MedPath

Study to Gather Information About the Proper Dosing and Safety of the Oral FXIa Inhibitor BAY 2433334 in Patients Following an Acute Heart Attack

Phase 2
Completed
Conditions
Acute Myocardial Infarction
Interventions
Other: BAY2433334 matching placebo
Registration Number
NCT04304534
Lead Sponsor
Bayer
Brief Summary

The purpose of this study is to try to find the best dose of the new drug BAY 2433334 to give to participants and to look at how well BAY 2433334 works on top of a dual antiplatelet therapy (acetylsalicylic acid +/- clopidogrel) in patients following a recent heart attack (myocardial infarction) that happens when a blood vessel in the heart suddenly becomes blocked. BAY 2433334, works by blocking a step of the blood clotting process in our body and thins the blood and is a so called oral FXIa inhibitor.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1601
Inclusion Criteria
  • Participants must be 45 years of age or older, at the time of signing the informed consent

  • Acute myocardial infarction (excluding MI associated with PCI or CABG revascularization procedures) with:

    • clinical symptoms of acute myocardial infarction AND

    • elevated biomarkers of myocardial necrosis (creatine kinase-muscle and brain isoenzyme [CK-MB] or cardiac troponins) AND

    • at least one of the following risk factors need to be fulfilled:

      • Age ≥ 65 years
      • Prior MI (before the index AMI event)
      • Prior peripheral arterial disease
      • Diabetes Mellitus
      • Prior coronary artery bypass grafting (CABG) AND
    • initial angiography and revascularization procedures, either PCI or CABG, as treatment for the index event performed before randomization. (Note: a planned, staged PCI procedure can be performed after randomization)

  • Plan for dual antiplatelet therapy (ASA + P2Y12 inhibitor) after hospital discharge for the index AMI

  • Randomization during hospitalization for the index AMI event and latest within 5 days of hospital admission

  • Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol. Written informed consent has to be signed before any study-specific procedure.

Exclusion Criteria
  • Hemodynamically significant ventricular arrhythmias or cardiogenic shock at time of randomization
  • Active bleeding; known bleeding disorder, history of major bleeding (intracranial, retroperitoneal, intraocular) or clinically significant gastrointestinal bleeding within last 6 months of randomization
  • Planned use or requirement of full dose and long term anticoagulation therapy during study conduct.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
BAY 2433334 high doseBAY2433334-
BAY 2433334 medium doseBAY2433334-
BAY 2433334 low doseBAY2433334-
BAY2433334 matching placeboBAY2433334 matching placebo-
Primary Outcome Measures
NameTimeMethod
Efficacy - Number of Participants With Composite of CV Death, MI, Stroke and Stent Thrombosis (ST)From baseline up to 52 weeks

CV death included death due to stroke, MI, heart failure or cardiogenic shock, sudden death or any other death due to other cardiovascular causes. Death due to non-traumatic hemorrhage was included.

Acute MI was used when there was evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia.

Stroke was defined as an acute episode of focal or global neurological dysfunction caused by an injury of the brain, spinal cord, or retina as a result of hemorrhage or infarction.

ST was defined incorporating diagnostic certainty as well as timing: "Definite" ST: The highest level of certainty. Either angiographic or pathological confirmation of stent thrombosis. "Probable" ST: Regardless of the time after the index procedure, any MI that is related to documented acute ischemia in the territory of the implanted stent without angiographic confirmation of stent thrombosis and in the absence of any other obvious cause

Safety - Number of Participants With BARC Bleeding Definition Type 2, 3 and 5From baseline up to 52 weeks

