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Acute Coronary SyndromePhase 4NCT04728516

The Effect of Dual Eradication Therapy vs PPI on Gastrointestinal Bleeding in ACS Patients

A Phase 4 study testing Vonoprazan-based dual eradication therapy for two weeks, amoxicillin and Pantoprazole in people with Acute Coronary Syndrome and Helicobacter Pylori Infection, run by Qilu Hospital of Shandong University at 42 sites in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Patients with acute coronary syndrome (ACS) after Percutaneous Coronary Intervention (PCI) require routine treatment with dual antiplatelet (DAPT) treatment, but with the high risk of bleeding, gastrointestinal bleeding is the most common type of major bleeding. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Vonoprazan-based dual eradication therapy for two weeks, amoxicillin and Pantoprazole
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,600 participants
Where
42 sitesChina
Study dates
12 Apr 2023to 30 Jun 2026
Phase
Phase 4
Are there results?
Not yet: the study is under way

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

  • Patients with ACS and PCI treatment and postoperative DAPT ≥ 6 months;
  • Hp infection is positive;
  • Age ≥18 years old;
  • The patient himself or his authorized client signs the subject's consent.

Who cannot join

  • Previous history of gastrointestinal ulcer bleeding;
  • Long-term use of PPI and H2 receptor inhibitors in the past;
  • Complicated with gastroesophageal varices, or after gastrectomy;
  • Those who are taking anti-coagulation drugs such as vitamin K antagonists (warfarin) ,factor X or factor II inhibitors;
  • Recently received fibrinolytic therapy (using fibrin-specific drugs within 24 hours before randomization, or using non-fibrin-specific drugs within 48 hours before randomization);
  • Recently accepted (within 30 days before randomization) or planned to undergo coronary artery bypass grafting (CABG);
Show all 19Show fewer
  • Combining active bleeding or coagulation dysfunction (indicator);
  • In patients with liver and kidney disease, serum creatinine is greater than 150 μmol/L, GFR <60ml/min/1.73m2, alanine aminotransferase and aspartate aminotransferase increase ≥3 times from the normal value;
  • Complicated with hemorrhagic stroke, intracranial tumor, arteriovenous malformation or aneurysm;
  • Anemia (adult male hemoglobin less than 120 g/L or red blood cells less than 4×10^12/L,adult female hemoglobin less than 105 g/L or red blood cells less than 3.5×10^12/L);
  • Systemic glucocorticoid application;
  • Have taken antibiotics and other drugs that affect the flora in the stomach within the past month;
  • A history of allergy to aspirin, clopidogrel, ticagrelor, pantoprazole, penicillin and other test drugs;
  • Pregnancy or breastfeeding women and subjects of childbearing age who do not want to take contraceptive measures;
  • With malignant tumors and other diseases, the expected survival time is less than 1 year;
  • Patients who participated in clinical trials of other drugs or are participating in clinical studies of other new drugs within 30 days before enrollment;
  • Complicated with mental illness or severe neurosis;
  • Can't express subjective discomfort symptoms;
  • The investigator decides that it is not suitable to participate in this research.

Trial locations and contacts

42 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Yuan Bian, MD, PhD contact

