Platelet-dependent Thrombosis: a Placebo-controlled Trial of Antiplatelet Therapy (Clopidogrel)

NCT ID: NCT00728156

Last Updated: 2015-10-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-08-31

Study Completion Date

2012-04-30

Brief Summary

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Patients with diabetes are more likely to develop furring of their coronary arteries and present with angina and heart attacks. Furthermore, after such an event, they have poorer outcomes (higher rates of death) and survivors are more likely to have recurring symptoms. Using a novel "clotting chamber" the investigators have shown that patients with diabetes are more likely to develop blood clots. This study will look at the role of different blood thinning medications in patients with diabetes. If successful, the investigators will provide evidence to conduct large clinical studies to look at the role of additional blood thinning medication in reducing heart attacks and strokes in patients with diabetes.

Detailed Description

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The objective of this study is to compare the effect of Clopidogrel on platelet dependent thrombosis in patients with T2DM and CAD with placebo. The Badimon chamber, an ex vivo arterial injury model is used for this purpose. This model simulates the in vivo situation of high shear arterial wall damage and helps to quantify thrombus which is the sum endpoint of all haemostatic abnormalities seen in vitro.

Conditions

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Type 2 Diabetes Mellitus Coronary Artery Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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C

Patients assigned to clopidogrel in addition to their standard care.(all patients will be on aspirin)We aim to study the effect of clopidogrel as dual antiplatelet therapy in patients with established coronary artery disease and type 2 diabetes. Ninety patients with type 2 diabetes and stable coronary artery disease has been randomly treated with clopidogrel or placebo (45 each) for one week in addition to their standard care (including aspirin,75 mg once daily).

Group Type ACTIVE_COMPARATOR

clopidogrel

Intervention Type DRUG

75 milligrams, oral, clopidogrel, one tablet daily, for seven days after the baseline chamber study.

P

Patients assigned to placebo in addition to their standard care.(all patients will be on aspirin).This is a single-centre randomised double-blind placebo-controlled parallel design study, comparing efficacy of clopidogrel versus placebo in patients with T2DM and coronary artery disease. Ninety patients have completed the study. All patients were on their routine medications as per standard practice. After informed consent, participants were randomised to receive either clopidogrel 75mg daily or placebo for 7 days.

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

Placebo: Hydroxy methyl cellulose, similar in weight to the active medication 75 mgs, oral tablets, once a day

Interventions

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clopidogrel

75 milligrams, oral, clopidogrel, one tablet daily, for seven days after the baseline chamber study.

Intervention Type DRUG

placebo

Placebo: Hydroxy methyl cellulose, similar in weight to the active medication 75 mgs, oral tablets, once a day

Intervention Type DRUG

Other Intervention Names

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Plavix, 75 milligrams Sanofi Pharma Bristol-Myers Squibb SNC 174 Avenue de France F-75013 Paris - France EU/1/98/069/005a

Eligibility Criteria

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Inclusion Criteria

* Patients with T2DM and CAS as defined below:

* Clinical definitions
* T2DM: Diagnosed according to the WHO criteria \[53\].
* CAD:Presence of any one of the following: Angina plus positive exercise tolerance test, enzyme and/or Q wave positive myocardial infarction, angiographic evidence ( \>50% stenosis of one vessel), percutaneous or surgical coronary revascularisation.
* Aged between 18 and 75
* Provided written consent for participation in the trial prior to any study-specific procedures or requirements.

Exclusion Criteria

* Contraindication to Clopidogrel
* Smoking (current smokers and patients who quit smoking less than six months)
* Malignancy(diagnosed or under investigation)
* Haematological disorders (Anaemia, malignancy, bleeding disorders)
* Women of child-bearing potential
* Use of corticosteroids/other antithrombotic agents(warfarin)
* Chronic liver disease (Cirrhosis, malignancy and patients with more than twice the upper limit of liver function tests)
* Unable to consent.
* Use of other investigational study drugs within 1 year prior to study entry
* Previous participation in this study
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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British Heart Foundation

OTHER

Sponsor Role collaborator

University of Newcastle Upon-Tyne

OTHER

Sponsor Role collaborator

Newcastle-upon-Tyne Hospitals NHS Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Azfar G Zaman, MD FRCP

Role: PRINCIPAL_INVESTIGATOR

Consultant cardiologist and Honoraray Lecturer

Locations

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Newcastle Diabetes Centre, Newcastle General Hospital

Newcastle upon Tyne, Tyne and Wear, United Kingdom

Site Status

Freeman Hospital

Newcastle upon Tyne, Tyne and Wear, United Kingdom

Site Status

Countries

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United Kingdom

References

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Natarajan A, Marshall SM, Worthley SG, Badimon JJ, Zaman AG. The presence of coronary artery disease increases platelet-dependent thrombosis in patients with type 2 diabetes mellitus. J Thromb Haemost. 2008 Dec;6(12):2210-3. doi: 10.1111/j.1538-7836.2008.03176.x. Epub 2008 Oct 1. No abstract available.

Reference Type BACKGROUND
PMID: 18983525 (View on PubMed)

Osende JI, Badimon JJ, Fuster V, Herson P, Rabito P, Vidhun R, Zaman A, Rodriguez OJ, Lev EI, Rauch U, Heflt G, Fallon JT, Crandall JP. Blood thrombogenicity in type 2 diabetes mellitus patients is associated with glycemic control. J Am Coll Cardiol. 2001 Nov 1;38(5):1307-12. doi: 10.1016/s0735-1097(01)01555-8.

Reference Type BACKGROUND
PMID: 11691500 (View on PubMed)

Shechter M, Merz CN, Paul-Labrador MJ, Kaul S. Blood glucose and platelet-dependent thrombosis in patients with coronary artery disease. J Am Coll Cardiol. 2000 Feb;35(2):300-7. doi: 10.1016/s0735-1097(99)00545-8.

Reference Type BACKGROUND
PMID: 10676673 (View on PubMed)

Helft G, Osende JI, Worthley SG, Zaman AG, Rodriguez OJ, Lev EI, Farkouh ME, Fuster V, Badimon JJ, Chesebro JH. Acute antithrombotic effect of a front-loaded regimen of clopidogrel in patients with atherosclerosis on aspirin. Arterioscler Thromb Vasc Biol. 2000 Oct;20(10):2316-21. doi: 10.1161/01.atv.20.10.2316.

Reference Type BACKGROUND
PMID: 11031221 (View on PubMed)

Natarajan A, Zaman AG, Marshall SM. Platelet hyperactivity in type 2 diabetes: role of antiplatelet agents. Diab Vasc Dis Res. 2008 Jun;5(2):138-44. doi: 10.3132/dvdr.2008.023.

Reference Type BACKGROUND
PMID: 18537103 (View on PubMed)

Other Identifiers

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British Heart Foundation

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

3639a

Identifier Type: -

Identifier Source: org_study_id

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