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Safety Study of Apixaban in Recent Acute Coronary Syndrome

Phase 2
Completed
Conditions
Acute Coronary Syndrome (ACS)
Interventions
Drug: Placebo
Registration Number
NCT00313300
Lead Sponsor
Bristol-Myers Squibb
Brief Summary

The purpose of this clinical research study is to determine whether apixaban will be safe in people who have recently had unstable angina or a heart attack.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1741
Inclusion Criteria
  • Recent (< = 7 days) Acute Coronary Syndrome (ACS).
  • Clinically stable on optimal treatment

Key

Exclusion Criteria
  • High bleeding risk.
  • Ongoing anticoagulant use.
  • Need for chronic (>3 months) daily nonsteroidal anti-inflammatory drug (NSAID) or chronic high dose acetylsalicylic acid (ASA) use (>325 mg/day

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
A1Apixaban-
A2Apixaban-
A3Placebo-
A4Apixaban-
Primary Outcome Measures
NameTimeMethod
Event Rate of Composite of Adjudicated Major Bleeding and Clinically Relevant Non-Major Bleeding During the Treatment Period- Treated Participants With Placebo or Apixaban Low DosesFrom first dose of study drug (Day 1) to last dose plus 2 days, up to Year 2 of the Study

Bleeding was assessed using the International Society on Thrombosis and Hemostasis (ISTH) guidelines. Events were adjudicated by the Clinical Events Committee (CEC). Event rate was number of participants with events divided by the number of participants treated, measured as a percentage (%). The primary outcome is based on data for the placebo and 2 apixaban low-dose groups (2.5 mg BID and 10 mg QD) combined across Phase A and Phase B. The analyses of Phase B data across all doses of apixaban are secondary because of the premature termination of the apixaban high-dose groups (10mg BID, 20mg QD) and the resulting lower duration of exposure for these groups.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With a Composite of Adjudicated Cardiovascular Death, Non-Fatal Myocardial Infarction, Severe Recurrent Ischemia and Non-Hemorrhagic Stroke During the Intended Treatment Period - Randomized ParticipantsRandomization to 182 days after randomization (183 days)

Events were adjudicated by the Clinical Events Committee (CEC). Intended Treatment Period refers to the period starting on the day of randomization and ending 182 days after the day of randomization (for a total period duration of 183 days). Data in this outcome are combined across Phase A and Phase B.

Event Rate for Adjudicated All Bleeding Events During the Treatment Period - Treated Participants With Placebo or Apixaban Low Dosesfirst dose (Day 1) to last dose plus 2 days (or for SAEs, plus 30 days), up to Year 2 of the Study

Bleeding was assessed using the International Society on Thrombosis and Hemostasis (ISTH) guidelines. Events were adjudicated by the Clinical Events Committee (CEC). Event rate was number of participants with events divided by the number of participants treated (%). All bleeding events includes major bleeding, clinically relevant non-major bleeding and minor bleeding. Treatment Period refers to the period from first dose through 2 days, or through 30 days for Serious Adverse Event (SAE) tabulations, after discontinuation of study drug. Data in this outcome are combined across Phase A and Phase B.

Number of Participants With a Composite of Adjudicated All-Cause Death, Non-Fatal Myocardial Infarction, Severe Recurrent Ischemia, and Non-Hemorrhagic Stroke During the Intended Treatment Period - Randomized ParticipantsDay of randomization to 182 days after day of randomization (183 days)

Events were adjudicated by the Clinical Events Committee (CEC). Event rate was number of participants with events divided by the number of participants treated (%). Intended Treatment Period refers to the period starting on the day of randomization and ending 182 days after the day of randomization (for a total period duration of 183 days). Data in this outcome are combined across Phase A and Phase B

Event Rate of Confirmed Adjudicated Major Bleeding During the Treatment Period- Treated Participants With Placebo or Apixaban Low Dosesfrom first dose (Day 1) to last dose plus 2 days, up to Year 2 of the Study

Bleeding was assessed using the ISTH guidelines. Events were adjudicated by the Clinical Events Committee. Event rate was number of participants with events divided by the number of participants treated, measured as a percentage (%).

Number of Participants With Composite of Adjudicated All-Cause Death, Non-Fatal Myocardial Infarction, Severe Recurrent Ischemia, Non-Hemorrhagic Stroke During the Phase B Adjusted Intended Treatment Period - Participants Randomized in Phase BDay of randomization and ends on high dose termination date, 1-Oct-2007

Phase B Adjusted Intended Treatment Period=day of randomization and ends on termination date of high dose apixaban, 1-Oct-2007. The analyses of Phase B data across all doses of apixaban are secondary due to the premature termination of the apixaban high dose groups and the lower duration of exposure.

