| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
| Myocardial infarction <= 12 hours |
|
| E.1.1.1 | Medical condition in easily understood language |
| Myocardial infarction is a disease in which one or more of the vessels supplying the heart muscle cells with blood are occluded. |
|
| E.1.1.2 | Therapeutic area | Diseases [C] - Cardiovascular Diseases [C14] |
| MedDRA Classification |
| E.1.2 Medical condition or disease under investigation |
| E.1.2 | Version | 15.0 |
| E.1.2 | Level | PT |
| E.1.2 | Classification code | 10000891 |
| E.1.2 | Term | Acute myocardial infarction |
| E.1.2 | System Organ Class | 10007541 - Cardiac disorders |
|
| E.1.3 | Condition being studied is a rare disease | No |
| E.2 Objective of the trial |
| E.2.1 | Main objective of the trial |
| Inhibition of platelet aggregation by prasugrel and clopidogrel, assessed by the platelet reactivity index (PRI) 2 hrs. after initiation of therapy. |
|
| E.2.2 | Secondary objectives of the trial |
PRI 4 hrs. after initiation of therapy
Rate of complete ST segement resolution 60min after PCI
TIMI 2/3 patency of infarct related artery prior to PCI
TIMI 3 patency before PCI
TIMI 3 patency after PCI
ST resolution before angiography
Partial or no ST resolution 60min after PCI
ST segment deviation 60min after PCI
Death, re-MI, stent thrombosis and urgent revascularisation until 48hrs, day 7, and day 30
Stroke
Severe bleeding complications |
|
| E.2.3 | Trial contains a sub-study | No |
| E.3 | Principal inclusion criteria |
Age >= 18years and < 75years
Acute STEMI <= 12hrs.
Planned percutaneous coronary intervention
Legal capacity (including ability to understand the nature, scope, and possible consequences of the study participation)
Informed consent
First medical contact in prehospital setting, in a non-PCI hospital, or in a PCI-hospital, if the expected time until the start of the scheduled PCI is at least 20 minutes |
|
| E.4 | Principal exclusion criteria |
Age >= 75years
Body weight < 60kg
Thrombolytic therapy within 24hrs before randomization
Oral anticoagulation
Known hemorrhagic diathesis
History of stroke or TIA
Cardiogenic shock
Evidence of active gastrointestinal or urogenital bleeding
Major surgery within 6 weeks
Contraindication to prasugrel or clopidogrel
Severe renal or hepatic insufficiency
Contraindication to coronary angiography
Planned administration of GP IIb/IIIa inhibitor before angiography
Pregnant or nursing women
Patients currently treated with clopidogrel, prasugrel, ticlopidine, or ticagrelor
Uncontrollable hypertension (blood pressure ≥ 200/110 mmHg in repeated measurements)
Treatment with NSAIDs
Participation in another clinical or device trial within previous 30 days
Expected time between administration of loading dose and start of PCI is < 20 minutes |
|
| E.5 End points |
| E.5.1 | Primary end point(s) |
| Platelet reactivity index measured by VASP phosphorylisation |
|
| E.5.1.1 | Timepoint(s) of evaluation of this end point |
| 2 hours after the initiation of the therapy |
|
| E.5.2 | Secondary end point(s) |
1) Platelet reactivity index
2) Complete (>70%) ST segment resolution
3) TIMI 2/3 patency
4) TIMI 3 patency
5) TIMI 3 patency
6) ST resolution
7) Partial or no ST resolution
8) ST segment deviation
9) Death, re-MI, stent thrombosis, urgent revascularisation |
|
| E.5.2.1 | Timepoint(s) of evaluation of this end point |
1) 4 hours after the initiation of the therapy
2) 60 minutes after PCI
3) prior to PCI
4) before PCI
5) after PCI
6) immediately before angiography
7) 60 minutes after PCI
8) 60 minutes after PCI
9) 48 hours, day 7, day 30
|
|
| E.6 and E.7 Scope of the trial |
| E.6 | Scope of the trial |
| E.6.1 | Diagnosis | No |
| E.6.2 | Prophylaxis | No |
| E.6.3 | Therapy | Yes |
| E.6.4 | Safety | Yes |
| E.6.5 | Efficacy | Yes |
| E.6.6 | Pharmacokinetic | No |
| E.6.7 | Pharmacodynamic | No |
| E.6.8 | Bioequivalence | No |
| E.6.9 | Dose response | No |
| E.6.10 | Pharmacogenetic | No |
| E.6.11 | Pharmacogenomic | No |
| E.6.12 | Pharmacoeconomic | No |
| E.6.13 | Others | No |
| E.7 | Trial type and phase |
| E.7.1 | Human pharmacology (Phase I) | No |
| E.7.1.1 | First administration to humans | No |
| E.7.1.2 | Bioequivalence study | No |
| E.7.1.3 | Other | No |
| E.7.1.3.1 | Other trial type description | |
| E.7.2 | Therapeutic exploratory (Phase II) | No |
| E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
| E.7.4 | Therapeutic use (Phase IV) | No |
| E.8 Design of the trial |
| E.8.1 | Controlled | Yes |
| E.8.1.1 | Randomised | Yes |
| E.8.1.2 | Open | No |
| E.8.1.3 | Single blind | No |
| E.8.1.4 | Double blind | Yes |
| E.8.1.5 | Parallel group | Yes |
| E.8.1.6 | Cross over | No |
| E.8.1.7 | Other | No |
| E.8.2 | Comparator of controlled trial |
| E.8.2.1 | Other medicinal product(s) | Yes |
| E.8.2.2 | Placebo | No |
| E.8.2.3 | Other | No |
| E.8.2.4 | Number of treatment arms in the trial | 2 |
| E.8.3 |
The trial involves single site in the Member State concerned
| No |
| E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
| E.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
| E.8.5 | The trial involves multiple Member States | Yes |
| E.8.5.1 | Number of sites anticipated in the EEA | 5 |
| E.8.6 Trial involving sites outside the EEA |
| E.8.6.1 | Trial being conducted both within and outside the EEA | No |
| E.8.6.2 | Trial being conducted completely outside of the EEA | No |
| E.8.7 | Trial has a data monitoring committee | Yes |
| E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
| Planned end of the trial is the last visit of the last subject |
|
| E.8.9 Initial estimate of the duration of the trial |
| E.8.9.1 | In the Member State concerned years | 1 |
| E.8.9.1 | In the Member State concerned months | 10 |
| E.8.9.1 | In the Member State concerned days | 0 |
| E.8.9.2 | In all countries concerned by the trial years | 1 |
| E.8.9.2 | In all countries concerned by the trial months | 10 |
| E.8.9.2 | In all countries concerned by the trial days | 0 |