Status:

WITHDRAWN

Study in Diabetes Mellitus Patients Without Prior Myocardial Infarction or Stroke Undergoing Elective Percutaneous Coronary Intervention.

Lead Sponsor:

Region Skane

Collaborating Sponsors:

IHF GmbH - Institut für Herzinfarktforschung

Hippocrates Research

Conditions:

Diabetes Mellitus

Microvascular Coronary Artery Disease

Eligibility:

All Genders

18+ years

Phase:

PHASE3

Brief Summary

This study is designed to test the hypothesis that ticagrelor is superior to clopidogrel, in improving coronary microvascular function, as measured by coronary flow reserve (CFR) in patients with T2DM...

Detailed Description

Coronary artery disease (CAD) can be divided into macrovascular and microvascular disease, both different manifestations of atherosclerosis. Macrovascular CAD, i.e. obstructive CAD of epicardial coron...

Eligibility Criteria

Inclusion

  • Provision of informed consent prior to any study specific procedures
  • Men or women ≥18 years of age
  • Diagnosed with T2DM defined as treatment with ongoing glucose lowering drug (oral medications and/or insulin) for at least 1 month
  • Presence of CAD undergoing elective PCI
  • Impaired coronary microvascular function post PCI as defined by a CFR ≤2.5 (as per local reading)
  • TIMI 3 flow post PCI

Exclusion

  • Previous MI defined as a documented hospitalization with a final diagnosis of spontaneous MI (with the exception of definite secondary MI \[e.g., due to coronary revascularization procedure, profound hypotension, hypertensive emergency, tachycardia, or profound anemia\]).
  • Previous stroke (transient ischemic attack \[TIA\] is not included in the stroke definition)
  • Use of an intravenous antiplatelet therapy (i.e., cangrelor or GPI) during PCI
  • On treatment with clopidogrel, prasugrel, or ticagrelor due to a prior acute major CV event (MI or stroke) (on treatment with clopidogrel due to prior vascular intervention not secondary to a major CV event is allowed)
  • Planned use of aspirin treatment at doses \>150 mg od
  • Anticipated concomitant oral or intravenous therapy with strong cytochrome P450 3A4 (CYP3A4) inhibitors or CYP3A4 substrates with narrow therapeutic indices that cannot be stopped for the course of the study:
  • Strong CYP3A4 inhibitors: ketoconazole, itraconazole, voriconazole, telithromycin, clarithromycin (but not erythromycin or azithromycin), nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir
  • CYP3A4 substrates with narrow therapeutic index: quinidine, simvastatin at doses \>40 mg daily or lovastatin at doses \>40 mg daily
  • Hypersensitivity to ticagrelor or any of its excipients
  • Need for chronic oral anticoagulant therapy or chronic low-molecular-weight heparin
  • Patients with known bleeding diathesis or coagulation disorder
  • History of intracerebral bleed at any time, gastrointestinal (GI) bleed within the past 6 months prior to randomization, or major surgery within 30 days prior to randomization
  • Increased risk of bradycardic events (e.g., known sick sinus syndrome, second or third-degree AV block or previous documented syncope suspected to be due to bradycardia) unless treated with a pacemaker
  • Known severe liver disease (e.g., ascites and/or clinical signs of coagulopathy)
  • Renal failure requiring dialysis
  • Known platelet count \<145 x109 platelets/L
  • Known hemoglobin \<9 g/dL
  • Women of child-bearing potential (WOCBP)\*, who are not willing to use a method of contraception that is considered highly reliable\*\* per CTFG (Clinical Trial Facilitation Group), OR who have a positive pregnancy test at enrolment or randomization OR women who are breast-feeding
  • Inability of the patient to understand and/or comply with study procedures and/or follow up, in the opinion of the investigator, OR any conditions that, in the opinion of the investigator, may render the patient unable to complete the study
  • Life expectancy of less than 6 month based on investigator's judgement
  • Participation in another clinical study with an investigational (defined as non-approved) product, if taken within five half-lives or 28 days prior to the first administration of the trial medication, whichever is longer
  • Previous randomization in the present study
  • Severe asthma
  • Hypersensitivity to adenosine or mannitol
  • Long QT syndrome
  • Chronic obstructive lung disease, with evidence of bronchospasm
  • Severe low blood pressure
  • Unstable angina pectoris
  • Severe heart failure
  • Hypovolemia
  • Treatment with dipyradimol
  • Increased intracranial pressure \* fertile, following menarche until becoming post-menopausal, unless permanently sterile (permanent sterilisation methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy) \*\* estrogen/progestogen or progestogen (oral, intravaginal or transdermal administration); intrauterine device (IUD); intrauterine hormone-releasing system (IUS); bilateral tubal occlusion; vasectomised partner; sexual abstinence

Key Trial Info

Start Date :

September 15 2019

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

March 31 2022

Estimated Enrollment :

Patients enrolled

Trial Details

Trial ID

NCT04069234

Start Date

September 15 2019

End Date

March 31 2022

Last Update

April 8 2020

Active Locations (0)

Enter a location and click search to find clinical trials sorted by distance.

Page 1 of 0 (0 locations)

No Results Found

We couldn’t find results for the location/zipcode entered or within the selected range. Please check your input or adjust your search.