Type 2: any overt, actionable sign of hemorrhage that doesn't fit the criteria for type 3 or 5 but meets at least one of the following criteria: 1) requires nonsurgical, med intervention by a HCP, 2) leads to hospital or rise in level of care, or 3) prompt eval. Type 3a: 1) overt bleed + Hg drop of 3 to \<5 g/dl (provided Hg drop is related to bleed); 2 any transfusion with overt bleed. Type 3b: 1) overt bleed + Hg drop ≥5 g/dL (provided Hg drop is related to bleed); 2) cardiac tamponade; 3) bleed requiring surgical intervention for control (exclude dental/nasal /skin/hemorrhoid); 4) bleed requiring IV vasoactive agents. Type 3c: 1) ICH hemorrhage (doesn't include microbleeds or HT, does include intraspinal); subcategories confirmed by autopsy or imaging or LP; 2) intraocular bleed compromising vision. Type 5: fatal bleed. Type 5a: probable fatal bleed; no autopsy or image confirmation but clinical suspicion. Type 5b: definite fatal bleed; overt bleed or autopsy or image confirmation.

Secondary Outcome Measures
NameTimeMethod
Efficacy - Number of Participants With CV DeathFrom baseline up to 52 weeks

CV death included death due to stroke, MI, heart failure or cardiogenic shock, sudden death or any other death due to other cardiovascular causes. Death due to non-traumatic hemorrhage was included.

Efficacy - Number of Participants With MIFrom baseline up to 52 weeks

Acute MI was used when there was evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. According to MI Universal Definition from 2018 the diagnosis of MI requires combination of: 1. Presence of acute myocardial injury. 2. Evidence of acute myocardial ischemia derived from the clinical presentation, electrocardiographic changes, or the results of myocardial or coronary artery imaging, or in case of post-mortem pathological findings irrespective of biomarker values.

Efficacy - Number of Participants With StrokeFrom baseline up to 52 weeks

Stroke was defined as an acute episode of focal or global neurological dysfunction caused by an injury of the brain, spinal cord, or retina as a result of hemorrhage or infarction.

Efficacy - Number of Participants With Stent ThrombosisFrom baseline up to 52 weeks

ST was defined incorporating diagnostic certainty as well as timing: "Definite" ST: The highest level of certainty. Either angiographic or pathological confirmation of stent thrombosis. "Probable" ST: Regardless of the time after the index procedure, any MI that is related to documented acute ischemia in the territory of the implanted stent without angiographic confirmation of stent thrombosis and in the absence of any other obvious cause

Efficacy - Number of Participants With All Cause MortalityFrom baseline up to 52 weeks
Safety - Number of Participants With All BleedingFrom baseline up to 52 weeks

All bleeding events occurred from first intake of study intervention until 2 days after the last intake of study intervention

Safety - Number of Participants With BARC Bleeding Definition Type 3, 5From baseline up to 52 weeks

Type 3a: 1) overt bleed + Hg drop of 3 to \<5 g/dl (provided Hg drop is related to bleed); 2 any transfusion with overt bleed. Type 3b: 1) overt bleed + Hg drop ≥5 g/dL (provided Hg drop is related to bleed); 2) cardiac tamponade; 3) bleed requiring surgical intervention for control (exclude dental/nasal /skin/hemorrhoid); 4) bleed requiring IV vasoactive agents. Type 3c: 1) ICH hemorrhage (doesn't include microbleeds or HT, does include intraspinal); subcategories confirmed by autopsy or imaging or LP; 2) intraocular bleed compromising vision. Type 5: fatal bleed. Type 5a: probable fatal bleed; no autopsy or image confirmation but clinical suspicion. Type 5b: definite fatal bleed; overt bleed or autopsy or image confirmation.

Safety - Number of Participants With BARC Bleeding Definition Type 1,2,3,5From baseline up to 52 weeks

Type 1: bleeding that is not actionable and does not cause the patient to seek unscheduled performance of studies, hospitalization, or treatment by a healthcare professional; may include episodes leading to self-discontinuation of medical therapy by the patient without consulting a healthcare professional. For BARC bleeding definition 2,3 and 5, please refer to second primary endpoint.

