The Randomized OPTIMAL-ACT Trial

NCT ID: NCT03772613

Last Updated: 2023-04-04

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-02-08

Study Completion Date

2021-10-25

Brief Summary

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The purpose of this study is to find the ideal range of the activated clotting time (ACT) during percutaneous coronary intervention (PCI) that is associated with lowering the rate of undesirable medical outcomes

Detailed Description

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Conditions

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Coronary Artery Disease Ischemic Heart Disease Anticoagulant-induced Bleeding Coronary Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Low ACT Target

ACT target range of 225 to 275 seconds is achieved prior to PCI if no planned glycoprotein IIb/IIIa inhibitor used

Group Type ACTIVE_COMPARATOR

Unfractionated heparin

Intervention Type DRUG

Administration of unfractionated heparin will be assessed using the activated clotting time

Medium ACT Target

ACT target range of 275 to 325 seconds is achieved prior to PCI if no planned glycoprotein IIb/IIIa inhibitor used

Group Type ACTIVE_COMPARATOR

Unfractionated heparin

Intervention Type DRUG

Administration of unfractionated heparin will be assessed using the activated clotting time

High ACT Target

ACT target range of 325 to 375 seconds is achieved prior to PCI if no planned glycoprotein IIb/IIIa inhibitor used

Group Type ACTIVE_COMPARATOR

Unfractionated heparin

Intervention Type DRUG

Administration of unfractionated heparin will be assessed using the activated clotting time

Interventions

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Unfractionated heparin

Administration of unfractionated heparin will be assessed using the activated clotting time

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age\>18
* Referred for coronary angiography with possible coronary revascularization or adjunctive invasive diagnostic testing (IVUS/OCT, FFR, or iFR)

Exclusion Criteria

* Receipt of LMWH at treatment dose (not DVT prophylaxis dose) within 6 hours of coronary angiography
* Prior GP IIb/IIIa use within the previous 72 hours
* Use of warfarin (vitamin K antagonist) or direct oral anticoagulant
* Patients on LMWH bridging strategy
* PCI within prior 30 days
* Planned use of bivalirudin as the procedural anticoagulant
* Rotational atherectomy
* Excimer laser coronary angioplasty
* Chronic total occlusions
* Patients with active bleeding disorders or bleeding diathesis
* Patients with ST-segment elevation myocardial infarction
* Patient with clinical evidence of cardiogenic shock (defined as SBP\<90 mmHg for ≥30 min OR support to maintain SBP ≥90 mmHg AND evidence of end-organ hypoperfusion (urine output \<30 mL/h or cool extremities)
* Chronic kidney disease stage 4/5 (GFR 30 mL/min)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Shahyar M. Gharacholou

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Shahyar M Gharacholou, MD, MSc

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Mayo Clinic in Florida

Jacksonville, Florida, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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Other Identifiers

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18-005209

Identifier Type: -

Identifier Source: org_study_id

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