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3 Months Versus 12 Months Dual Antiplatelet Therapy After Drug-eluting Stent Implantation in STEMI

Phase 4
Conditions
ST Elevation Myocardial Infarction
Interventions
Registration Number
NCT04570345
Lead Sponsor
Dong-A University
Brief Summary

To compare the clinical outcomes of dual antiplatelet therapy with aspirin and P2Y12 receptor inhibitor vs. ticagrelor monotherapy at 3 months after PCI in patients with ST-elevation myocardial infarction.

Detailed Description

The purpose of this study is to compare the use of ticagrelor alone versus P2Y12 receptor inhibitor and aspirin together after PCI among ST-elevation myocardial infarction patients who complete 3-month course of dual antiplatelet therapy. The object of this study is to determine the effectiveness and safety of ticagrelor alone, compared to P2Y12 receptor inhibitor plus aspirin in reducing clinically relevant bleeding and in reducing ischemic adverse events among patients diagnosed with ST-elevation myocardial infarction undergoing PCI with second-generation drug-eluting stent.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
1002
Inclusion Criteria
  • Patients ≥ 19 years old
  • Patients who received new generation sirolimus-eluting (Osiro®) stent implantation for treating ACS
  • Provision of informed consent
Exclusion Criteria
  • Age > 80 years
  • Pregnant women or women with potential childbearing
  • Life expectancy < 1 year

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Ticagrelor monotherapyticagrelor monotherapyTicagrelor monotherapy after 3-month DAPT(aspirin with ticagrelor)
Aspirin with P2Y12 receptor inhibitorticagrelor monotherapyAspirin with P2Y12 receptor inhibitor after 3-month DAPT(aspirin with ticagrelor)
Aspirin with P2Y12 receptor inhibitorAspirin with P2Y12 receptor inhibitorAspirin with P2Y12 receptor inhibitor after 3-month DAPT(aspirin with ticagrelor)
Primary Outcome Measures
NameTimeMethod
NACE: net clinical adverse event12 months after randomization

The sum of major adverse cardiac and cerebrovaascular event(MACCE) and bleeding event(BARC score)

Major adverse cardiac and cerebrovaascular event(MACCE)12 months after randomization

Major adverse cardiac and cerebrovaascular event(MACCE) includes 1)all-cause motality, 2) acute MI, 3)cerebrovascular event, 4)stent thrombosis

Major bleeding (BARC type 3,5)12 months after randomization

The number of participants with first occurrence of clinically relevant bleeding episode, defined as Bleeding Academic Research Consortium (BARC) Types 3 or 5 bleeding. BARC bleeding types range from 0 (no bleeding) to 5 (fatal bleeding).

type 3a: Overt bleeding plus hemoglobin drop of 3 to \< 5 g/dL (provided hemoglobin drop is related to bleed); transfusion with overt bleeding, type 3b: Overt bleeding plus hemoglobin drop \< 5 g/dL (provided hemoglobin drop is related to bleed); cardiac tamponade; bleeding requiring surgical intervention for control; bleeding requiring IV vasoactive agents, type 3c: Intracranial hemorrhage confirmed by autopsy, imaging, or lumbar puncture; intraocular bleed compromising vision, type 5a: Probable fatal bleeding, type 5b: Definite fatal bleeding (overt or autopsy or imaging confirmation in accordance with BARC Definitions

Secondary Outcome Measures
NameTimeMethod
Individual component of MACCE and bleeding episode12 months after randomization

1. All-cause mortality :Individual component of MACCE

2. Acute MI :Individual component of MACCE

3. Cerebrovascular event :Individual component of MACCE

4. Stent thrombosis :Definite or probable stent thrombosis defined by Academic Research Consortium (ARC)

5. Bleeding :Bleeding Academic Research Consortium (BARC) type 3 or 5

Trial Locations

Locations (1)

Department of Internal Medicine,Dong-A University College of Medicine

🇰🇷

Busan, Korea, Republic of

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