Trial Locations

Locations (160)

Maryland Cardiovascular Specialists

🇺🇸

Baltimore, Maryland, United States

Logan Health Research

🇺🇸

Kalispell, Montana, United States

Reinier de Graaf Gasthuis

🇳🇱

Delft, Netherlands

Zuyderland Medisch Centrum

🇳🇱

Heerlen, Netherlands

VieCuri - Medisch Centrum voor Noord-Limburg locatie Venlo

🇳🇱

Venlo, Netherlands

Landesklinikum Wiener Neustadt

🇦🇹

Wiener Neustadt, Niederösterreich, Austria

Petz Aladar Megyei Oktato Korhaz

🇭🇺

Gyor, Hungary

Uniwersytecki Szpital Kliniczny w Bialymstoku

🇵🇱

Bialystok, Poland

Centre Hospitalier Universitaire Vaudois (CHUV)

🇨🇭

Lausanne, Vaud, Switzerland

Universitätsherzzentrum Freiburg - Bad Krozingen

🇩🇪

Bad Krozingen, Baden-Württemberg, Germany

Debreceni Egyetem Klinikai Kozpont

🇭🇺

Debrecen, Hungary

Lister Hospital

🇬🇧

Stevenage, Hertfordshire, United Kingdom

Worcestershire Acute Hospital Trust

🇬🇧

Worcester, Worcestershire, United Kingdom

IRCCS Ospedale Policlinico San Martino

🇮🇹

Genova, Liguria, Italy

Krankenhaus St. Josef Braunau

🇦🇹

Braunau, Oberösterreich, Austria

Medizinische Universität Graz

🇦🇹

Graz, Steiermark, Austria

Pandy Kalman Korhaz

🇭🇺

Gyula, Hungary

Asl Roma 2

🇮🇹

Roma, Lazio, Italy

Ospedale regionale di Lugano

🇨🇭

Lugano, Switzerland

Hôpital Cantonal Universitaire de Genève

🇨🇭

Genève, Switzerland

Uniwersyteckie Centrum Kliniczne Warszawskiego UM

🇵🇱

Warszawa, Poland

Luzerner Kantonsspital

🇨🇭

Luzern, Switzerland

ASST Valle Olona

🇮🇹

Varese, Lombardia, Italy

A.O.U. di Sassari

🇮🇹

Sassari, Sardegna, Italy

Danderyds sjukhus

🇸🇪

Stockholm, Sweden

Midwest Heart & Vascular Specialists

🇺🇸

Overland Park, Kansas, United States

Cardiology Partners Clinical Research Institute

🇺🇸

Palm Beach Gardens, Florida, United States

Reid Health

🇺🇸

Richmond, Indiana, United States

Trinity Medical WNY

🇺🇸

Cheektowaga, New York, United States

The Valley Hospital, Inc.

