨🇳

Fuyang, Anhui, China

Taihe County People'S Hospital

🇨🇳

Fuyang, Anhui, China

Bozhou Peoples Hospital

🇨🇳

Haozhou, Anhui, China

Huainan Oriental Hospital Group Affiliated Hospital of Anhui University of Science & Technology

🇨🇳

Huainan, Anhui, China

The First Hospital of Anhui University of Science&Technology

🇨🇳

Huainan, Anhui, China

Suzhou Municipal Hospital

🇨🇳

Suzhou, Anhui, China

Beijing Luhe Hospital.Capital Medical University

🇨🇳

Beijing, Beijing, China

Scroll for more (75 remaining)
Bengbu Second People's Hospital
🇨🇳Bengbu, Anhui, China

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