Trial Outcomes & Findings for Clopidogrel Monotherapy in Patients With High Bleeding Risk (NCT NCT05223335)

NCT ID: NCT05223335

Last Updated: 2024-02-21

Results Overview

The number of participants to experience ischemic events as defined as cardiac deaths, spontaneous myocardial infarctions (MIs) and stent thrombosis after percutaneous intervention (PCI).

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

98 participants

Primary outcome timeframe

Through study completion, approximately 90 days.

Results posted on

2024-02-21

Participant Flow

Participant milestones

Participant milestones
Measure
Genotype-Guided Therapy
Subjects with high bleeding risk (HBR) on dual antiplatelet therapy (DAPT) with clopidogrel and aspirin, that underwent successful percutaneous coronary intervention (PCI) were stratified by the CYP2C19 loss-of-function (LOF) allele within one week of DAPT initiation. In this group, subjects identified as CYP2C19\*2 or\*3 LOF allele carrier were given prasugrel or ticagrelor monotherapy. Prasugrel: 60 mg bolus then 10 mg daily Tricagrelor: 180 mg bolus then 90 mg twice daily
Conventional Therapy
Subjects with high bleeding risk (HBR) on dual antiplatelet therapy (DAPT) with clopidogrel and aspirin, that underwent successful percutaneous coronary intervention (PCI) were stratified by the CYP2C19 loss-of-function (LOF) allele within one week of DAPT initiation. In this group, subjects identified as CYp2C19\*2 or\*3 LOF allele non-carriers continued with clopidogrel monotherapy. Clopidogrel: 75 mg/day
Overall Study
STARTED
29
69
Overall Study
COMPLETED
29
69
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Clopidogrel Monotherapy in Patients With High Bleeding Risk

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Genotype-Guided Therapy
n=29 Participants
Subjects with high bleeding risk (HBR) on dual antiplatelet therapy (DAPT) with clopidogrel and aspirin, that underwent successful percutaneous coronary intervention (PCI) were stratified by the CYP2C19 loss-of-function (LOF) allele within one week of DAPT initiation. In this group, subjects identified as CYP2C19\*2 or\*3 LOF allele carrier were given prasugrel or ticagrelor monotherapy. Prasugrel: 60 mg bolus then 10 mg daily Tricagrelor: 180 mg bolus then 90 mg twice daily
Conventional Therapy
n=69 Participants
Subjects with high bleeding risk (HBR) on dual antiplatelet therapy (DAPT) with clopidogrel and aspirin, that underwent successful percutaneous coronary intervention (PCI) were stratified by the CYP2C19 loss-of-function (LOF) allele within one week of DAPT initiation. In this group, subjects identified as CYp2C19\*2 or\*3 LOF allele non-carriers continued with clopidogrel monotherapy. Clopidogrel: 75 mg/day
Total
n=98 Participants
Total of all reporting groups
Age, Continuous
72.8 years
STANDARD_DEVIATION 11.7 • n=5 Participants
75.3 years
STANDARD_DEVIATION 10.8 • n=7 Participants
74.6 years
STANDARD_DEVIATION 11.1 • n=5 Participants
Sex: Female, Male
Female
11 Participants
n=5 Participants
23 Participants
n=7 Participants
34 Participants
n=5 Participants
Sex: Female, Male
Male
18 Participants
n=5 Participants
46 Participants
n=7 Participants
64 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
29 Participants
n=5 Participants
69 Participants
n=7 Participants
98 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
White
26 Participants
n=5 Participants
68 Participants
n=7 Participants
94 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
29 participants
n=5 Participants
69 participants
n=7 Participants
98 participants
n=5 Participants

PRIMARY outcome

Timeframe: Through study completion, approximately 90 days.

The number of participants to experience ischemic events as defined as cardiac deaths, spontaneous myocardial infarctions (MIs) and stent thrombosis after percutaneous intervention (PCI).

