Coronary Artery DiseasePhase 4NCT02282332
NIRS Ticagrelor Evaluation
A Phase 4 study testing Ticagrelor in people with Coronary Artery Disease, run by Medstar Health Research Institute.
Trial summary
The Impact of Ticagrelor on Coronary Atherosclerotic Lipid Pool and Inflammation Assessed by Near-Infrared Spectroscopy study will evaluate whether ticagrelor leads to a 20% reduction in the LCBI with NIRS/IVUS suggesting coronary plaque stabilization and reduced inflammation in patients already on long-term statin… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Coronary Artery Disease
- What is being tested?
- Ticagrelor
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- No sites listed yet
- Study dates
- Jun 2014to Apr 2016
- Phase
- Phase 4
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
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
Who may be able to join
- • Female (post menopausal or surgically sterile) and/or male aged 18 years or older
- Multi-vessel coronary artery disease CAD
- Statin therapy for minimum of 6 weeks prior to enrollment in the study with no plan for further adjustment
- Non-emergent PCI for ACS with stent placement requiring dual-antiplatelet therapy
- Ability to safely perform NIRS/IVUS for a concomitant non-culprit lesion with diameter stenosis ≥50% that was not treated with PCI
- Willing and able to sign informed consent and participate in follow-up
Who cannot join
- Thienopyridine or ticagrelor use in the last month
- Need for coronary artery bypass surgery or other surgeries during the follow-up period
- Documented medication non-compliance
- Chronic inflammatory disorder or treatment with anti-inflammatory or immunosuppressive drugs
- Prior or current malignancy within the last 5 years
- Concomitant severe illness or reduced life expectancy that will prevent follow-up cardiac catheterization
Show all 13Show fewer
- Active infection
- Pregnant or lactating women
- End-stage renal disease
- History of intracranial hemorrhage
- Active pathological bleeding
- Known severe hepatic impairment
- Known hypersensitivity to ticagrelor
About this study
Official title: The Impact of Ticagrelor on Coronary Atherosclerotic Lipid Pool and Inflammation Assessed by Near-Infrared Spectroscopy
The Impact of Ticagrelor on Coronary Atherosclerotic Lipid Pool and Inflammation Assessed by Near-Infrared Spectroscopy study will evaluate whether ticagrelor leads to a 20% reduction in the LCBI with NIRS/IVUS suggesting coronary plaque stabilization and reduced inflammation in patients already on long-term statin therapy undergoing non-urgent PCI. It is hypothesized that the treatment with ticagrelor following PCI will lead to a significant 20% reduction in the lipid pool as measured by NIRS/IVUS at follow-up when compared with baseline imaging, suggesting a reduction in inflammation and stabilization of the lipid core in atherosclerotic lesions not treated during the index procedure.
Read the detailed description
Single-Center, open-label study of the effect of ticagrelor on the reduction in the lipid pool in 30 patients with multi-vessel CAD 2 Treatment periods over 6 months, with 2 additional follow-up phone calls at 1 and 3 months.
Non-urgent PCI requiring stent placement and evaluation by NIRS/IVUS at baseline and 6 month follow up A second concomitant coronary lesion with diameter stenosis greater than 50% will also be imaged using NIRS/IVUS.
Patients will be discharged on a ticagrelor regiment of 90 mg twice a day for the 6 month study.
Blood samples will be drawn at baseline prior to ticagrelor being administered and again at follow up.