🇺🇸

Ridgewood, New Jersey, United States

St. Mary's/Duluth Clinic Health System

🇺🇸

Duluth, Minnesota, United States

Cardiovascular Research of Knoxville

🇺🇸

Powell, Tennessee, United States

White Oak Medical Center

🇺🇸

Silver Spring, Maryland, United States

Klinikum Klagenfurt am Wörthersee

🇦🇹

Klagenfurt, Kärnten, Austria

Kepler Universitätsklinikum Campus III

🇦🇹

Linz, Oberösterreich, Austria

CHR de la Citadelle - Cardiology

🇧🇪

Liege, Belgium

Krankenhaus Dresden-Friedrichstadt

🇩🇪

Dresden, Sachsen, Germany

Fakultni nemocnice Brno

🇨🇿

Brno, Czechia

Universitätsklinikum AKH Wien

🇦🇹

Wien, Austria

Klinik Ottakring - Wilhelminenspital

🇦🇹

Wien, Austria

Klinik Floridsdorf - Krankenhaus Nord

🇦🇹

Wien, Austria

OL Vrouwziekenhuis - Campus Aalst

🇧🇪

Aalst, Belgium

Imeldaziekenhuis - St-Elisabethkliniek

🇧🇪

Bonheiden, Belgium

CU Saint-Luc/UZ St-Luc

🇧🇪

Bruxelles - Brussel, Belgium

Ziekenhuis Oost-Limburg

🇧🇪

Genk, Belgium

Jessa Ziekenhuis

🇧🇪

Hasselt, Belgium

UZ Leuven Gasthuisberg

🇧🇪

Leuven, Belgium

Fakultni nemocnice u sv. Anny

🇨🇿

Brno, Czechia

Universitätsmedizin der Johannes Gutenberg Universität Mainz

🇩🇪

Mainz, Rheinland-Pfalz, Germany

Nemocnice Slany

🇨🇿

Slany, Czechia

Institut Klinicke a Experimentalni Mediciny

🇨🇿

Praha 4, Czechia

Ustredni vojenska nemocnice Praha

🇨🇿

Praha 6, Czechia

Allami Szivkorhaz

🇭🇺

Balatonfured, Hungary

St. Vinzenz-Hospital

🇩🇪

Köln, Nordrhein-Westfalen, Germany

Budai Irgalmasrendi Korhaz

🇭🇺

Budapest, Hungary

Zala Megyei Szent Rafael Korhaz

🇭🇺

Zalaegerszeg, Hungary

IRCCS Centro Cardiologico Monzino S.p.A

🇮🇹

Milano, Lombardia, Italy

ASL TO3 di Collegno e Pinerolo

🇮🇹

Torino, Piemonte, Italy

A.O.U. Ospedali Riuniti "Umberto I - G.M.Lancisi - G.Salesi"

🇮🇹

Ancona, Marche, Italy

Eszak-Pesti Centrumkorhaz-Honvedkorhaz

🇭🇺

Budapest, Hungary

Josa Andras Hospital

🇭🇺

Nyiregyhaza, Hungary

Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz

🇭🇺

Szolnok, Hungary

Daido Hospital, Social Medical Corporation Kojunkai

🇯🇵

Nagoya, Aichi, Japan

Takahashi Hospital

🇯🇵

Kobe, Hyogo, Japan

Fukuoka Tokushukai Hospital

🇯🇵

Kasuga, Fukuoka, Japan

Tokyo Medical and Dental University Hospital

🇯🇵

Bunkyo-ku, Tokyo, Japan

Leids Universitair Medisch Centrum

🇳🇱

Leiden, Netherlands

Universitair Medisch Centrum St. Radboud

🇳🇱

Nijmegen, Netherlands

Shin-Kuki General Hospital

🇯🇵

Kuki, Saitama, Japan

Fukui Prefectural Hospital

🇯🇵

Fukui, Japan

Kishiwada Tokushukai Hospital

🇯🇵

Kishiwada, Osaka, Japan

Saitama Sekishinkai Hospital

🇯🇵

Sayama, Saitama, Japan

Hospital de la Santa Creu i de Sant Pau | Cardiología

🇪🇸

Barcelona, Spain

Elkerliek Ziekenhuis, Lokatie Helmond

🇳🇱

Helmond, Netherlands

Ikazia Ziekenhuis

🇳🇱

Rotterdam, Netherlands

Szpital Grochowski im. dr.med. Rafala Masztaka

🇵🇱

Warszawa, Poland

Szpital sw. Wincentego a Paulo

🇵🇱

Gdynia, Poland

Samodzielny Publiczny Specjalistyczny Szpital Zachodni

🇵🇱

Grodzisk Mazowiecki, Poland

Uniwersytecki Szpital Kliniczny w Opolu

🇵🇱

Opole, Poland

Kliniczny Szpital Wojewodzki Nr 2 im. Sw. Jadwigi Krolowej

🇵🇱

Rzeszow, Poland

Uniwersytecki Szpital Kliniczny UM we Wroclawiu

🇵🇱

Wroclaw, Poland

Kantonsspital Baden

🇨🇭

Baden, Switzerland

Hospital Clinico Universitario Virgen de la Arrixaca | Neurology Department - Stroke

