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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/show/NCT00790387




Registration number
NCT00790387
Ethics application status
Date submitted
11/11/2008
Date registered
13/11/2008
Date last updated
24/03/2010

Titles & IDs
Public title
Tirofiban and Enoxaparin in High Risk Coronary Intervention
Scientific title
High Bolus Dose Tirofiban and Enoxaparin Provides Reduced Thrombin Generation and Inflammatory Markers in Patients With High Risk Undergoing Percutaneous Intervention
Secondary ID [1] 0 0
EC2006
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Acute Coronary Syndrome 0 0
Condition category
Condition code
Cardiovascular 0 0 0 0
Coronary heart disease

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Enoxaparin
Treatment: Drugs - Tirofiban
Treatment: Drugs - unfractionated heparin

Experimental: 1 High dose tirofiban and enoxaparin - Enoxaparin was administered at the commencement of PCI at a dose of 0.75 mg/kg .
Tirofiban was administered once the wire had crossed the lesion during PCI with a bolus dose of 25 µg/kg of bodyweight, followed by an infusion of 0.15 µg per kilogram per minute for 18 to 24 hours.

Active Comparator: 2 tirofiban and unfractionated heparin - Tirofiban was administered once the wire had crossed the lesion during PCI with a bolus dose of 25 µg/kg of bodyweight, followed by an infusion of 0.15 µg per kilogram per minute for 18 to 24 hours.
UFH heparin was administered as a bolus of 70 U/kg and additional heparin was given to maintain the activated clotting time (ACT) at 250


Treatment: Drugs: Enoxaparin
Enoxaparin was administered at the commencement of PCI at a dose of 0.75 mg/kg

Treatment: Drugs: Tirofiban


Treatment: Drugs: unfractionated heparin


Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Thrombus generation as determined by Prothrombin fragment 1+2, D-dimer
Timepoint [1] 0 0
24 hours
Secondary outcome [1] 0 0
A panel of platelet activation markers:P selectin, MAC-1, PMAs, factor V/Va,Platelet inhibition as assessed by whole blood aggregometry
Timepoint [1] 0 0
10 minutes , 24 hours
Secondary outcome [2] 0 0
Inflammatory biomarkers :CD40L,vWF and CRP
Timepoint [2] 0 0
10 minutes,24 hours

Eligibility
Key inclusion criteria
- Patients were recruited from those undergoing PCI with a planned placement of an
intracoronary stent

- Including patients with unstable angina pectoris, acute coronary syndrome or NSTEMI

- Experienced ischaemic pain at rest

- Lasting 10 minutes and occurring within 7 days before enrollment

- As well as one of the following: ECG changes: New or presumably new ST-segment
depression greater than or equal to 0.1 mV (1 mm), or transient (< 30 minutes)
ST-segment elevation greater than or equal to 0.1 mV (1 mm) in at least 2 contiguous
leads

- Abnormal cardiac enzymes within the 24 hours before enrollment, defined as elevated
Troponin I defined as elevated Troponin I (above the normal reference -High-risk
angiographic features that included intraluminal filling defect, angiographically
visible thrombus eccentric lesion, type, location in a proximal major vessel and
thrombolysis in myocardial infarction (TIMI) flow of II or less
Minimum age
18 Years
Maximum age
75 Years
Gender
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
- Increased bleeding risk: ischaemic stroke within the last year or any previous
haemorrhagic stroke, tumour or intracranial aneurysm;

- Recent (<1 month) trauma or major surgery (including bypass surgery);

- Active bleeding

- Unexplained clinically significant bleeding, thrombocytopenia (platelet count < 100 x
109/L) or history of thrombocytopenia with GP IIb/IIIa, heparin or enoxaparin therapy

- Angina from secondary causes such as severe uncontrolled hypertension (systolic blood
pressure > 180 mm Hg despite treatment)

- Valvular disease, congenital heart disease, hypertrophic cardiomyopathy, -Thrombolytic
therapy within preceding 24 hours

- Receiving antiIIb/IIIa therapy

- Creatinine clearance of <30 mL/min

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Phase 4
Type of endpoint(s)
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
QLD
Recruitment hospital [1] 0 0
The Prince Charles Hospital - Brisbane
Recruitment postcode(s) [1] 0 0
4032 - Brisbane

Funding & Sponsors
Primary sponsor type
Other
Name
The Prince Charles Hospital
Address
Country
Other collaborator category [1] 0 0
Commercial sector/Industry
Name [1] 0 0
Sanofi
Address [1] 0 0
Country [1] 0 0
Other collaborator category [2] 0 0
Commercial sector/Industry
Name [2] 0 0
Merck Sharp & Dohme Corp.
Address [2] 0 0
Country [2] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
Patients undergoing coronary angioplasty are frequently treated with new drugs that stop
blood platelets working and so improve the success of the procedure. Individual patients may
vary in the dose of the drug required. New platelet tests have been developed which can be
performed near the patient and possibly immediately tell the doctor the degree of platelet
inhibition achieved so that the dose can be adjusted accordingly. This study aims to
investigate if these platelet tests indicate if new anticoagulants are more effective at
inhibiting platelet function than the traditional anticoagulants. The study will demonstrate
if these newer drugs improve blood flow through the heart muscle and thereby provide better
long term outcomes for patients undergoing percutaneous intervention.
Trial website
https://clinicaltrials.gov/show/NCT00790387
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Darren L Walters
Address 0 0
The Prince Charles Hospital
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries

Summary results
Other publications