Inclusion Criteria:
- Female (post menopausal or surgically sterile) and/or male aged 18 years or older
- Multi-vessel coronary artery disease
- Statin therapy for minimum of 6 weeks prior to enrollment in the study with no plan for further adjustment
- Non-emergent PCI for ACS with stent placement requiring dual-antiplatelet therapy
- Ability to safely perform NIRS/IVUS for a concomitant non-culprit lesion with diameter stenosis ≥ 50% that was not treated with PCI
- Willing and able to sign informed consent and participate in follow-up
Exclusion Criteria:
- Thienopyridine or ticagrelor use in the last month
- Need for coronary artery bypass surgery or other surgeries during the follow-up period
- Documented medication non-compliance
- Chronic inflammatory disorder or treatment with anti-inflammatory or immunosuppressive drugs
- Prior or current malignancy within the last 5 years
- Concomitant severe illness or reduced life expectancy that will prevent follow-up cardiac catheterization
- Active infection
- Pregnant or lactating women
- End-stage renal disease
- History of intracranial hemorrhage
- Active pathological bleeding
- Known sever hepatic impairment
- Known hypersensitivity to ticagrelor
Study Procedures:
After consent is obtained non-urgent PCI requiring stent placement and evaluation by NIRS/IVUS at baseline is performed and once again at 6 month follow up. A second concomitant coronary lesion with diameter stenosis greater than 50% will also be imaged using NIRS/IVUS. Patients will be discharged on a ticagrelor regiment of 90 mg twice a day for the 6 month study.Blood samples will be drawn at baseline prior to ticagrelor being administered and again at follow up. There will be 1 month phone follow up, 3 month phone follow up and a 6 month clinical follow up that includes collecting blood, repeat catheterization, and repeat NIRS/IVUS procedure.
- Conditions
- Coronary Artery Disease
- Being tested
- Ticagrelor
- Medical subject headings
- Coronary Artery Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TicagrelorDrug
| Study group | Role | What they receive |
|---|---|---|
| Patiens Discharged on Ticagrelor | Experimental | Patients to be discharged on ticagrlore regiment of 90mg twice a day for 6 months. Receives: Drug: Ticagrelor |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change From Baseline Lipid Pool to Follow up as Assessed by NIRS/IVUS With Treatment of Ticagrelor
Treatment with ticagrelor following PCI will lead to significant 20% reduction in the LCBI as assessed at follow up by NIRS/IVUS when compared with baseline imaging data of the reference vessel, suggesting a reduction in inflammation and stabilization of the lipid core in atherosclerotic lesions not treated during the index procedure.
Measured: 6 months
Secondary outcomes (1)
Change From Baseline Inflammatory Markers to Follow up With Treatment of Ticagrelor
We expect to see a significant reduction of inflammatory markers of Hs-CRP, MCP-1, IL-1, IL-6, IL-18, and TNF- α as well as an increase in IL-10, a cytokine associated with a reduction in inflammation, following therapy with ticagrelor when compared with baseline values. This is expected as inflammatory markers should be lower in stable coronary artery disease compared with patients presenting with ACS. While there is no control group in the proposed study, it will be important to assess whether changes in established biomarkers associated with inflammation correlate with changes in LCBI. While ticagrelor was not shown to reduce inflammatory biomarkers to a greater degree than clopidogrel, it will be important to assess whether the reduction in LCBI is independent of or associated with reductions in inflammatory markers or platelet reactivity.
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Nov 2014 (estimated)
- Study startJun 2014
- Primary completionApr 2016
- Study completionApr 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Coronary Artery DiseaseStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 30 participants (actual)
Sponsor and investigators
- Lead sponsor
- Medstar Health Research Institute
- Sponsor type
- University, hospital or other
- Collaborators
- AstraZeneca
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02282332
- Sponsor's protocol ID
- AZ_ISSBRIL0304
- Status last verified
- Mar 2021
- First submitted
- 15 Oct 2014
- Last updated
- 8 Apr 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 8 Apr 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Impact of Ticagrelor on Coronary Atherosclerotic Lipid Pool and Inflammation Assessed by Near-Infrared Spectroscopy
- ClinicalTrials.gov ID
- NCT02282332
- Acronym / sponsor ID
- AZ_ISSBRIL0304
- Conditions
- Coronary Artery Disease
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 30 participants (actual)
- Lead sponsor
- Medstar Health Research InstituteUniversity, hospital or other
- Collaborators
- AstraZeneca
- Study start
- Jun 2014
- Primary completion
- Apr 2016 (actual)
- Study completion
- Apr 2016 (actual)
- First posted
- 4 Nov 2014 (estimated)
- Results
- Posted 8 Apr 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The Impact of Ticagrelor on Coronary Atherosclerotic Lipid Pool and Inflammation Assessed by Near-Infrared Spectroscopy study will evaluate whether ticagrelor leads to a 20% reduction in the LCBI with NIRS/IVUS suggesting coronary plaque stabilization and reduced inflammation in patients already on long-term statin therapy undergoing non-urgent PCI. It is hypothesized that the treatment with ticagrelor following PCI will lead to a significant 20% reduction in the lipid pool as measured by NIRS/IVUS at follow-up when compared with baseline imaging, suggesting a reduction in inflammation and stabilization of the lipid core in atherosclerotic lesions not treated during the index procedure.