Outcome measures

Outcome measures
Measure
Genotype-Guided Therapy
n=29 Participants
Subjects with high bleeding risk (HBR) on dual antiplatelet therapy (DAPT) with clopidogrel and aspirin, that underwent successful percutaneous coronary intervention (PCI) were stratified by the CYP2C19 loss-of-function (LOF) allele within one week of DAPT initiation. In this group, subjects identified as CYP2C19\*2 or\*3 LOF allele carrier were given prasugrel or ticagrelor monotherapy. Prasugrel: 60 mg bolus then 10 mg daily Tricagrelor: 180 mg bolus then 90 mg twice daily
Conventional Therapy
n=69 Participants
Subjects with high bleeding risk (HBR) on dual antiplatelet therapy (DAPT) with clopidogrel and aspirin, that underwent successful percutaneous coronary intervention (PCI) were stratified by the CYP2C19 loss-of-function (LOF) allele within one week of DAPT initiation. In this group, subjects identified as CYp2C19\*2 or\*3 LOF allele non-carriers continued with clopidogrel monotherapy. Clopidogrel: 75 mg/day
Ischemic Risk Post-PCI in High Bleed Risk Patients With Genotype-guided Single Antiplatelet Therapy
0 Participants
1 Participants

Adverse Events

Genotype-Guided Therapy

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Conventional Therapy

Serious events: 1 serious events
Other events: 3 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Genotype-Guided Therapy
n=29 participants at risk
Subjects with high bleeding risk (HBR) on dual antiplatelet therapy (DAPT) with clopidogrel and aspirin, that underwent successful percutaneous coronary intervention (PCI) were stratified by the CYP2C19 loss-of-function (LOF) allele within one week of DAPT initiation. In this group, subjects identified as CYP2C19\*2 or\*3 LOF allele carrier were given prasugrel or ticagrelor monotherapy. Prasugrel: 60 mg bolus then 10 mg daily Tricagrelor: 180 mg bolus then 90 mg twice daily
Conventional Therapy
n=69 participants at risk
Subjects with high bleeding risk (HBR) on dual antiplatelet therapy (DAPT) with clopidogrel and aspirin, that underwent successful percutaneous coronary intervention (PCI) were stratified by the CYP2C19 loss-of-function (LOF) allele within one week of DAPT initiation. In this group, subjects identified as CYp2C19\*2 or\*3 LOF allele non-carriers continued with clopidogrel monotherapy. Clopidogrel: 75 mg/day
Vascular disorders
Possible Stent Thrombosis
0.00%
0/29 • Adverse Events were collected from baseline to end of study, approximately 90 days
1.4%
1/69 • Number of events 1 • Adverse Events were collected from baseline to end of study, approximately 90 days

Other adverse events

Other adverse events
Measure
Genotype-Guided Therapy
n=29 participants at risk
Subjects with high bleeding risk (HBR) on dual antiplatelet therapy (DAPT) with clopidogrel and aspirin, that underwent successful percutaneous coronary intervention (PCI) were stratified by the CYP2C19 loss-of-function (LOF) allele within one week of DAPT initiation. In this group, subjects identified as CYP2C19\*2 or\*3 LOF allele carrier were given prasugrel or ticagrelor monotherapy. Prasugrel: 60 mg bolus then 10 mg daily Tricagrelor: 180 mg bolus then 90 mg twice daily
Conventional Therapy
n=69 participants at risk
Subjects with high bleeding risk (HBR) on dual antiplatelet therapy (DAPT) with clopidogrel and aspirin, that underwent successful percutaneous coronary intervention (PCI) were stratified by the CYP2C19 loss-of-function (LOF) allele within one week of DAPT initiation. In this group, subjects identified as CYp2C19\*2 or\*3 LOF allele non-carriers continued with clopidogrel monotherapy. Clopidogrel: 75 mg/day
Vascular disorders
BARC 3 bleeding event
0.00%
0/29 • Adverse Events were collected from baseline to end of study, approximately 90 days
4.3%
3/69 • Number of events 3 • Adverse Events were collected from baseline to end of study, approximately 90 days

Additional Information

Mandeep Singh, M.D.

Mayo Clinic

Phone: 507-255-2398

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place