Randomized Evaluation of short-term Dual anti platelet therapy in patients with acute coronary syndrome treated with the COMBO dual-therapy stEnt.

Recruitment & Eligibility

Status: Completed

Sex: Not specified

Target Recruitment: 1500

Inclusion Criteria

The patient must be ≥ 18 years of age
- The patient has been diagnosed with STEMI, NSTEMI or UA
- The patient is willing to comply with specified follow-up evaluations
- The patient has been informed of the nature of the study, agrees to its provisions and has been provided written informed consent, approved by the appropriate Medical Ethics Committee (MEC), Institutional Review Board (IRB), or Human Research Ethics Committee (HREC)
- Successful COMBO stent implantation (TIMI 3 flow with residual stenosis < 20% based visual estimation), with no clinical adverse event during hospitalization (Death, stent thrombosis (ST), stroke, target vessel revascularisation (TVR), bleeding (BARC II, III, V))

Exclusion Criteria

- Patients presenting with cardiogenic shock
- Patients with recent major bleeding complications or contraindication to DAPT, such as:
a) Hypersensitivity to Aspirin, Clopidogrel, Prasugrel or Ticagrelor
b) Need for oral anticoagulation
c) History of bleeding diathesis or known coagulopathy (including heparin-induced thrombocytopenia) or refusal of blood transfusions
d) History of intracerebral mass, aneurysm, arteriovenous malformation, or hemorrhagic stroke
e) Stroke or transient ischemic attack within the past 6 months or any permanent residual neurologic defect
f) Gastrointestinal or genitourinary bleeding within the last 2 months or major surgery within 6 weeks
g) Recent history or known current platelet count <100 000 cells/mm3 or hemoglobin <10 g/dL
h) An elective surgical procedure is planned that would necessitate interruption of thienopyridines during the first 12 months post enrollment
- Planned need for concomitant cardiac surgery (e.g., valve surgery or resection of aortic or left ventricular aneurysm etc.)
- Planned intervention of another lesion (target vessel or non-target vessel) after index hospital discharge
- Any revascularization performed within index hospitalization with other stents than COMBO
- Potential for non-compliance towards the requirements in the trial protocol (especially the medical treatment) or follow-up visits
- Patients requiring permanent DAPT due to comorbidities
- Patient has received any organ transplant or is on a waiting list for any organ transplant
- Life expectancy of less than 2 years
- Pregnancy or intention to become pregnant during the course of the trial
- Any significant medical or mental condition, which in the Investigators opinion may interfere with the patients optimal participation in the study
- Currently participating in another investigational drug or device study
- Patients who have been treated with another DES within 9 months prior to the index procedure

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Composite of all cause mortality, Myocardial Infarction (MI), stent thrombosis(ST), stroke, target vessel revascularization (TVR) or bleeding (BARC II, III,V) at 360 days.

Secondary Outcome Measures

Name	Time	Method
Bleeding (BARC II, III, V) at 360 days,All cause mortality, MI, ST, stroke, TVR, bleeding (BARC II, III, V) at 360 and 720 days,All cause mortality, MI, ST, stroke and TVR at 360 and 720 days. Mortality at 360 and 720 days,Cardiac Mortality at 360 and 720 days,Any MI at 360 and 720 days,ST at 360 and 720 days,Repeat revascularization at 360 and 720 days,Time to event as defined by the occurrence of one of the following: all cause mortality, MI, ST, stroke, TVR or bleeding (BARC II, III, V) within 360 and 720 days,Prespecified landmark analysis of Primary Endpoint (without TVR) from 90 to 360 days.