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Acute Myocardial InfarctionNCT01144819

Platelet Inhibition in the Acute Phase of STEMI

An observational study of Acute Myocardial Infarction and Antiplatelet Therapy, run by University of Aarhus at 1 site in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Background: Dual antithrombotic treatment with aspirin and clopidogrel is recommended in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Read more about this study

Who is it for?
Ages 18 years and older
How many people
46 participants
Where
1 siteDenmark
Study dates
Oct 2009to Aug 2010
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Residents of the Central Denmark Region.

Who may be able to join

  • Above 18 years of age
  • Patients with ST-segment elevation myocardial infarction (STEMI) referred to primary PCI at University Hospital of Aarhus, Skejby.

Who cannot join

  • Treatment with NSAID, ticlopidine and dipyramidole.
  • Treatment with anticoagulants (Vitamin K antagonists)
  • Patients diagnosed with platelet disease or haemophilia.
  • Patients unable to give written, informed consent to participation in this project.

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Aarhus University Hospital, Skejby

    Aarhus N, Central Jutland, 8200

Other trials in Denmark

About this study

Official title: Platelet Inhibition in the Acute Phase of ST-segment Elevation Myocardial Infarction

Background:

Dual antithrombotic treatment with aspirin and clopidogrel is recommended in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). The European Society of Cardiology (ESC) Guidelines recommend a bolus dose of aspirin of 250-500 mg and a 600 mg bolus dose of clopidogrel as soon as STEMI is suspected. Studies have shown that more newly produced platelets are present in the acute phase of STEMI, and it is likely that these immature platelets are haemostatically more active and might be of importance in thrombus formation.

Read more

The enhanced platelet reactivity may reduce the effect of aspirin and clopidogrel in the acute phase of STEMI compared to measurements made in the same patients 3 months after primary PCI.

Aim:

This study aims to compare platelet response to aspirin and clopidogrel in the acute phase of STEMI with the platelet response in the same patients 3 months after STEMI .

Design:

This study is an observational follow-up study.

Materials and methods:

46 patients with STEMI referred to primary PCI at Aarhus University Hospital, Skejby will be included in the study. A total of 3 blood samples are obtained in the acute phase of STEMI: Prior to primary PCI (Blood sample 1), at 4 hours (Blood sample 2) and at 12 hours (Blood sample 3) after administration of loading dose aspirin and clopidogrel. When patients are in a stable phase 3 month later, a final blood sample is taken (Blood sample 4). The blood is analyzed 30 minutes after withdrawal of blood by the platelet aggregation test Multiplate® aggregometry (agonists: Collagen, arachidonic acid and adenosinediphosphate) and VerifyNow® arachidonic acid and P2Y12 aggregometry. Platelet count, volume and the immature platelet fraction (IPF) will be measured using Sysmex® flowcytometry.

Keywords
STEMI, Acute myocardial infarction, Antiplatelet therapy, aspirin, clopidogrel, VerifyNow aggregometry, Multiplate aggregometry
Medical subject headings
ST Elevation Myocardial Infarction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT01144819
Study groupRoleWhat they receive
STEMIPatients with STEMI according to ESC STEMI guidelines: Age above 18 years and able to give written, informed consent to participation in the project.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Difference between aggregation induced by agonist collagen (1 μg/ml) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 1: Obtained immediately before primary PCI in the catherization laboratory. The blood sample is obtained from the femoral artery catheter.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  2. Difference between aggregation induced by agonist collagen (1 μg/ml) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 2: 4 hours after administration of loading dose (LD) aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  3. Difference between aggregation induced by agonist collagen (1 μg/ml) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 3: 12 hours after administration of LD aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  4. Difference between aggregation induced by agonist arachidonic acid (1,0 mM) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 1: Obtained immediately before primary PCI in the catherization laboratory. The blood sample is obtained from the femoral artery catheter.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  5. Difference between aggregation induced by agonist arachidonic acid (1,0 mM) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 2: 4 hours after administration of loading dose (LD) aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  6. Difference between aggregation induced by agonist arachidonic acid (1,0 mM) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 3: 12 hours after administration of LD aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  7. Difference between aggregation induced by agonist adenosine diphosphate (6,4 µM) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 1: Obtained immediately before primary PCI in the catherization laboratory. The blood sample is obtained from the femoral artery catheter.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  8. Difference between aggregation induced by agonist adenosine diphosphate (6,4 µM) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 2: 4 hours after administration of loading dose (LD) aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  9. Difference between aggregation induced by agonist adenosine diphosphate (6,4 µM) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 3: 12 hours after administration of LD aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  10. Difference between aggregation induced by agonist adenosine diphosphate (20 µM) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 1: Obtained immediately before primary PCI in the catherization laboratory. The blood sample is obtained from the femoral artery catheter.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  11. Difference between aggregation induced by agonist adenosine diphosphate (20 µM) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 2: 4 hours after administration of loading dose (LD) aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  12. Difference between aggregation induced by agonist adenosine diphosphate (20 µM) measured by Multiplate® Aggregometry (Unit=AUC).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 3: 12 hours after administration of LD aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  13. Difference between aggregation measured by VerifyNow® Aggregometry using the ASPI-kit (Unit = ARU).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 1: Obtained immediately before primary PCI in the catherization laboratory. The blood sample is obtained from the femoral artery catheter.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  14. Difference between aggregation measured by VerifyNow® Aggregometry using the ASPI-kit (Unit = ARU).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 2: 4 hours after administration of loading dose (LD) aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  15. Difference between aggregation measured by VerifyNow® Aggregometry using the ASPI-kit (Unit = ARU).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 3: 12 hours after administration of LD aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  16. Difference between aggregation measured by VerifyNow® Aggregometry using the P2Y12-kit (Unit = PRU).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 1: Obtained immediately before primary PCI in the catherization laboratory. The blood sample is obtained from the femoral artery catheter.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  17. Difference between aggregation measured by VerifyNow® Aggregometry using the P2Y12-kit (Unit = PRU).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 2: 4 hours after administration of loading dose (LD) aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  18. Difference between aggregation measured by VerifyNow® Aggregometry using the P2Y12-kit (Unit = PRU).

