Crushed Ticagrelor Versus Eptifibatide Bolus + Clopidogrel
| Status: | Recruiting |
|---|---|
| Conditions: | Angina, Angina, Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/17/2018 |
| Start Date: | September 2016 |
| End Date: | December 2023 |
| Contact: | Mehak Goel, PhD |
| Email: | mehakgoel@uabmc.edu |
| Phone: | 205-975-4021 |
The Effects of Crushed Ticagrelor Versus Eptifibatide Bolus +Clopidogrel in Troponin-Negative ACS Patients Undergoing Coronary Intervention
Patients with troponin-negative acute coronary syndrome (ACS) are not routinely pre-treated
with P2Y12 inhibitors and the rate of high on-treatment platelet reactivity (HPR) remains
elevated after a loading dose of ticagrelor at the time of percutaneous coronary intervention
(PCI). This suggests that faster platelet inhibition with crushed ticagrelor , eptifibatide ,
or cangrelor is needed to reduce HPR and periprocedural myocardial infarction and injury
(PMI). The present study compared the effects of crushed ticagrelor vs. eptifibatide bolus +
clopidogrel in troponin-negative ACS patients undergoing PCI.
with P2Y12 inhibitors and the rate of high on-treatment platelet reactivity (HPR) remains
elevated after a loading dose of ticagrelor at the time of percutaneous coronary intervention
(PCI). This suggests that faster platelet inhibition with crushed ticagrelor , eptifibatide ,
or cangrelor is needed to reduce HPR and periprocedural myocardial infarction and injury
(PMI). The present study compared the effects of crushed ticagrelor vs. eptifibatide bolus +
clopidogrel in troponin-negative ACS patients undergoing PCI.
Platelet activation and accumulation causes the formation of blood clots that may cause heart
attack. As a standard of care, the doctor can prescribe medications such as are ticagrelor,
eptifibatide, clopidogrel, to prevent the formation of blood clots.
100 patients with unstable angina, both male and female, will be randomized to either Group
A- Crushed Ticagrelor or Group B- Eptifibatide bolus +Clopidogrel administrated immediately
before PCI. Platelet function testing, troponin, and ECG will be performed.
attack. As a standard of care, the doctor can prescribe medications such as are ticagrelor,
eptifibatide, clopidogrel, to prevent the formation of blood clots.
100 patients with unstable angina, both male and female, will be randomized to either Group
A- Crushed Ticagrelor or Group B- Eptifibatide bolus +Clopidogrel administrated immediately
before PCI. Platelet function testing, troponin, and ECG will be performed.
Inclusion Criteria:
- Patients with unstable angina/troponin negative ACS.
Exclusion Criteria:
1. need for oral anticoagulation therapy (Warfarin, Dabigatran, Rivaroxaban, Apixaban,
Edoxaban)
2. increased risk of bradycardia, and the associated therapy with a strong cytochrome
P-450 inhibitors (anti-retroviral agents, antifungal agents and some antibiotics eg.
Indinavir, Nelfinavir, Lopinavir, Ritonavir, Itraconazole, Ketoconazole, Voriconazole,
Clarithromycin, Telithormycin)
3. surgery<4 weeks
4. use of any thienopyridines (Clopidogrel, Prasugrel) 7 days prior to randomization
5. administration of GP IIb/IIIa inhibitors
6. bleeding diathesis or major bleeding episode within 2 weeks
7. thrombocytopenia (Platelet count < 100000)
8. incessant chest pain
9. hemodynamic instability (Mean arterial pressure < 65 mm Hg; need for vasopressor or
inotropic agents; need for mechanical circulatory support for coronary intervention),
NSTEMI as evidenced by elevation of troponin levels (Troponin > 0.034 ng/ml); renal
failure with a serum creatinine >2.0 mg/dL
10. anemia with HCT<30%.
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