Genotyping Infarct Patients to Adjust and Normalize Thienopyridine Treatment (GIANT)

The recruitment status of this study is unknown because the information has not been verified recently.
Verified July 2011 by Biotronik France.
Recruitment status was  Recruiting
European Cardiovascular Research Center
ACTION - Allies in Cardiovascular Trials Initiatives and Organized Network
Information provided by:
Biotronik France Identifier:
First received: May 28, 2010
Last updated: July 1, 2011
Last verified: July 2011

The objective of GIANT Study is to evaluate the clinical impact of genetic resistance to thienopyridine profile determination (CYP2C19 gene) and the clinical impact of compliance to an adjusted thienopyridine treatment on STEMI patients treated by primary PCI within the 24 hours following the first chest pain.

Condition Phase
Coronary Artery Disease
Acute Coronary Syndrome
Genetic Resistance to Clopidogrel
Compliance to Thienopyridine Treatment
Phase 4

Study Type: Observational
Study Design: Observational Model: Case Control
Time Perspective: Prospective
Official Title: Genotyping Infarct Patients to Adjust and Normalize Thienopyridine Treatment

Resource links provided by NLM:

Further study details as provided by Biotronik France:

Primary Outcome Measures:
  • statistical difference in Death, MI and stent thrombosis between genetically resistant patients (*2 genotype) with adapted treatment and non resistant patients (*1 genotype) [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Difference in MACCE between responder + compliant patients vs responders + non compliant patients vs non responder patients. [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Biospecimen Retention:   Samples With DNA

DNA Samples from saliva to observe CYP2C19 genetic variants

Estimated Enrollment: 1500
Study Start Date: June 2010
Estimated Study Completion Date: December 2012
Estimated Primary Completion Date: December 2012 (Final data collection date for primary outcome measure)
[*1] Genotype - Good responders to Clopidogrel
This group of patients is defined thanks to the DNA extracted from their saliva: [*1] genotype patients are good responders to clopidogrel
[*2] genotype with adapted thienopyridine treatment
This group of patients is defined thanks to the DNA extracted from their saliva: [*2] genotype patients are bad responders to clopidogrel and their thienopyridine treatment has been adapted

Detailed Description:

All the STEMI patients treated by primary PCI (with stent implantation) within the 24 hours following the first chest pain can be included in the GIANT study. After the PCI, they'll receive DAT (Aspirin + Clopidogrel/Prasugrel).

Patients will then be genotyped to determine if they carry one of the CYP2C19 gene variants making them resistant or hyper responder to clopidogrel. The genetic profile of the patients will be communicated to the physician who took care of them so that he can (or not) adjust the thienopyridine treatment (increase of the clopidogrel dosage, switch to prasugrel or switch to clopidogrel). A treatment will be prescribed for 12 months as according to the European guidelines.

One year after the PCI, the patients will have to be available for a follow up visit. They'll be submitted to a VERIFY NOW P2Y12 protocol to determine whether they were compliant to their thienopyridine treatment. A clinical follow up will be also performed to evaluate the cardiovascular events.


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population

STEMI patients treated within the first 24 hours following the first chest pain by Primary PCI (with stent implantation)


Inclusion Criteria:

  • STEMI patient treated within the first 24 hours with primary PCI (with stent implantation)
  • Age superior or equal to 18 years old
  • Informed consent signed
  • Patient volunteer to be submitted to the 1 year visit follow up and to the clinical exams during this visit
  • Patient benefiting from French social health system

Exclusion Criteria:

  • NONSTEMI patient with high troponin
  • STEMI patient treated after the first 24 hours
  • Stable / unstable angina or silent ischemia
  • Cardiogenic shock
  • Oral anticoagulation (Vitamin K Antagonists)
  • Contraindication for PCI
  • Age inferior to 18 years old
  • Life expectancy inferior to 1 year
  • Participation in another clinical trial
  • No signed informed consent
  • Patient not available for the 1 year visit follow up
  • Pregnant women
  • Known allergy to media contrast that can not be controlled by an adapted treatment
  • Known allergy to cobalt chromium alloy
  • Left ventricular ejection fraction lower than 30%
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01134380

Contact: Virginie Colin +33146759660
Contact: Dominique Roy +33146759660

Centre Hospitalier de la Région Annecienne Recruiting
Annecy, France
Contact: Loïc Belle         
Principal Investigator: Loïc BELLE, MD         
Hôpital Albert Schweitzer Recruiting
Colmar, France, 68003
Contact: Hervé Faltot    +33389212718      
Principal Investigator: Nicolas Lhoest, Dr         
Centre Hospitalier Sud Francilien Recruiting
Corbeil Essonnes, France
Contact: Romain BERTHIER         
Principal Investigator: Romain BERTHIER         
Centre Hospitalier d'Haguenau Recruiting
Haguenau, France
Principal Investigator: Fabien De Poli, MD         
Centre Hospitalier Saint Joseph et Saint Luc Recruiting
Lyon, France, 69007
Contact: Bernard Ritz, Dr         
Principal Investigator: Bernard Ritz         
Hôpital Privé Jacques Cartier Recruiting
Massy, France, 91300
Contact: Beatrice Bortolussi    +33160134602      
Principal Investigator: Bernard Chevalier, Dr         
Hôpital Bon Secours Active, not recruiting
Metz, France
Hôpital Arnaud de Villeneuve Recruiting
Montpellier, France
Contact: Christophe PIOT         
Principal Investigator: Christophe PIOT         
Centre Hospitalier Universitaire Caremeau Recruiting
Nîmes, France
Contact: Laurent SCHMUTZ         
Principal Investigator: Laurent SCHMUTZ         
Groupe Hospitalier Pitié Salpêtrière Recruiting
Paris, France
Contact: Gilles MONTALESCOT         
Principal Investigator: Gilles MONTALESCOT         
Centre Hospitalier Rene Dubos Recruiting
Pontoise, France
Contact: Nils GUILLARD         
Principal Investigator: François FUNCK         
CHI de Villeneuve Recruiting
Villeneuve Saint Georges, France
Contact: Dominique DUMANT, MD         
Principal Investigator: Dominique DUMANT, MD         
Sponsors and Collaborators
Biotronik France
European Cardiovascular Research Center
ACTION - Allies in Cardiovascular Trials Initiatives and Organized Network
Principal Investigator: Bernard Chevalier Hopital Privé Jacques Cartier
Principal Investigator: Gilles Montalescot Assistance Publique - Hôpitaux de Paris
Principal Investigator: Loïc Belle Centre Hospitalier de la région Annecienne
  More Information

No publications provided

Responsible Party: Virginie COLIN, Biotronik France Identifier: NCT01134380     History of Changes
Other Study ID Numbers: GIANT200905-04
Study First Received: May 28, 2010
Last Updated: July 1, 2011
Health Authority: France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)

Keywords provided by Biotronik France:
Percutaneous coronary intervention
Acute coronary syndrome
Dual antiplatelet therapy

Additional relevant MeSH terms:
Coronary Artery Disease
Myocardial Ischemia
Coronary Disease
Acute Coronary Syndrome
Heart Diseases
Cardiovascular Diseases
Arterial Occlusive Diseases
Vascular Diseases
Pathologic Processes
Angina Pectoris
Chest Pain
Signs and Symptoms
Platelet Aggregation Inhibitors
Hematologic Agents
Therapeutic Uses
Pharmacologic Actions
Purinergic P2Y Receptor Antagonists
Purinergic P2 Receptor Antagonists
Purinergic Antagonists
Purinergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs processed this record on September 18, 2014