NCT02325466

Brief Summary

The hypothesis being that both aspirin-ticagrelor and ticagrelor monotherapy will be superior to aspirin monotherapy in the reduction of whole blood viscosity at the end of each 4 week treatment period. Study participants will be randomized into 3 groups, and each group will receive each of 3 treatments in the cross-over study. At the end of each individual 4 week treatment period the investigators will determine whether there are differences in low and high shear rate dependent viscosity and investigate the effect of the treatment on peripheral arterial blood flow using pulse volume recordings, ankle brachial index and toe pressures. Subjects will be eligible if they have ankle-brachial index less than or equal to 0.85, or if a patient's blood vessels are calcified, patients will have toe-brachial index less than or equal to 0.6 performed using continuous-wave Doppler.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
70

participants targeted

Target at below P25 for phase_3

Timeline
Completed

Started Apr 2015

Typical duration for phase_3

Geographic Reach
1 country

1 active site

Status
completed

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

December 19, 2014

Completed
6 days until next milestone

First Posted

Study publicly available on registry

December 25, 2014

Completed
3 months until next milestone

Study Start

First participant enrolled

April 1, 2015

Completed
3.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 4, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

May 4, 2018

Completed
3.9 years until next milestone

Results Posted

Study results publicly available

March 21, 2022

Completed
Last Updated

March 21, 2022

Status Verified

March 1, 2022

Enrollment Period

3.1 years

First QC Date

December 19, 2014

Results QC Date

May 6, 2019

Last Update Submit

March 18, 2022

Conditions

Keywords

Peripheral Artery DiseaseType 2 DiabetesBlood ViscosityTicagrelorAspirin

Outcome Measures

Primary Outcomes (2)

  • Mean Change in Low Shear Blood Viscosity

    Compare the effect of aspirin-ticagrelor and ticagrelor monotherapy with aspirin on blood viscosity from week 16 to baseline

    baseline, week 16

  • Mean Change in High Shear Blood Viscosity

    Compare the effect of aspirin-ticagrelor and ticagrelor monotherapy with aspirin on blood viscosity at week 16 to baseline

    baseline and week 16

Secondary Outcomes (2)

  • Mean Change in Peripheral Arterial Blood Flow

    baseline and week 16

  • Mean Change in Microvascular Blood Flow Composite Score

    baseline and week 16

Study Arms (3)

Aspirin/Ticagrelor placebo

PLACEBO COMPARATOR

aspirin 81 mg daily and ticagrelor placebo twice daily

Drug: AspirinDrug: Ticagrelor Placebo

Aspirin/Ticagrelor

ACTIVE COMPARATOR

aspirin 81 mg daily and ticagrelor 90 mg twice daily

Drug: AspirinDrug: Ticagrelor

Aspirin Placebo/Ticagrelor

ACTIVE COMPARATOR

aspirin placebo daily and ticagrelor 90 mg twice daily

Drug: TicagrelorDrug: Aspirin Placebo

Interventions

Aspirin 81mg

Also known as: ASA
Aspirin/TicagrelorAspirin/Ticagrelor placebo

ticagrelor 90 mg

Aspirin Placebo/TicagrelorAspirin/Ticagrelor
Also known as: Placebo
Aspirin Placebo/Ticagrelor
Also known as: Placebo
Aspirin/Ticagrelor placebo

Eligibility Criteria

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

You may qualify if:

  • Female or male aged ≥ 35 years
  • Type 2 diabetes mellitus
  • Symptomatic PAD
  • Ankle-brachial index ≤ 0.85 or calcified blood vessels with toe-brachial index ≤ 0.6 and/or abnormal post-exercise ankle-brachial index
  • Prior surgical or percutaneous intervention of the peripheral arteries ≥12 months previously with a residual stenoses of ≥50% in a non-dilated artery.

You may not qualify if:

  • Subject is pregnant or breast-feeding
  • Planned revascularization or amputation
  • Known bleeding disorder
  • History of intracranial hemorrhag3
  • Considered at risk of hemorrhagic events
  • Hypersensitivity or allergic reactions to aspirin
  • Concomitant use of anticoagulants such as warfarin, dabigatran, factor Xa inhibitors or antiplatelet drugs such as clopidogrel, dipyridamole and sulfapyridine
  • Subject has a condition or circumstance which would prevent them from adhering to treatment regimens
  • Subject has active infection
  • Subject has an anemia
  • Subject has given blood or received a blood transfusion at any point during the study
  • Subject has polycythemia vera or any hyperviscosity syndrome
  • Subjects with Waldenstrom's macroglobulinemia who have an increased risk of hyperviscosity syndrome
  • Subject has history of severe liver disease, obstructive liver disease such as primary biliary cirrhosis or end-stage renal disease (eGFR \<30 mL/min/m2)
  • Family members or employees of the investigator or study centers involved in the study
  • +1 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Icahn School of Medicine at Mount Sinai

New York, New York, 10029, United States

Location

Related Publications (1)

  • Rosenson RS, Chen Q, Najera SD, Krishnan P, Lee ML, Cho DJ. Ticagrelor improves blood viscosity-dependent microcirculatory flow in patients with lower extremity arterial disease: the Hema-kinesis clinical trial. Cardiovasc Diabetol. 2019 Jun 7;18(1):77. doi: 10.1186/s12933-019-0882-5.

MeSH Terms

Conditions

Peripheral Arterial DiseaseDiabetes Mellitus, Type 2

Interventions

AspirinTicagrelor

Condition Hierarchy (Ancestors)

AtherosclerosisArteriosclerosisArterial Occlusive DiseasesVascular DiseasesCardiovascular DiseasesPeripheral Vascular DiseasesDiabetes MellitusGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System Diseases

Intervention Hierarchy (Ancestors)

SalicylatesHydroxybenzoatesPhenolsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsAdenosinePurine NucleosidesPurinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic CompoundsNucleosidesNucleic Acids, Nucleotides, and NucleosidesRibonucleosides

Results Point of Contact

Title
Dr. Robert S. Rosenson
Organization
Icahn School of Medicine at Mount Sinai

Study Officials

  • Robert Rosenson, MD

    Icahn School of Medicine at Mount Sinai

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restriction Type
OTHER
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor Medicine, Cardiology

Study Record Dates

First Submitted

December 19, 2014

First Posted

December 25, 2014

Study Start

April 1, 2015

Primary Completion

May 4, 2018

Study Completion

May 4, 2018

Last Updated

March 21, 2022

Results First Posted

March 21, 2022

Record last verified: 2022-03

Locations