Apixaban + DAPT in Lowering Platelet Reactivity and Thrombin Generation

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

40 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-07-10

Study Completion Date

2019-11-08

Brief Summary

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Investigating Synergistic Effects of Apixaban with Dual Anti-Platelet Therapy (DAPT) in Lowering Platelet Reactivity and Thrombin Generation

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Detailed Description

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Combination anti-platelet therapies particularly those combining aspirin with a P2Y12 antagonist (DAPT) are regarded as the current standard of care therapy for patients with Acute Coronary Syndrome (ACS). As thrombin potently induces platelet dense granular release and causes secondary adenosine 5'-diphosphate (ADP)-mediated P2Y12 receptor activation, apixaban via inhibition of thrombin generation may exhibit synergistic activity with direct P2Y12 receptor blockers such as clopidogrel or ticagrelor. The results from the study will provide a clearer understanding of how these antithrombotic agents work in combination and how the anti-Xa, apixaban, may reduce the contribution of thrombin and general platelet reactivity when used alone and in combination with antiplatelet agents. This study does NOT involve administration of medication to subjects. Experiments will be performed on donated blood samples from participants.

Conditions

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Acute Coronary Syndrome

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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ACS using clopidogrel + aspirin

Apixaban combined with blood specimens (in vitro) from Acute Coronary Syndrome participants prescribed a regimen of DAPT in the form of clopidogrel + aspirin

Flow Cytrometry; Thrombin Generation Assay

Intervention Type DIAGNOSTIC_TEST

Apixaban combined with blood specimens (in vitro) of study participants

ACS using ticagrelor + aspirin

Apixaban combined with blood specimens (in vitro) from Acute Coronary Syndrome participants prescribed a regimen of DAPT in the form of ticagrelor + aspirin

Flow Cytrometry; Thrombin Generation Assay

Intervention Type DIAGNOSTIC_TEST

Apixaban combined with blood specimens (in vitro) of study participants

Healthy Donors

Apixaban combined with blood specimens (in vitro) from healthy participants

Flow Cytrometry; Thrombin Generation Assay

Intervention Type DIAGNOSTIC_TEST

Apixaban combined with blood specimens (in vitro) of study participants

Interventions

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Flow Cytrometry; Thrombin Generation Assay

Apixaban combined with blood specimens (in vitro) of study participants

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Provision of informed consent prior to any study specific procedures (i.e., venipuncture).
2. Male or female at least 18 years of age but equal to or less than 75 years of age.
3. Females must be post-menopausal for at least one year or surgically sterile for at least 6 months.
4. For ACS Subjects:

1. Documented prior history of ACS within the past 12 months.

Exclusion Criteria

3. Have taken DAPT medication for at least 7 days as prescribed prior to blood collection.
5. For Healthy Subjects:

1. Male or female less than 18 or greater than 75 years of age.
2. No prior history of ACS within 12 months (unless Healthy Subject)
3. Pregnancy
4. Currently prescribed and/or taking any of the following medications:

Within the last 1 month:
* PAR-1 antagonist (vorapaxar/Zontivity®)
* Coumadin®
* Heparin including low molecular weight heparin (enoxaparin/Lovenox®)
* Factor Xa inhibitors (rivaroxaban/Xarelto®, apixaban/Eliquis®, edoxaban/Savaysa®, betrixaban/Bevyxxa®)
* Direct thrombin inhibitors (hirudin, bivalirudin/Angiomax®, dabigatran/Pradaxa®)

Within last 10 days:
* Glycoprotein IIb/IIIa inhibitors (Eptifibatide/Integrilin®, Tirofiban/Aggrastat®, Abciximab/ReoPro®)
* Acetylsalicylic Acid/Aspirin products (Alka-Seltzer®, Goody Powder®, BC Powder®, Pepto Bismol®, Aggrenox®) (except aspirin as prescribed for DAPT participants)

Within last 3 days:
* Phosphodiesterase inhibitors (cilostazol/Pletal®)
* Adenosine reuptake inhibitors (dipyridamole/Persantine®)
* NSAIDs
* Decongestants
* Antidepressants or Anti-anxiety medications:
* Selective Serotonin Reuptake Inhibitors (SSRI) (fluoxetine/Prozac®, sertraline/Zoloft®, paroxetine/Paxil®)
* Selective Norepinephrine Reuptake Inhibitors (SNRI) (venlafaxine/Effexor® or duloxetine/Cymbalta®)
5. Diagnosed with or possessing significant renal dysfunction as defined by the physician/investigator.

Minimum Eligible Age

18 Years

Maximum Eligible Age

74 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes