To determine the safety and efficacy of Ticagrelor versus Clopidogrel for the reduction of adverse cardiovascular outcomes in patients with high platelet reactivity on clopidogrel after successful implantation of coronary drug-eluting stents.
This is a multi-center, randomized, single-blind, investigator-initiated study with a parallel design. Patients with coronary artery disease undergoing percutaneous coronary intervention and presenting high platelet reactivity on clopidogrel as assessed with the PL-11 analyzer (platelet maximum aggregation ratio \[MAR%\] ≥ 55 %) at 2 hours post-clopidogrel 300mg LD (Day 0), will be randomized after informed consent, in a 1:1 ratio to the following treatment groups: Group Α: Ticagrelor 180 mg immediate loading (on Day 0) followed by 180mg/day starting from Day 1 until Day 365 (12 months after randomization). Group Β: Clopidogrel 150mg per day, starting from Day 1 until Day 365 (12 months after randomization). Platelet reactivity assessment will be performed before randomization (Day 0), and 3-day after randomization (Day 3). Documentation of major adverse cardiac and cerebrovascular events (death, myocardial infarction, stent thrombosis, stroke, revascularization procedure with PCI or CABG) and serious adverse events (bleeding, other adverse events) will be performed until 12 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Daily administration of ticagrelor 180mg for 12 months
Daily administration of clopidogrel 150mg for 12 months
Nanjing First Hospital
Nanjing, Jiangsu, China
12-Month Freedom From MACE
Major adverse cardiovascular and cerebrovascular events consist of all-cause death, target vessel myocardial infarction, stroke, stent thrombosis.
Time frame: 12 months
12-Month Freedom From Mortality
All-cause death
Time frame: 12 months
12-Month Freedom From Cardiac death
Cardiac death
Time frame: 12 months
12-Month Freedom From MI
Myocardial infarction
Time frame: 12 months
12-Month Freedom From TLR
Target lesion revascularisation
Time frame: 12 months
12-Month Freedom From TVR
Target vessel revascularisation
Time frame: 12 months
12-Month Freedom From Stent Thrombosis
Stent thrombus was classified as definite, probable, or possible, according to the definitions provided by the Academic Research Consortium (ARC).Regarding timing, ST was defined as early (\<30 days), late (30 days to 1 year), or too late (\>1 year).
Time frame: 12 months
12-Month Freedom From Stroke
Stroke
Time frame: 12 months
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