Active Detection of the Extension of Atherothrombosis in High Risk Coronary Patients

Assistance Publique - Hôpitaux de Paris526 enrolled

Overview

Coronary artery disease is the first cause of death related to atherothrombosis.

Coronary artery disease is the first cause of death related to atherothrombosis. There is a close correlation between the extension of coronary artery disease and the severity of atherosclerotic lesions in extra coronary arterial beds. In addition, these symptomatic extracoronary lesions dramatically decrease the survival of these patients. However, scant data are available regarding the prevalence of extracoronary asymptomatic lesions. Conversely, the annual absolute risk of these lesions remains unknown. Consequently, whether a systematic identification of these extracoronary asymptomatic lesions is relevant remains to be established. The Primary Objective and Primary Endpoint of the AMERICA study is to demonstrate the superiority of an active detection and management of the extension of atherothrombosis in high Risk coronary patients (active strategy) in comparison with standard of care for coronary atherosclerosis (conservative strategy).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

526

Conditions

Coronary Artery Disease

Interventions

Arterial doppler for screening asymptomatic and significant extracoronary arterial stenoses in all arterial bedsOTHER

A strategy of systematic screening of these extra-coronary asymptomatic lesions combined with a specific treatment if needed and an aggressive secondary prevention pharmacological treatment of atherothrombosis

Conservative armOTHER

Conservative medical approach

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion criteria: 1. Three vessel disease recently identified recently (\<6 month) 2. Accrue coronary syndromes in patients\>75 years old (\<1 month) Exclusion criteria: 1. Absence of significant coronary lesions 2. Other causes of rise in the troponin level 3. Patient\<18 years old 4. Pregnant women 5. Patient without affiliation to National Social Security

Locations (1)

Hopital Pitie-Salpetriere

Paris, France

Outcomes

Primary Outcomes

death (all cause) or any ischemic event leading to rehospitalisation or any evidence of organ failure.

Time frame: during the study

Secondary Outcomes

Incidence of each composite of the primary endpoint.

Time frame: during the study

Data from ClinicalTrials.gov

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