Platelet Reactivity After an Eastern Asian Loading Dose of Prasugrel in Taiwanese ACS Patients

NCT ID: NCT04768582

Last Updated: 2021-02-26

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-05-01

Study Completion Date

2021-05-01

Brief Summary

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Prasugrel has a faster onset of action and greater platelet inhibition with less inter-individual response variability than clopidogrel. Japan and Taiwan are the only two nations where adjusted/Asian dose of prasugrel (loading dose (LD)/maintenance (MD): 20/3.75 mg) was approved for clinical use. However, there is no data regarding the effectiveness of adjusted dose of prasugrel on platelet reactivity in Taiwanese patients with acute coronary syndrome (ACS). This study aim to evaluate the pharmacodynamic of the Asian dose prasugrel on the platelet reactivity after percutaneous coronary intervention (PCI) for patients with ACS.

Detailed Description

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Rationale and Background Prasugrel provides more potent and rapid platelet inhibition compared to Clopidogrel.

Rapid and effective inhibition of the platelet P2Y12 receptor is of pivotal importance in patients with AMI who undergo PCI.

Prasugrel (60 mg loading and 10 mg/day maintenance dose) is a new generation P2Y12 inhibitor that achieves greater and faster platelet inhibition comparing with clopidogrel in patients undergoing PCI.

As revealed by 2 head-to-head studies, reducing Prasugrel dosages to 20/3.75 LD/MD (mg) was still efficacious but led to less bleeding events than the original 60/10 LD/MD (mg).

In TRITON-TIMI 38 trial, prasugrel was associated with not only significantly less ischemic events but also more non-CABG TIMI major bleeding, as compared to Clopidogrel.

In the PRASFIT-ACS study from Japan (20 mg loading and 3.75 mg/day maintenance dose), prasugrel was associated with a 23% reduction of MACE and the incidence of non-CABG major bleeding was similar to clopidogrel.

There is NO data regarding the effectiveness of Japanese loading dose of prasugrel on platelet reactivity in Taiwanese patients with AMI.

This study use PRU for efficacy and ISTH major bleeding for safety evaluations; the anticipated results are prompt and effective platelet inhibition as well as comparably low bleeding rate.

Conditions

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Acute Coronary Syndrome Hemorrhage Treatment Side Effects

Keywords

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Acute Coronary Syndrome Prasugrel VerifyNow-P2Y12 assay

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Efient group

ACS patients who received oral Prasugrel after coronary angiography been done

Group Type EXPERIMENTAL

P2Y12-reaction-units (PRU) by VerifyNow-P2Y12 assay

Intervention Type DIAGNOSTIC_TEST

The efficacy endpoint was platelet reactivity, of which was serially assessed using the VerifyNow-P2Y12 assay and the results were expressed as P2Y12-reaction-units (PRU).

Interventions

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P2Y12-reaction-units (PRU) by VerifyNow-P2Y12 assay

The efficacy endpoint was platelet reactivity, of which was serially assessed using the VerifyNow-P2Y12 assay and the results were expressed as P2Y12-reaction-units (PRU).

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Age\>=20
* Mentally competent to provide an informed consent.
* A person being diagnosed with acute coronary syndrome and arranged for a percutaneous coronary intervention.

Exclusion Criteria

* A history of hemorrhagic stroke at any time in the past.
* Active internal bleeding or has a history of a bleeding disorder (i.e. hemophilia).
* Severe liver disease; for example, cirrhosis.
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cheng-Hsin General Hospital

OTHER

Sponsor Role collaborator

Feng Yuan Hospital, Ministry of Health and Welfare

OTHER_GOV

Sponsor Role lead

Responsible Party

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Chen-Rong, Tsao M.D.

Chief of Cardiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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CHEN RONG TSAO, M.D.

Role: PRINCIPAL_INVESTIGATOR

Feng Yuang Hospital

Locations

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Feng Yuan Hospital

Taichung, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Ms. Hao-Yien Pan

Role: CONTACT

Phone: +88625271180

Email: [email protected]

Facility Contacts

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ChenRong Tsao, M.D.

Role: primary

Other Identifiers

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FYHIRB109001

Identifier Type: -

Identifier Source: org_study_id