🇪🇸

Murcia, Spain

Hospital Gral. Univ. de Valencia | Cardiologia

🇪🇸

Valencia, Spain

Kantonsspital Aarau

🇨🇭

Aarau, Aargau, Switzerland

Falu Lasarett

🇸🇪

Falun, Sweden

Inst Investigacio Sanitaria Pere Virgili | Hosp Univ Joan XXIII de Tarragona - Neurology - Stroke, No-Cardioembolic-Tia

🇪🇸

Tarragona, Spain

Länssjukhuset Ryhov

🇸🇪

Jönköping, Sweden

Skånes Universitetssjukhus

🇸🇪

Lund, Sweden

Hospital Clinico Universitario San Carlos | Cardiologia

🇪🇸

Madrid, Spain

Hospital Universitario Virgen de las Nieves|Cardiologia

🇪🇸

Granada, Spain

Ogaki Municipal Hospital

🇯🇵

Ogaki, Gifu, Japan

Hyogo Prefectural Harima-Himeji General Medical Center

🇯🇵

Himeji, Hyogo, Japan

Hokkaido Cardiovascular Hospital

🇯🇵

Sapporo, Hokkaido, Japan

Japanese Red Cross Fukuoka Hospital

🇯🇵

Fukuoka, Japan

Saiseikai Kumamoto Hospital

🇯🇵

Kumamoto, Japan

Sana-Klinikum Remscheid GmbH

🇩🇪

Remscheid, Nordrhein-Westfalen, Germany

Forschungszentrum Ruhr - KliFoCenter GmbH

🇩🇪

Witten, Nordrhein-Westfalen, Germany

Methodist Physicians Clinic

🇺🇸

Omaha, Nebraska, United States

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitari i Politècnic La Fe | Cardiología

🇪🇸

Valencia, Spain

Nemocnice Ceske Budejovice, a.s. Department of kardiologie

🇨🇿

Ceske Budejovice, Czechia

Fakultni Nemocnice Hradec Kralove

🇨🇿

Hradec Kralove, Czechia

Fakultni nemocnice v Motole

🇨🇿

Praha 5, Czechia

Valley Clinical Trials, Inc. - Covina

🇺🇸

Covina, California, United States

Florida Premier Cardiology

🇺🇸

Boynton Beach, Florida, United States

Clearwater Cardiovascular Associates | Clearwater, FL

🇺🇸

Clearwater, Florida, United States

Cardiology Associates Research Company

🇺🇸

Daytona Beach, Florida, United States

Southwest Florida Research

🇺🇸

Naples, Florida, United States

Cardiovascular Associates Research, LLC

🇺🇸

Covington, Louisiana, United States

Southern Clinical Research, LLC

🇺🇸

Zachary, Louisiana, United States

Jefferson Heart Institute

🇺🇸

Philadelphia, Pennsylvania, United States

PharmaTex Research, LLC

🇺🇸

Amarillo, Texas, United States

North Texas Research Associates

🇺🇸

McKinney, Texas, United States

Universitätsklinikum St. Pölten

🇦🇹

St. Pölten, Niederösterreich, Austria

AZ Sint-Jan Brugge-Oostende | Sint-Jan - Cardiology

🇧🇪

Brugge, Belgium

Fakultni nemocnice Plzen - Lochotin

🇨🇿

Plzen, Czechia

Vseobecna fakultni nemocnice v Praze

🇨🇿

Praha 2, Czechia

Fakultni nemocnice Kralovske Vinohrady

🇨🇿

Praha 10, Czechia

Kliniken Maria Hilf GmbH

🇩🇪

Mönchengladbach, Nordrhein-Westfalen, Germany

Universitätsklinikum Essen

🇩🇪

Essen, Nordrhein-Westfalen, Germany

Universitätsklinikum Hamburg Eppendorf (UKE)

