Antiplatelet Therapies in Patients With Depression and Coronary Disease

NCT ID: NCT05821062

Last Updated: 2023-04-20

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

Total Enrollment

400 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-04-14

Study Completion Date

2024-02-29

Brief Summary

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Depression after an acute coronary syndrome (ACS) but also at any time after CAD diagnosis, is highly associated with death, and it predicts mortality more than any other risk factor, comorbidity or follow-up events, suggesting that the standard medical therapy may not be sufficient to prevent the poor prognosis in these patients.

This study aims to assess whether depression might affect the response to dual antiplatelet therapy (DAPT) as recommended in coronary artery disease (CAD) patients.

Specific aims:

* to evaluate whether depression affects the antithrombotic response during Aspirin (ASA) plus clopidogrel (CLP) therapy in CAD patients.
* to assess the antithrombotic effects of ASA plus ticagrelor or prasugrel (TCG/PSG) therapy in CAD patients with depression by evaluating pro-thrombotic phenotype in CAD patients with and without depression during ASA+TCG/PSG.
* to assess whether there is or not the reactivation of pro-thrombotic profile after cessation of dual antiplatelet therapy in CAD patients with or without depression in single antiplatelet therapy after TCG/PSG cessation.

Detailed Description

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This study is a multicentre, prospective, observational, case-control, and cross-sectional study. It is planned to enrol 400 patients/subjects (300 patients at Centro Cardiologico Monzino and 100 subjects at IRCCS National Neurological Institute "C. Mondino" Foundation).

Pharmacological treatments in progress will be recorded, administration of Beck Depression Inventory-II (BDI-II), and a fasting blood venous sample (from ante-cubital vein) will be carried out for the haematochemical analyses and for research samples. First morning-urine will be collected for oxidative stress evaluation.

Conditions

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Coronary Artery Disease Depression

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Group 1a

CAD patients with depression on standard ASA+CLP therapy.

standard Aspirin (ASA) + clopidogrel (CLP) therapy

Intervention Type OTHER

ASA100mg + CLP 75mg daily

Group 1b

CAD Patients without depression on standard ASA+CLP therapy.

standard Aspirin (ASA) + clopidogrel (CLP) therapy

Intervention Type OTHER

ASA100mg + CLP 75mg daily

Group 2a

CAD patients with depression on standard ASA+TCG/PSG therapy.

standard Aspirin (ASA) + Ticagrelor (TCG) or Prasugrel (PSG) therapy

Intervention Type OTHER

ASA 100 mg + TCG 90mg/b.i.d or PSG10mg daily

Group 2b

CAD patients without depression on standard ASA+TCG/PSG therapy.

standard Aspirin (ASA) + Ticagrelor (TCG) or Prasugrel (PSG) therapy

Intervention Type OTHER

ASA 100 mg + TCG 90mg/b.i.d or PSG10mg daily

Group 3a

CAD patients with depression on standard ASA treatment alone at least 1 month after TCG/PSG cessation.

standard ASA therapy

Intervention Type OTHER

ASA 100 mg daily

Group 3b

CAD patients without depression on standard ASA treatment alone at least 1 month after TCG/PSG cessation.

standard ASA therapy

Intervention Type OTHER

ASA 100 mg daily

Group 1c

Subjects with depression without CAD (DS) are enrolled are enrolled as a comparison group.

No interventions assigned to this group

Group 1d

Healthy control subjects (HC), subjects without depression and without CAD are enrolled as a comparison group.

No interventions assigned to this group

Interventions

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standard Aspirin (ASA) + clopidogrel (CLP) therapy

ASA100mg + CLP 75mg daily

Intervention Type OTHER

standard Aspirin (ASA) + Ticagrelor (TCG) or Prasugrel (PSG) therapy

ASA 100 mg + TCG 90mg/b.i.d or PSG10mg daily

Intervention Type OTHER

standard ASA therapy

ASA 100 mg daily

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Centro Cardiologico Monzino: Patients/subjects of both sexes, aged between 18 and 85 years with or without depression, with CAD:

* Group 1: CAD patients in ASA+CLP (100mg+75mg/daily) therapy with the absence of acute coronary symptoms for at least 5 months.
* Group 2: CAD patients in ASA+TCG/PSG (TCG:90mg/b.i.d or PSG:10mg/daily) therapy, at least 6 months after ACS.
* Group 3: CAD patients during ASA treatment alone at least 1 month after TCG/PSG cessation.
2. IRCCS National Neurological Institute "C. Mondino" Foundation:

* Group 1: Patients/subjects of both sexes, aged between 18 and 85 years with or without depression, without CAD.

Exclusion Criteria

* severe chronic heart failure (NYHA class III/IV)
* severe concomitant valvular disease
* infectious pathologies
* autoimmune diseases
* haematological diseases
* serious kidney or liver failure
* positive anamnesis for current or previous neoplasia in the 5 years prior to enrolment
* positive anamnesis for major traumas and/or surgery in the 6 months prior to enrolment
* taking immunosuppressive drugs
* taking of anti-inflammatory drugs
* taking of antidepressant drugs
* presence of dementia and psychiatric disorders other than depression
* Coronavirus disease-19 (COVID-19) swab positive
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS National Neurological Institute "C. Mondino" Foundation

OTHER

Sponsor Role collaborator

Centro Cardiologico Monzino

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Giancarlo Marenzi, MD

Role: PRINCIPAL_INVESTIGATOR

IRCCS Centro Cardiologico Monzino

Locations

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IRCCS Centro Cardiologico Monzino

Milan, , Italy

Site Status RECRUITING

IRCCS National Neurological Institute "C. Mondino" Foundation

Pavia, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Giancarlo Marenzi, MD

Role: CONTACT

02.58002582

Silvia Stella Barbieri, PhD

Role: CONTACT

02.58002021

Facility Contacts

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Giancarlo Marenzi, MD

Role: primary

02.58002582

Silvia Stella Barbieri, PhD

Role: backup

02.58002021

Giulia Perini, MD

Role: primary

0382.380343

Other Identifiers

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CCM 1422

Identifier Type: -

Identifier Source: org_study_id

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