Detailed description
Single-Center, open-label study of the effect of ticagrelor on the reduction in the lipid pool in 30 patients with multi-vessel CAD 2 Treatment periods over 6 months, with 2 additional follow-up phone calls at 1 and 3 months.
Non-urgent PCI requiring stent placement and evaluation by NIRS/IVUS at baseline and 6 month follow up A second concomitant coronary lesion with diameter stenosis greater than 50% will also be imaged using NIRS/IVUS.
Patients will be discharged on a ticagrelor regiment of 90 mg twice a day for the 6 month study.
Blood samples will be drawn at baseline prior to ticagrelor being administered and again at follow up.
Inclusion Criteria:
- Female (post menopausal or surgically sterile) and/or male aged 18 years or older
- Multi-vessel coronary artery disease
- Statin therapy for minimum of 6 weeks prior to enrollment in the study with no plan for further adjustment
- Non-emergent PCI for ACS with stent placement requiring dual-antiplatelet therapy
- Ability to safely perform NIRS/IVUS for a concomitant non-culprit lesion with diameter stenosis ≥ 50% that was not treated with PCI
- Willing and able to sign informed consent and participate in follow-up
Exclusion Criteria:
- Thienopyridine or ticagrelor use in the last month
- Need for coronary artery bypass surgery or other surgeries during the follow-up period
- Documented medication non-compliance
- Chronic inflammatory disorder or treatment with anti-inflammatory or immunosuppressive drugs
- Prior or current malignancy within the last 5 years
- Concomitant severe illness or reduced life expectancy that will prevent follow-up cardiac catheterization
- Active infection
- Pregnant or lactating women
- End-stage renal disease
- History of intracranial hemorrhage
- Active pathological bleeding
- Known sever hepatic impairment
- Known hypersensitivity to ticagrelor
Study Procedures:
After consent is obtained non-urgent PCI requiring stent placement and evaluation by NIRS/IVUS at baseline is performed and once again at 6 month follow up. A second concomitant coronary lesion with diameter stenosis greater than 50% will also be imaged using NIRS/IVUS. Patients will be discharged on a ticagrelor regiment of 90 mg twice a day for the 6 month study.Blood samples will be drawn at baseline prior to ticagrelor being administered and again at follow up. There will be 1 month phone follow up, 3 month phone follow up and a 6 month clinical follow up that includes collecting blood, repeat catheterization, and repeat NIRS/IVUS procedure.
Study design
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Patiens Discharged on Ticagrelor | Experimental | Drug: TicagrelorPatients to be discharged on ticagrlore regiment of 90mg twice a day for 6 months. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- • Female (post menopausal or surgically sterile) and/or male aged 18 years or older
Key exclusion criteria (13 listed)
- Thienopyridine or ticagrelor use in the last month
- Need for coronary artery bypass surgery or other surgeries during the follow-up period
- Documented medication non-compliance
- Chronic inflammatory disorder or treatment with anti-inflammatory or immunosuppressive drugs
- Prior or current malignancy within the last 5 years
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ticagrelor | Drug | Patiens Discharged on Ticagrelor |
Primary outcome
Change From Baseline Lipid Pool to Follow up as Assessed by NIRS/IVUS With Treatment of Ticagrelor
Time frame: 6 months
Treatment with ticagrelor following PCI will lead to significant 20% reduction in the LCBI as assessed at follow up by NIRS/IVUS when compared with baseline imaging data of the reference vessel, suggesting a reduction in inflammation and stabilization of the lipid core in atherosclerotic lesions not treated during the index procedure.
1 secondary outcome
Change From Baseline Inflammatory Markers to Follow up With Treatment of Ticagrelor
Time frame: 6 months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Apr 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Ticagrelor in people with Coronary Artery Disease, run by Medstar Health Research Institute.
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 6 inclusion and 13 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 8 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.
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.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 8 Apr 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
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?
Change From Baseline Lipid Pool to Follow up as Assessed by NIRS/IVUS With Treatment of Ticagrelor (time frame: 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 8 Apr 2021.