+8618560083065

bianyuan@sdu.edu.cn

42 sites in 1 country

China42 sites, 34 recruiting
  • Aviation General Hospital

    Beijing, Beijing Municipality, 100012

    Yanfu Wang

    Recruiting
  • China-Japan Friendship Hospital

    Beijing, Beijing Municipality, 100029

    Mingjing Shao

    Recruiting
  • Bozhou People's Hospital

    Bozhou, Anhui, 236800

    Duoxue Chen

    Recruiting
  • Hospital of Chengdu University of Traditional Chinese Medicine

    Chengdu, Sichuan, 610072

    Withdrawn
  • Chuzhou First People's Hospital

    Chuzhou, Anhui, 239000

    Tongtong Shen

    Recruiting
  • The First Affiliated Hospital of Dalian Medical University

    Dalian, Liaoning

    Junjie Wang

    Recruiting
  • Qilu Hospital of Shandong University Dezhou Hospital

    Dezhou, Shandong, 253000

    Hongwei Dong

    Recruiting
  • Pingyuan First People'S Hospital

    Dezhou, Shandong, 253100

    Xia Li

    Recruiting
  • NINGJIN People's Hospital

    Dezhou, Shandong, 253400

    Tao Zhang

    Recruiting
  • Dongying People's Hospital

    Dongying, Shandong, 257091

    Xiaotian Wang

    Recruiting
  • THE Second People's Hospital of Dongying

    Dongying, Shandong, 257335

    Tianjin Gu

    Recruiting
  • The First Affiliated Hospital of Anhui Medical University

    Hefei, Anhui, 230000

    xianhe lin

    Not yet recruiting
  • Heze Municipal Hospital

    Heze, Shandong, 274031

    Ke Liang

    Recruiting
  • The 960th Hospital of the Joint Logistic Support Force

    Jinan, Shandong, 250000

    Withdrawn
  • Shandong Second Provincial General Hospital

    Jinan, Shandong, 250002

    Withdrawn
  • Affiliated Hospital of Shandong University of Traditional Chinese Medicine

    Jinan, Shandong, 250011

    Zhen Wang

    Recruiting
  • Qilu Hospital of Shandong University

    Jinan, Shandong, 250012

    YUGUO CHEN

    Not yet recruiting
  • Shandong Provincial Third Hospital

    Jinan, Shandong, 250031

    Guo Zhou

    Recruiting
  • The fourth People's Hospital of jinan

    Jinan, Shandong, 250031

    Qiang Liu

    Recruiting
  • Shandong Public Health Clinical Center

    Jinan, Shandong, 250100

    Xiaojuan Zhang

    Recruiting
  • JINA CITY People's Hospital

    Jinan, Shandong, 271199

    Zengtang Zhang

    Recruiting
  • Central Hospital Affiliated to Shandong First medical University

    Jinan, Shandong

    Withdrawn
  • The First People's Hospital of Jining City

    Jining, Shandong, 272000

    shuyin sun

    Not yet recruiting
  • Liaocheng People's Hospital

    Liaocheng, Shandong, 252000

    yuzeng xue

    Not yet recruiting
  • Linyi City People's Hospital

    Linyi, Shandong, 276000

    yanjin wei

    Not yet recruiting
  • Linshu County People'S Hospital

    Linyi, Shandong, 276700

    Xiaozhou Wang

    Recruiting
  • Qilu Hospital of Shandong University (Qingdao)