🇩🇪

Hamburg, Germany

Universitätsklinikum Heidelberg

🇩🇪

Heidelberg, Germany

University of Semmelweis/ Semmelweis Egyetem

🇭🇺

Budapest, Hungary

Somogy Megyei Kaposi Mor Oktato Korhaz

🇭🇺

Kaposvar, Hungary

A.O. San Pio

🇮🇹

Benevento, Campania, Italy

ASL Caserta

🇮🇹

Caserta, Campania, Italy

A.O.U. di Ferrara

🇮🇹

Ferrara, Emilia-Romagna, Italy

Istituto Clinico Humanitas - Humanitas Mirasole S.p.A.

🇮🇹

Milano, Lombardia, Italy

AUSL Toscana Sud-Est

🇮🇹

Grosseto, Toscana, Italy

A.O. S.Croce e Carle

🇮🇹

Cuneo, Piemonte, Italy

ULSS3 Serenissima

🇮🇹

Venezia, Veneto, Italy

Kokura Memorial Hospital

🇯🇵

Kitakyushu, Fukuoka, Japan

Chiba-Nishi General Hospital

🇯🇵

Matsudo, Chiba, Japan

Nishinomiya Watanabe Cardiovascular Center

🇯🇵

Nishinomiya, Hyogo, Japan

Kanagawa Cardiovascular and Respiratory Center

🇯🇵

Yokohama, Kanagawa, Japan

Tsukuba Medical Center Hospital

🇯🇵

Tsukuba, Ibaraki, Japan

Akademiska sjukhuset Hjärtforskningsmottagningen

🇸🇪

Uppsala, Sweden

Oita Prefectural Hospital

🇯🇵

Oita, Japan

Osaka General Medical Center

🇯🇵

Osaka, Japan

Noord West Ziekenhuisgroep-Medisch Centrum Alkmaar

🇳🇱

Alkmaar, Netherlands

Jeroen Bosch Ziekenhuis

🇳🇱

Den Bosch, Netherlands

Albert Schweitzer Ziekenhuis, Dordwijk

🇳🇱

Dordrecht, Netherlands

Canisius Wilhelmina Ziekenhuis

🇳🇱

Nijmegen, Netherlands

Bravis Ziekenhuis

🇳🇱

Roosendaal, Netherlands

Gelre Ziekenhuizen Zutphen

🇳🇱

Zutphen, Netherlands

Isala

🇳🇱

Zwolle, Netherlands

Hospital Universitari de Bellvitge | Bellvitge Biomedical Research Institute - Cardiology - AF, Stroke Prevention

🇪🇸

Barcelona, Spain

Ciutat Sanitaria i Universitaria de la Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital Ramon y Cajal | Cardiologia

🇪🇸

Madrid, Spain

Hospital Universitario Virgen de la Macarena

🇪🇸

Sevilla, Spain

Sahlgrenska Universitetssjukhuset

🇸🇪

Göteborg, Sweden

Länssjukhuset Sundsvall-Härnösand

🇸🇪

Sundsvall, Sweden

Västmanlands Sjukhus Västerås

🇸🇪

Västerås, Sweden

Kantonsspital Baselland - Standort Liestal

🇨🇭

Liestal, Basel-Landschaft, Switzerland

Freeman Hospital

🇬🇧

Newcastle Upon Tyne, Tyne And Wear, United Kingdom

Wythenshawe Hospital

🇬🇧

Manchester, United Kingdom

Imperial College London

🇬🇧

London, United Kingdom

Columbus Regional Research Institute

🇺🇸

Columbus, Georgia, United States

Universitetssjukhuset Örebro

🇸🇪

Örebro, Sweden

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