Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention

ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI0 个研究点目标入组 610 人开始时间: 待定最近更新: 2021年11月24日

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•Clinical Inclusion Criteria (MUST MEET AT LEAST ONE):
•1. Adult patients >= 65 years of age
•2. Female gender
•3.Troponin positive acute coronary syndrome
•4. Established vascular disease defined as previous MI, documented PAD or CAD/PAD revascularization
•5. Diabetes mellitus treated with medications (oral hypoglycemic, subcutaneous injection of insulin)
•6. Chronic kidney disease defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 or creatinine clearance (CrCl) < 60 ml/min
•Angiographic Inclusion Criteria (MUST MEET AT LEAST ONE):
•7. Multivessel coronary artery disease
•8.Target lesion requiring total stent length >30 mm
•9.Thrombotic target lesion(s)
•10.Bifurcation lesions with Medina X,1,1 classification requiring at least 2 stents
•11. Left main (>=50%) or proximal LAD (>=70%) lesion
•12. Calcified target lesion(s) requiring atherectomy

•Exclusion Criteria:
•1.Under 18 years of age
•2.Contraindication to aspirin
•3. Contraindication to ticagrelor
•4. Planned surgery within 90 days
•5. Planned coronary revascularization (surgical or percutaneous) within 90 days
•6.Need for chronic oral anticoagulation
•7.Prior stroke
•8.Dialysis-dependent renal failure
•9.Active bleeding or extreme-risk for major bleeding (e.g. active peptic ulcer disease, gastrointestinal pathology with a raised risk for bleeding, malignancies with a raised risk for bleeding)
•10.Salvage PCI or STEMI presentation.
•11.Liver cirrhosis
•12.Life expectancy < 1 year
•13.Unable or unwilling to provide informed consent
•14.Women of child bearing potential (as determined by hospital standard of care)
•Fibrinolytic therapy within 24 hours of index PCI
•15. Concomitant therapy with a strong cytochrome P-450 3A inhibitor or inducer
•16.Platelet count < 100,000 mm3
•17.Requiring ongoing treatment with aspirin >= 325 mg daily

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