    Qingdao, Shandong, 266000

    beian you

    Not yet recruiting
  • The Affiliated Hospital of Qingdao University

    Qingdao, Shandong, 266003

    Peng Li

    Recruiting
  • Ru Shan People's Hospital

    Rushan, Yantai, 264500

    Lei Dong

    Recruiting
  • The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine

    Shanghai, Shanghai Municipality, 200000

    changqian wang

    Not yet recruiting
  • Tianjin Chest Hospital

    Tianjin, Tianjin Municipality, 300222

    Withdrawn
  • Affiliated Hospital of Shandong Second Medical University

    Weifang, Shandong, 261031

    Luchang Yin

    Recruiting
  • Weifang Hospital of Traditional Chinese Medicine

    Weifang, Shandong, 261041

    Qinwei Zhu

    Recruiting
  • Weihai Central Hospital

    Weihai, Shandong, 264200

    Withdrawn
  • Weihai Municipal Hospital

    Weihai, Shandong, 264200

    xinfu zhou

    Not yet recruiting
  • Qinghai Red Cross Hospital

    Xining, Qinghai, 810000

    Jiuping Zhao

    Recruiting
  • Haiyang People's Hospital

    Yantai, Shandong, 256100

    Xuguang Liu

    Recruiting
  • Shandong Healthcare Group Zaozhuang Central Hospital

    Zaozhuang, Shandong, 277000

    Withdrawn
  • Zaozhuang Municipal Hospital

    Zaozhuang, Shandong, 277100

    Jun Yang

    Recruiting
  • The First Affiliated Hospital of Zhengzhou University

    Zhengzhou, Henan, 450052

    Junhui Xing

    Recruiting
  • Zibo Central Hospital

    Zibo, Shandong, 255000

    Withdrawn
  • The First People'S Hospital of Zunyi

    Zunyi, Guizhou, 563000

    Xiaochuan Bai

    Recruiting

Other trials in China

About this study

Official title: The Effect of Vonoprazan-based Dual Eradication Therapy vs PPI Treatment on Gastrointestinal Bleeding in ACS Patients With Hp Infection and Coronary Stents: an Open-label, Randomized, Controlled Trial

Patients with acute coronary syndrome (ACS) after Percutaneous Coronary Intervention (PCI) require routine treatment with dual antiplatelet (DAPT) treatment, but with the high risk of bleeding, gastrointestinal bleeding is the most common type of major bleeding. Helicobacter pylori (Hp) infection is a high-risk factor for gastrointestinal bleeding, with an incidence of about 50%. Foreign authoritative DAPT guidelines do not give individual guidance to Hp-infected patients. It is recommended that those with high bleeding risk should be combined with proton pump inhibitors (PPI), but long-term compliance with PPI is not ideal. Authoritative experts in China have agreed to recommend Hp detection and eradication therapy for DAPT patients, but loss of evidence. Vonoprazan is a novel potassium ion competitive acid blocker, based on Vonoprazan's dual Hp eradication therapy is simple and effective. Our team will conduct a multi-center, open-label, randomized controlled clinical trial using a non-inferior design to compare the combination of Vonoprazan + amoxicillin combined with pantoprazole (PPI) for 6 months after PCI on the bleeding events of the digestive tract.

Read the detailed description

This study plans to enroll 2600 patients, 1300 patients in each group, in the project participating hospitals who received coronary stenting and are expected to undergo DAPT ≥6 months after operation. Hp13C-urea breath test and serum Hp antibody scores Type detection, patients with positive Hp infection.

Antiplatelet drugs (DAPT) use aspirin 100 mg qd, plus clopidogrel 75 mg qd or aspirin 100mg qd plus ticagrelor 90 mg bid. The specific medication is evaluated and decided by the interventional doctor.

After the subjects in each center signed a written informed consent form, they randomly divided each test case into a test group or a control group at a 1:1 ratio:

  1. Test group: In the project participating hospitals who received coronary stenting and are expected to undergo DAPT ≥6 months after operation. Hp13C-urea breath test and serum Hp antibody scores Type detection, patients with positive Hp infection. Antiplatelet drugs (DAPT) use aspirin 100 mg qd, plus clopidogrel 75 mg qd or aspirin 100 mg qd, plus ticagrelor 90 mg bid. The specific medication is evaluated and decided by the interventional doctor.
  2. pylori eradication using a dual eradication regimen, a course of 14 days, followed up to 6 months after randomization; the treatment regimen is as follows: routine use of Vonoprazan 20mg bid + amoxicillin 1g tid, a duration of 14 days(Considering the high drug resistance rate of Hp strains in China, we increase the course of eradication treatment to 14 days) .
  3. Introduce the subject to the possible adverse reactions to the dual eradication at the informed stage, and inform the subject that when the adverse reaction occurs, the researcher should be contacted as soon as possible to deal with it as soon as possible to reduce unnecessary shedding. For patients who are unable to tolerate the combination therapy and fall off, record the reason for the incomplete treatment and the corresponding time point, and continue the safety visit. ii. More than 1 month after completion of the dual eradication (scheduled at the 12th week of follow-up, visit 3), use the 13C-urea breath test to retest Hp infection. For subjects who failed H. pylori eradication, in the Department of Gastroenterology Remedial treatment under the guidance of a doctor.
  4. Control group:

In the project participating hospitals who received coronary stenting and are expected to undergo DAPT ≥ 6 months after operation. Hp13C-urea breath test and serum Hp antibody scores Type detection, patients with positive Hp infection. Antiplatelet drugs (DAPT) use aspirin 100 mg qd, plus clopidogrel 75 mg qd or aspirin 100 mg qd plus ticagrelor 90 mg bid. The specific medication is evaluated and decided by the interventional doctor. Taking pantoprazole 40 mg daily, followed up to 6 months after randomization.

