Clinical Significance of Platelet Reactivity on Clopidogrel During Off-pump Coronary Artery Bypass

NCT ID: NCT01959191

Last Updated: 2013-10-09

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

Total Enrollment

859 participants

Study Classification

OBSERVATIONAL

Study Start Date

2008-01-31

Study Completion Date

2013-07-31

Brief Summary

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Objective: To evaluate the early and late prognoses of patients according to platelet reactivity after clopidogrel administration and determine whether the measurement of platelet inhibition predicted 1-year clinical outcomes after off-pump coronary bypass (OPCAB) Study design

* Prospective, observational, single-center study
* Subjects with OPCAB surgery who meet all inclusion and exclusion criteria will be enrolled.
* Platelet reactivity after 7-days clopidogrel treatment from the day of surgery will be measured by VerifyNow system.
* Dual antiplatelet therapy including aspirin and clopidogrel will be administered for 1 year after surgery and subjects will be followed-up for 1 year about primary endpoint.
* Cutoff value of P2Y12 reactivity units (PRUs) for primary endpoint will be assessed and the cohort will be divided by the PRU cutoff value (low/high platelet reactivity groups).
* The primary and secondary endpoints will be compared between two groups

Detailed Description

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Conditions

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Coronary Artery Disease

Keywords

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Platelet activity, CABG, off-pump surgery

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Low platelet reactivity group

Platelet reactivity will be measured after 7-days treatment of clopidogrel by VerifyNow system and the cohort will be divided by two group according to P2Y12 reactivity unit (PRU) cutoff value. Receiver operating characteristic (ROC) curves will be plotted to assess the optimal PRU cutoff value for differentiating between patients with and without subsequent MACEs after 1 year of follow-up. Low platelet reactivity indicates good response to clopidogrel and high platelet reactivity, resistance to clopidogrel. Groups will be "Low platelet reactivity group" and "High platelet reactivity group"

Dual antiplatelet therapy including aspirin and clopidogrel after off-pump coronary bypass surgery

Intervention Type DRUG

aspirin 100mg/day and clopidogrel 75mg/day, PO, from the day of surgery for 1 year

high platelet reactivity group

Platelet reactivity will be measured after 7-days treatment of clopidogrel by VerifyNow system and the cohort will be divided by two group according to P2Y12 reactivity unit (PRU) cutoff value. Receiver operating characteristic (ROC) curves will be plotted to assess the optimal PRU cutoff value for differentiating between patients with and without subsequent MACEs after 1 year of follow-up. Low platelet reactivity indicates good response to clopidogrel and high platelet reactivity, resistance to clopidogrel. Groups will be "Low platelet reactivity group" and "High platelet reactivity group"

Dual antiplatelet therapy including aspirin and clopidogrel after off-pump coronary bypass surgery

Intervention Type DRUG

aspirin 100mg/day and clopidogrel 75mg/day, PO, from the day of surgery for 1 year

Interventions

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Dual antiplatelet therapy including aspirin and clopidogrel after off-pump coronary bypass surgery

aspirin 100mg/day and clopidogrel 75mg/day, PO, from the day of surgery for 1 year

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients with indications for surgical myocardial revascularization
* Patients who undergo off-pump coronary artery bypass
* Age between 19\~80 years
* Patients with signed informed consent

Exclusion Criteria

* Patients with combined surgery with coronary bypass grafting
* On-pump conversion
* Patients with moderate renal dysfunction (creatinine\>2.0mg/dl) or need for dialysis
* Patients with chronic treatment with proton pump inhibitors
* Patients with preoperative bleeding
* Thrombocytopenia (Platelet count 70,000/ml)
* Re-do surgery
* Early death before the measurement of platelet reactivity
Minimum Eligible Age

19 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yonsei University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Division of Cardiovascular Surgery, Severance Cardiovascular Hospital , Yonsei University College of Medicine

Seoul, , South Korea

Site Status

Countries

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South Korea

References

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Patti G, Nusca A, Mangiacapra F, Gatto L, D'Ambrosio A, Di Sciascio G. Point-of-care measurement of clopidogrel responsiveness predicts clinical outcome in patients undergoing percutaneous coronary intervention results of the ARMYDA-PRO (Antiplatelet therapy for Reduction of MYocardial Damage during Angioplasty-Platelet Reactivity Predicts Outcome) study. J Am Coll Cardiol. 2008 Sep 30;52(14):1128-33. doi: 10.1016/j.jacc.2008.06.038.

Reference Type BACKGROUND
PMID: 18804738 (View on PubMed)

Other Identifiers

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4-2011-0309

Identifier Type: -

Identifier Source: org_study_id