    Outcome is the difference between aggregation measurements. In this case between:

    Blood sample 3: 12 hours after administration of LD aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

Secondary outcomes (6)
  1. Difference in immature platelet fraction measured by Sysmex® flowcytometry.

    Outcome is the difference between measurements. In this case between:

    Blood sample 1: Obtained immediately before primary PCI in the catherization laboratory. The blood sample is obtained from the femoral artery catheter.

    Blood sample 4: 2-3 months after administration of LD aspirin and clopidogrel.

    Measured: Approximately 2-3 months

  2. Difference in serum P-selectin

    Outcome is the difference between measurements. In this case between:

    Blood sample 1: Obtained immediately before primary PCI in the catherization laboratory. The blood sample is obtained from the femoral artery catheter.

    Blood sample 4: 2-3 months after administration of LD aspirin and clopidogrel.

    Measured: Approximately 2-3 months

  3. Difference in serum trombopoietin

    Outcome is the difference between measurements. In this case between:

    Blood sample 1: Obtained immediately before primary PCI in the catherization laboratory. The blood sample is obtained from the femoral artery catheter.

    Blood sample 4: 2-3 months after administration of LD aspirin and clopidogrel.

    Measured: Approximately 2-3 months

  4. Difference in serum thromboxane B2

    Outcome is the difference between measurements. In this case between:

    Blood sample 1: Obtained immediately before primary PCI in the catherization laboratory. The blood sample is obtained from the femoral artery catheter.

    Blood sample 4: 2-3 months after administration of LD aspirin and clopidogrel.

    Measured: Approximately 2-3 months

  5. Difference in immature platelet fraction measured by Sysmex® flowcytometry.

    Outcome is the difference between measurements. In this case between:

    Blood sample 2: 4 hours after administration of loading dose (LD) aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

  6. Difference in immature platelet fraction measured by Sysmex® flowcytometry.

    Outcome is the difference between measurements. In this case between:

    Blood sample 3: 12 hours after administration of LD aspirin and clopidogrel.

    Blood sample 4: 2-3 months after primary PCI.

    Measured: Approximately 2-3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Jun 2010 (estimated)
  2. Study startOct 2009
  3. Primary completionJul 2010
  4. Study completionAug 2010

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case only
Time perspective
Prospective
Enrolment
46 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01144819
Sponsor's protocol ID
23374
Status last verified
Sep 2013
First submitted
26 Mar 2010
Last updated
9 Sep 2013
Results posted
No
Data monitoring committee
No

Publications

  • Funck-Jensen KL, Dalsgaard J, Grove EL, Hvas AM, Kristensen SD. Increased platelet aggregation and turnover in the acute phase of ST-elevation myocardial infarction. Platelets. 2013;24(7):528-37. doi: 10.3109/09537104.2012.738838. Epub 2012 Dec 5.

    PubMed 23216571

Questions about this trial

What is this clinical trial studying?

An observational study of Acute Myocardial Infarction and Antiplatelet Therapy, run by University of Aarhus at 1 site in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Sep 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Difference between aggregation induced by agonist collagen (1 μg/ml) measured by Multiplate® Aggregometry (Unit=AUC). (time frame: Approximately 2-3 months). The study lists 18 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01144819, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Sep 2013.

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