Being tested
Vonoprazan-based dual eradication therapy for two weeks, amoxicillin, Pantoprazole
Medical subject headings
Acute Coronary Syndrome

What participants receive

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

  • Vonoprazan-based dual eradication therapy for two weeksDrug

    Patients with ACS after PCI, associated with positive Hp need a long-term DAPT treatment. We conducted a study on the prevention of gastrointestinal bleeding between vonoprazan-based dual eradication therapy for two weeks and pantoprazole for six months of a rountine therapy.

  • amoxicillinDrug

    amoxicillin

  • PantoprazoleDrug

    Pantoprazole

Study groups in NCT04728516
Study groupRoleWhat they receive
Vonoprazan-based dual eradication therapyExperimentalH. pylori eradication using a dual eradication regimen, a course of 14 days, followed up to 6 months after randomization; the treatment regimen is as follows: routine use of Vonoprazan 20mg bid + amoxicillin 1g tid, a course of 14 days .
Receives: Drug: Vonoprazan-based dual eradication therapy for two weeks; Drug: amoxicillin
PantoprazoleActive comparatorTo take pantoprazole 40 mg daily, followed up to 6 months after randomization.
Receives: Drug: Pantoprazole

What is being measured

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

  1. Gastrointestinal bleeding of 6 months in patients with ACS after PCI

    To compare the effects of the combination of vonoprazan + amoxicillin and pantoprazole on gastrointestinal bleeding events within 6 months in patients with ACS after PCI,The primary endpoint was gastrointestinal bleeding, including gastroduodenal bleeding, gastrointestinal bleeding with unknown bleeding site, and occult gastrointestinal bleeding.

    Measured: 6 months

Secondary outcomes (2)
  1. major adverse cardiovascular and cerebrovascular events (MACCE)

    To compare the effects of the combination of vonoprazan + amoxicillin and pantoprazole on major adverse cardiovascular and cerebrovascular events (MACCE) within 6 months in patients with ACS after PCI. The secondary outcomes measure were MACCE , including :stent thrombosis, recurrent myocardial infarction, unplanned revascularization cardiogenic shock, stroke, cardiovascular death, and all-cause death.

    Measured: 6 month

  2. complex gastrointestinal event

    To compare the effects of the combination of vonoprazan + amoxicillin and pantoprazole on complex gastrointestinal events. The secondary outcomes measure were complex gastrointestinal events, including upper gastrointestinal bleeding (BARC type), symptomatic gastroduodenal ulcer, gastroesophageal reflux, intestinal obstruction, gastrointestinal perforation, diarrhea, dyspepsia.

    Measured: 6month

Timeline

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

  1. First posted28 Jan 2021
  2. Study start12 Apr 2023
  3. Primary completion30 Jun 2026 (estimated)
  4. Study completion30 Jun 2026 (estimated)

Resources

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
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
2,600 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04728516
Sponsor's protocol ID
2020SDUCRCA006
Status last verified
Sep 2025
First submitted
20 Jan 2021
Last updated
16 Sep 2025
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Vonoprazan-based dual eradication therapy for two weeks, amoxicillin and Pantoprazole in people with Acute Coronary Syndrome and Helicobacter Pylori Infection, run by Qilu Hospital of Shandong University at 42 sites in China.

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 4 inclusion and 19 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: looking for participants now, as of the sponsor's last update on 16 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 42 sites in China. 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.

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?

This study is still under way. Results are not available in the source record yet.

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

Contact Yuan Bian, MD, PhD (+8618560083065, bianyuan@sdu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Gastrointestinal bleeding of 6 months in patients with ACS after PCI (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 16 Sep 2025.

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