Study of Policosanol to Improve Platelet Reactivity After Percutaneous Coronary Stent Implantation (PCI) (spirit)
Recruitment status was Recruiting
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Purpose
Thrombotic event is one of the most serious complications of coronary artery disease, which often result in myocardial infarction and even death. Even according to the standard guidelines for antiplatelet therapy, there are still 6% to 15% of patients occur thrombotic events, in high-risk patients, the proportion is higher, this phenomenon is called anti-platelet drug resistance in clinical practice
The aim of this multicenter prospective, randomized, controlled study is to observed policosanol on aspirin or clopidogrel resistance in patients with platelet aggregation after Percutaneous Coronary Stent Implantation (PCI) and occurrence of platelet aggregation and short-term prognosis to find new ways to the prevention of platelet aggregation .
| Condition | Intervention | Phase |
|---|---|---|
|
Coronary Artery Disease |
Drug: high maintenance clopidogrel Drug: routine dual antiplatelet Drug: policosanol on the top of dual antiplatelet treatment |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Study of Policosanol to Improve High on Clopidogrel Platelet Reactivity After Percutaneous Coronary Stent Implantation(Spirit) |
- Platelet aggregation induced by 20μmol/L ADP [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- major adverse cardiac events [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Stent thrombosis and TIMI bleeding events [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 350 |
| Study Start Date: | March 2011 |
| Estimated Study Completion Date: | September 2012 |
| Estimated Primary Completion Date: | June 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Routine therapy group
asprin 300mg/d for 1 month followed by 100mg/d chronically clopidogrel 75mg/d for 1year.
|
Drug: routine dual antiplatelet
aspirin 300mg/d for 1 month followed by 100mg/d chronically clopidogel 75mg/d for at least 1 year
|
|
Experimental: high dose Clopidogrel
aspirin 300mg/d for 1 month followed by 100mg/d chronically; clopidogrel 150mg/d for 1 month followed by 75mg/d for at least 1 year.
|
Drug: high maintenance clopidogrel
clopidogrel 150 mg/d for 30 days followed by 75 mg/d for at least 1 year
|
|
Experimental: Policosanol treatment group
asprin 300mg/d for 1 month followed by 100mg/d chronically; clopidogrel 75mg/d for at least 1 year; Policosanol 40mg/d for 6months.
|
Drug: policosanol on the top of dual antiplatelet treatment
aspirin 300 mg/d for 1 month followed by 100 mg/d chronically clopidogrel 75 mg/d for at least 1 year policosanol 40mg/d for 6 months
|
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with coronary heart disease and had received coronary stenting
- high on-treatment platelet reactivity defined as an ADP-induced platelet aggregation (by LTA)> 65% at 24 hr after clopidogrel loading (300 ~ 600mg)or 5 days after maintenance dose treatment (75mg / d)
- Informed Consent
Exclusion Criteria:
- receiving GP IIb / IIIa receptor antagonist treatment within 24h before enrollment
- using cilostazol within 7d before enrollment
- aspirin, clopidogrel or policosanol allergies
- NYHA grade III ~ IV
- planned elective coronary revascularization for multivessel coronary artery disease
- long term warfarin treatment after persistent atrial fibrillation, valve surgery or other circumstance
- Severe liver or kidney dysfunction
- Active ulcer or a history of recent gastrointestinal bleeding
- History of coagulation disorder, or recent history of active bleeding
- history of intracranial hemorrhage within 6 months
- Pregnancy
- LDL less than 70mg/dL
- Severe systemic diseases with life expectancy less than 1 year
- planned surgery within next 6 months
Contacts and Locations| Contact: Yaling Han, MD | +86-24-23922184 | hanyaling@263.net |
| China, Liao Ning | |
| The First Hospital of China Medical University | Recruiting |
| Shenyang, Liao Ning, China, 110001 | |
| Principal Investigator: | Yaling Han, MD | Shenyang Northern Hospital |
More Information
No publications provided
| Responsible Party: | Yaling Han, Shenyang Northern Hospital |
| ClinicalTrials.gov Identifier: | NCT01371058 History of Changes |
| Other Study ID Numbers: | NH-20110530 |
| Study First Received: | May 31, 2011 |
| Last Updated: | June 9, 2011 |
| Health Authority: | China: Ministry of Health |
Keywords provided by Shenyang Northern Hospital:
|
high on-treatment platelet reactivity percutaneous coronary intervention stent thrombosis |
Additional relevant MeSH terms:
|
Coronary Artery Disease Myocardial Ischemia Coronary Disease Heart Diseases Cardiovascular Diseases Arteriosclerosis Arterial Occlusive Diseases Vascular Diseases Clopidogrel Policosanol Ticlopidine 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 Fibrinolytic Agents Fibrin Modulating Agents Cardiovascular Agents Anticholesteremic Agents Hypolipidemic Agents Antimetabolites Lipid Regulating Agents |
ClinicalTrials.gov processed this record on May 16, 2013