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EDOXABAN TREATMENT VERSUS VKA IN PATIENTS WITH AF UNDERGOING PCI.

Phase 1
Conditions
MedDRA version: 19.0Level: PTClassification code 10003658Term: Atrial fibrillationSystem Organ Class: 10007541 - Cardiac disorders
Therapeutic area: Diseases [C] - Cardiovascular Diseases [C14]
Registration Number
EUCTR2016-002683-14-ES
Lead Sponsor
Daiichi Sankyo Europe GmbH
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
1500
Inclusion Criteria

1.OAC indication for atrial fibrillation for a period of at least 12 months following successful PCI with stenting.
Eligibility is assessed 4 hours after sheath removal and within 5 days after successful PCI with stent placement. If a staged PCI is planned, eligibility is assessed after completion of the last stage.

Successful PCI definition:
The success of a PCI procedure is defined by 2 interrelated components: angiographic findings, procedural / clinical outcomes as detailed below:
Angiographic Success
A minimum stenosis diameter of < 20% (as visually assessed by angiography - residual blockage or stenosis reduced to less than 20% of the artery’s diameter).
Sufficient enlargement of the lumen at the target site to improve coronary artery blood flow with final TIMI flow grade 3 (visually assessed by angiography), without occlusion of a significant side branch, flow-limiting dissection, distal embolization, or angiographic thrombus.
Procedural Success
No major in-hospital clinical complications(e.g. ongoing ISTH major or clinical relevant non-major procedural bleeding at the time of randomization, stroke, emergency CABG).
In summary, a clinically successful PCI requires both anatomic and procedural success along with relief of signs and/or symptoms of myocardial ischemia at the time of randomization.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 700
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 800

Exclusion Criteria

Bleeding risks or systemic conditions
1.Known bleeding diathesis, including but not limited to,
a.Uncontrolled active bleeding, encompassing both ISTH major and clinically relevant non-major bleeding, preceding randomization.
b.Lesion or condition, if considered to be a significant risk for major bleeding.
This may include but is not limited to: unresolved gastrointestinal ulceration, presence of malignant neoplasms at high risk of bleeding (e.g. malignancies with metastasis), recent unresolved brain or spinal injury, recent brain, spinal or ophthalmic surgery, any intracranial hemorrhage, known or suspected esophageal varices, arteriovenous malformations, vascular aneurysms (of more than 3.5 cm) or major intraspinal or intracerebral vascular abnormalities.
Medication-related
2.INR > 2.5 (the subject can be reconsidered at a later time, but within 5 days of sheath removal).
3.Contraindication to edoxaban, VKA, ASA and/or P2Y12 antagonists;
4.Concomitant treatment with other antithrombotic agents, fibrinolytic therapy and chronic nonsteroidal anti-inflammatory drugs (NSAIDs).
Concomitant conditions and therapies
5.Critically ill or hemodynamically unstable subjects (at the time of randomization) including:
a.cardiogenic shock or acute decompensated heart failure, with the requirement for vasopressor agents or inotropic support or mechanical support to support circulation
b.respiratory failure requiring endotracheal intubation and mechanical ventilation.
6.Any prior mechanical valvular prosthesis;
7.Planned coronary or vascular intervention or major surgery within 12 months; Randomization must be deferred to the last stage in a multistep, multivessel PCI procedure;
8.Moderate or severe mitral stenosis;
9.Ischemic stroke within 2 weeks prior to randomization;
10.Uncontrolled severe hypertension with a systolic blood pressure (BP) =180 mmHg and/or diastolic BP = 120 mmHg;
11.Severe renal impairment with estimated creatinine clearance (CrCL) < 15 mL/min or on dialysis;
12.Known abnormal liver function prior to randomization (incl. hepatic disease or biochemical evidence of significant liver derangement known prior to randomization
Other exclusion criteria
13.Any of the following abnormal local laboratory results prior to randomization:
a.Platelet count < 50 x109/L
b.Hemoglobin < 8 mg/dL
14.Unable to provide written IC;
15.Female subject of childbearing potential, i.e. who are not surgically sterile or post-menopausal (defined as no menses for 2 years without an alternative cause);
16.Pregnant or breast-feeding subjects;
17.Assessment that the subject is not likely to comply with the study procedures or have complete follow-up;
18.Participating in another clinical trial that potentially interferes with the current study;
19.Previous randomization in this study;
20.Known drug or alcohol dependence within the past 12 months as judged by the Investigator;
21.Life expectancy < 12 months.

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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