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Potential Impact of Cigarette Smoking on Platelet Reactivity in Patients on Dual Antiplatelet Therapy With P2Y12 Inhibitors

Phase 4
Conditions
Coronary Artery Disease
Interventions
Other: quit smoking for a 2 weeks period
Registration Number
NCT02026713
Lead Sponsor
University of Roma La Sapienza
Brief Summary

All consecutive patients undergone PTCA in the period between July 2013 and December 2013 are eligible to be enrolled. Study population are divided in :

Group 1: smokers on dual antiplatelet therapy with ASA (100 mg once a day) and Prasugrel (10 mg die); Group 2: smokers on dual antiplatelet therapy with ASA(100 mg once a day) and Ticagrelor (90 mg twice a day); Control group: smokers on dual antiplatelet therapy with ASA(100 mg once a day) and Clopidogrel (75 mg once a day).

Platelet function is evaluated using a validated method: the VerifyNow System (Accumetrics Inc., San Diego, CA), which is a point-of-care turbidimetry-based optical detection system that measures platelet-induced aggregation. These value are measured Platelet function, measured with the VerifyNow P2Y12. All patients on chronic dual antiplatelet therapy (\>1 month) quit smoking for a 2 weeks period. Therefore PRU values are obtained at baseline (at the enrollment time) and after 2 weeks after smoking cessation. Platelet reactivity are expressed in P2Y12 reaction units (PRU). PRU values \>240 are suggestive of high platelet reactivity.

Primary outcomes: P2Y12 reaction units (PRU) at baseline and two weeks after quitting smoking.

Detailed Description

All consecutive patients undergone PTCA in the period between July 2013 and December 2013 are eligible to be enrolled. Study population are divided in :

Group 1: smokers on dual antiplatelet therapy with ASA (100 mg once a day) and Prasugrel (10 mg die); Group 2: smokers on dual antiplatelet therapy with ASA(100 mg once a day) and Ticagrelor (90 mg twice a day); Control group: smokers on dual antiplatelet therapy with ASA(100 mg once a day) and Clopidogrel (75 mg once a day).

Platelet function is evaluated using a validated method: the VerifyNow System (Accumetrics Inc., San Diego, CA), which is a point-of-care turbidimetry-based optical detection system that measures platelet-induced aggregation. These value are measured Platelet function, measured with the VerifyNow P2Y12. All patients on chronic dual antiplatelet therapy (\>1 month) quit smoking for a 2 weeks period. Therefore PRU values are obtained at baseline (at the enrollment time) and after 2 weeks after smoking cessation. Platelet reactivity are expressed in P2Y12 reaction units (PRU). PRU values \>240 are suggestive of high platelet reactivity.

Primary outcomes: P2Y12 reaction units (PRU) at baseline and two weeks after quitting smoking.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
150
Inclusion Criteria
  • All consecutive patients undergone PTCA in our institution in the period between July 2013 and December 2013 will be eligible to be enrolled.
  • smokers will be all patients smoking 15±10 cigarettes daily.
  • patients on dual antiplatelet therapy with ASA and P2Y12 inhibitors.
  • recent (<12 months) percutaneous coronary interventions
  • angiographically-proven coronary artery disease
Exclusion Criteria
  • people unable to understand and willing to sign the informed consent form

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
smokers on dual antiplatelet therapy with ASA and Prasugrel orquit smoking for a 2 weeks periodAll patients quit smoking for a 2 weeks period
smokers on dual antiplatelet therapy with ASA and ticagrelorquit smoking for a 2 weeks periodAll patients on chronic dual antiplatelet therapy (\>1 month) quit smoking for a 2 weeks period
smokers on dual antiplatelet therapy with ASA and Clopidogrelquit smoking for a 2 weeks periodAll patients on chronic dual antiplatelet therapy (\>1 month) quit smoking for a 2 weeks period
Primary Outcome Measures
NameTimeMethod
Assessment of platelet reaction units (PRU)after 2 weeks of quitting smoking

Absolute changes in platelet reactivity (expressed as P2Y(12) reaction units by the point-of-care VerifyNow assay \[Accumetrics, San Diego, California\])

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Sapienza University of Rome

🇮🇹

Rome, Roma, Italy

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