Event Rate of Composite of Adjudicated Major Bleeding and Clinically Relevant Non-Major Bleeding During the Phase B Adjusted Treatment Period- Treated Participants Randomized in Phase BFrom first dose (Day 1) to last dose, plus 2 days (plus 30 days for SAEs), up to high dose termination, 1 October 2007

Bleeding was assessed using ISTH guidelines. Events were adjudicated by the CEC. Event rate was number of participants with events divided by the number of participants treated, measured as a percentage (%). The analyses of Phase B data across all doses of apixaban are secondary because of the premature termination of the apixaban high-dose groups and the lower duration of exposure. Phase B Adjusted Treatment Period=safety events occurring in the period from first dose through 2 days (or through 30 days for SAE tabulations) after the earliest of last dose date or 1-Oct-2007 (termination date for the 10 mg BID group).

Event Rate for Adjudicated All Bleeding Events During the Phase B Adjusted Treatment Period - Treated Participants Randomized in Phase BFrom first dose (Day 1) to last dose, plus 2 days (plus 30 days for SAEs), up to high dose termination, 1 October 2007

Bleeding was assessed using the ISTH guidelines. Events were adjudicated by the CEC. Event rate was number of participants with events divided by the number of participants treated (%). All bleeding events included major bleeding, clinically relevant non-major bleeding and minor bleeding. Phase B Adjusted Treatment Period=safety events occurring in the period from first dose through 2 days (or through 30 days for SAE tabulations) after the earliest of last dose date or 1-Oct-2007 (termination date for the 10 mg BID group).

Number of Participants With Composite of Adjudicated Cardiovascular Death, Non-Fatal Myocardial Infarction, Severe Recurrent Ischemia, Non-Hemorrhagic Stroke During the Phase B Adjusted Intended Treatment Period - Participants Randomized in Phase BDay of randomization up to high dose termination, 1-Oct-2007

Phase B Adjusted Intended Treatment Period=day of randomization and ends on 1-Oct-2007. The analyses of Phase B data across all doses of apixaban are secondary due to the premature termination of the apixaban high dose groups and the lower duration of exposure.

Event Rate of Confirmed Adjudicated Major Bleeding During the Phase B Adjusted Treatment Period - Treated Participants Randomized in Phase BFrom first dose (Day 1) to last dose, plus 2 days (plus 30 days for SAEs), up to high dose termination, 1 October 2007

Bleeding was assessed using the ISTH guidelines. Events were adjudicated by the CEC. Event rate was number of participants with events divided by the number of participants treated (%).

Trial Locations

Locations (31)

Midwest Cardiology Research Foundation

🇺🇸

Columbus, Ohio, United States

Georgia Heart Specialists

🇺🇸

Covington, Georgia, United States

Heartcare Midwest

🇺🇸

Peoria, Illinois, United States

New York Cardiovascular Associates

🇺🇸

New York, New York, United States

University Of Kentucky

🇺🇸

Lexington, Kentucky, United States

William Beaumont Hospital-Troy

🇺🇸

Troy, Michigan, United States

Unc Hospitals, Department Of Medicine

🇺🇸

Chapel Hill, North Carolina, United States

Local Institution

🇬🇧

Leicester, United Kingdom

The Dayton Heart Center

🇺🇸

Dayton, Ohio, United States

Carolina Heart Specialists

🇺🇸

Gastonia, North Carolina, United States

Oklahoma Cardiovascular Research Group

🇺🇸

Oklahoma City, Oklahoma, United States

Geisinger Clinic - Cardiology

🇺🇸

Danville, Pennsylvania, United States

Scottsdale Cardiovasular Research Institute

🇺🇸

Scottsdale, Arizona, United States

Radiant Research,Santa Rosa

🇺🇸

Santa Rosa, California, United States

Los Angeles County & University Of Southern Ca. Medical Cen.

🇺🇸

Los Angeles, California, United States

Watson Clinic Center For Research

🇺🇸

Lakeland, Florida, United States

South Denver Cardiology Associates

🇺🇸

Littleton, Colorado, United States

Heart & Vasc Inst Of Fl

🇺🇸

Safety Harbor, Florida, United States

Cardiac Disease Specialists, P.C.

🇺🇸

Atlanta, Georgia, United States

Iowa Heart Center

🇺🇸

Des Moines, Iowa, United States

Dumc

🇺🇸

Durham, North Carolina, United States

Piedmont Cardiology Associates

🇺🇸

Hickory, North Carolina, United States

Wake Forest Univ Health Sciences

🇺🇸

Winston-Salem, North Carolina, United States

Penn State Milton S. Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Tyler Cardiovascular Consultants

🇺🇸

Tyler, Texas, United States

University Of Texas Medical School - San Antonio

🇺🇸

San Antonio, Texas, United States

Virginia Commonwealth University

🇺🇸

Richmond, Virginia, United States

Cardiovascular Associates, P.C

🇺🇸

Kingsport, Tennessee, United States

Indian River Medical Center

🇺🇸

Vero Beach, Florida, United States

The Care Group, Llc.

🇺🇸

Indianapolis, Indiana, United States

Rhode Island Hospital

🇺🇸

Providence, Rhode Island, United States

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