NCT01916902

Brief Summary

Subjects presenting with probable acute coronary syndromes scheduled for cardiac catheterization will be enrolled in this study. Consented subjects will be randomized to receive ticagrelor started with a loading dose immediately after enrollment versus receiving a loading dose of ticagrelor during cardiac catheterization after diagnostic angiography but prior to stenting. Optical coherence tomography (OCT) will be performed after stenting and the volume of thrombus within the new stent will be measured and compared between the groups.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Geographic Reach
1 country

1 active site

Status
withdrawn

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 2, 2013

Completed
4 days until next milestone

First Posted

Study publicly available on registry

August 6, 2013

Completed
6 months until next milestone

Study Start

First participant enrolled

February 1, 2014

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2015

Completed
Last Updated

May 26, 2014

Status Verified

May 1, 2014

Enrollment Period

1 year

First QC Date

August 2, 2013

Last Update Submit

May 23, 2014

Conditions

Keywords

Optical Coherence TomographyTicagrelor

Outcome Measures

Primary Outcomes (1)

  • Total thrombus burden as measured by the volume of in-stent thrombus quantified by planimetry.

    The total thrombus burden measured on OCT images will be assessed. The volume of in-stent thrombus will be quantified by planimetry.

    Thrombus burden will be measured at the end of the coronary artery stenting procedure.

Secondary Outcomes (2)

  • PRI (platelet reactivity index) as measured bu the PLT-VASP assay.

    PRI iwill be measured at the time of OCT image acquisition.

  • P2Y12 Reaction Units as measured by the VerifyNow P2Y12 assay.

    P2Y12 will be measured at the time of OCT image acquisition.

Other Outcomes (1)

  • PCI-related myocardial infarction (MI)

    PCI-related MI will be assesed within 24 hours after the end of the coronary artery stenting procedure.

Study Arms (2)

Ticagrelor- Delayed Administration

ACTIVE COMPARATOR

Subjects receive 180 mg of ticagrelor during cardiac catheterization after diagnostic angiography and prior to stenting. OCT is performed prior to and after coronary artery stenting.

Drug: Ticagrelor- Delayed AdministrationProcedure: Optical Coherence Tomography

Ticagrelor- Immediate Administration

ACTIVE COMPARATOR

Subjects receive 180 mg of ticagrelor immediately after study enrollment. OCT is performed prior to and after coronary artery stenting.

Drug: Ticagrelor- Immediate AdministrationProcedure: Optical Coherence Tomography

Interventions

Subjects are randomized to receive ticagrelor immediately after enrollment versus at the time of cardiac catheterization. OCT is performed prior to and after coronary artery stenting.

Ticagrelor- Delayed Administration

Subjects are randomized to receive ticagrelor immediately after enrollment versus at the time of cardiac catheterization. OCT is performed prior to and after coronary artery stenting.

Ticagrelor- Immediate Administration
Ticagrelor- Delayed AdministrationTicagrelor- Immediate Administration

Eligibility Criteria

Age18 Years - 79 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patient Characteristics:
  • Males and non-pregnant females \> or equal to 18 and \< or equal to 79 years of age presenting with suspected acute coronary syndrome (unstable angina or NSTEMI)
  • Patients likely to be scheduled to undergo coronary angiography with possible percutaneous coronary intervention (PCI)
  • Lesion Characteristics on Diagnostic Coronary Angiography:
  • De novo lesions in native coronary arteries found by diagnostic coronary angiography
  • Angiographic stenosis \<100%
  • Reference vessel diameter 2.5 mm - 4.0 mm by visual estimation

You may not qualify if:

  • Subjects who are unable or unwilling to sign the informed consent form.
  • Subjects being treated with anti-platelet medications other than aspirin prior to diagnostic catheterization including glycoprotein IIb/IIIa inhibitors.
  • Subjects with NYHA class III or IV heart failure or known left ventricular ejection fraction \< 30%.
  • Subjects with an ST elevation myocardial infarction.
  • Subjects with hemodynamic or electrical instability (including shock).
  • Subjects diagnosed with severe, non-catheter-related coronary artery spasm.
  • Subjects who are or may be pregnant.
  • Subjects with known allergies to contrast media.
  • Subjects with eGFR \< 60 ml/min/1.73m2.
  • Subjects currently taking oral anticoagulants with an absolute contraindication to discontinuation of anticoagulation.
  • History of TIA or stroke \< 6 months.
  • History of hemorrhagic stroke.
  • Hepatic insufficiency defined as liver cirrhosis, AST/ALT/Alkaline Phosphatase greater than 3 times the upper limit of normal or hyperbilirubinemia.
  • Cardiac catheterization scheduled within 4 hours of randomization or more then 72 hours after randomization.
  • Lesions located in the left main coronary artery
  • +4 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

MeSH Terms

Conditions

Acute Coronary SyndromeCoronary Artery Disease

Interventions

Tomography, Optical Coherence

Condition Hierarchy (Ancestors)

Myocardial IschemiaHeart DiseasesCardiovascular DiseasesVascular DiseasesCoronary DiseaseArteriosclerosisArterial Occlusive Diseases

Intervention Hierarchy (Ancestors)

Tomography, OpticalOptical ImagingDiagnostic ImagingDiagnostic Techniques and ProceduresDiagnosisTomographyInvestigative Techniques

Study Officials

  • Ik-Kyung Jang, MD, PhD

    Massachusetts General Hospital

    PRINCIPAL INVESTIGATOR
0

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor of Medicine

Study Record Dates

First Submitted

August 2, 2013

First Posted

August 6, 2013

Study Start

February 1, 2014

Primary Completion

February 1, 2015

Last Updated

May 26, 2014

Record last verified: 2014-05

Locations