E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Subjects either male or female eligible for percutaneous coronary intervention (PCI) with lesions suitable for stent implantation who meet all eligibility criteria and provide written informed consent will be included. Of note, inclusion criteria will be kept comprehensive to reflect routine clinical practice (i.e. ?real world, all-comers? patients). |
Los sujetos elegibles ya sea hombre o mujer para la intervención coronaria percutánea (ICP) con lesiones adecuadas para la implantación de un stent que cumplan con todos los criterios de elegibilidad y y que den su consentimiento informado por escrito se incluirán. Es de destacar que los criterios de inclusión seran comprensibles para reflejar la práctica clínica habitual (es decir, "el mundo real, todos los pacientes que" los pacientes). |
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E.1.1.1 | Medical condition in easily understood language |
Patients with different levels of chest pain, due to poor blood flow to the heart. To improve the blood flow and symptoms, the artery is reopened followed by applicable treatment by medicines. |
Paciente con diferentes niveles de dolor de pecho por flujo de sangre insuficiente al corazón. Para mejorar el flujo de sangre y los síntomas la arteria se dilata seguido de tratamiento con medicacion |
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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 | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10011078 |
E.1.2 | Term | Coronary artery disease |
E.1.2 | System Organ Class | 10007541 - Cardiac disorders |
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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 |
To determine in all-comers patients undergoing PCI under standardised treatment (including the BioMatrix family of drug-eluting stents and bivalirudin), whether treatment with 1 month of ticagrelor and aspirin followed by 23 months of ticagrelor monotherapy is superior with respect to the composite of all-cause mortality or non-fatal new Q-wave MI compared to treatment with 12 months of standard dual anti platelet therapy (DAPT) followed by aspirin monotherapy. |
Determinar en todos los pacientes sometidos a una ICP como parte del tratamiento estándar (incluidos los stents liberadores de fármaco de la familia BioMatrix y bivalirudina) si el tratamiento de 1 mes con ticagrelor y aspirina seguido de 23 meses de ticagrelor en monoterapia es superior con respecto al compuesto de mortalidad por cualquier causa o nuevo IM con onda Q no mortal en comparación con el tratamiento antiplaquetario dual (TAD) estándar de 12 meses seguido de aspirina en monoterapia. |
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
?Real world, all comer? patients 1. Age ?18 years; 2. Presence of one or more coronary artery stenoses of 50% or more in a native coronary artery or in a saphenous venous or arterial bypass conduit suitable for coronary stent implantation in a vessel with a reference vessel diameter of at least 2.25 mm (no limitation on the number of treated lesions, and vessels, and lesion length). 3. Able to provide informed consent and willing to participate in 2 year follow-up period. |
1. Edad ? 18 años. 2. Presencia de una o más estenosis de arteria coronaria del 50% o más en una arteria coronaria nativa o en un conducto de derivación arterial o de la vena safena adecuada para la implantación del stent coronario. El vaso debe tener un diámetro de referencia mínimo de 2,25 mm (no existe ninguna limitación en el número de lesiones tratadas, vasos o longitud de la lesión). 3. Posibilidad de proporcionar el consentimiento informado y predisposición para participar en un período de seguimiento de 2 años. |
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E.4 | Principal exclusion criteria |
1. Known intolerance to aspirin, P2Y12 inhibitors, bivalirudin, stainless steel or biolimus; 2. Known intake of a strong CYP3A4 inhibitor (e.g., ketoconazole, clarithromycin, nefazodone, ritonavir, and atazanavir), as co-administration may lead to a substantial increase in exposure to ticagrelor; 3. Known moderate to severe hepatic impairment (alanine-aminotransferase ? 3 x ULN); 4. Planned surgery, including CABG as a staged procedure (hybrid) within 12 months of the index procedure, unless dual antiplatelet therapy is maintained throughout the peri-surgical period; 5. Need for chronic oral anti-coagulation therapy; 6. Active major bleeding or major surgery within the last 30 days; 7. Known history of intracranial haemorrhagic stroke or intra-cranial aneurysm; 8. Known stroke (any type) within the last 30 days; 9. Known pregnancy at time of randomisation; 10. Currently participating in another trial and not yet at its primary endpoint. |
1. Intolerancia conocida a la aspirina, a los inhibidores de P2Y12, a la bivalirudina, al acero inoxidable o al biolimus. 2. Ingesta conocida de un potente inhibidor del CYP3A4 (por ejemplo, ketoconazol, claritromicina, nefazodona, ritonavir y atazanavir), que coadministrado puede provocar un aumento considerable de la exposición a ticagrelor. 3. Insuficiencia hepática moderada o grave conocida (alanina aminotransferasa ? 3 x LSN). 4. Cirugía programada, incluido el IDAC como un procedimiento por etapas (híbrido) durante los 12 meses posteriores al procedimiento índice, a no ser que el tratamiento antiplaquetario dual se mantenga durante el período perioperatorio. 5. Necesidad de tratamiento anticoagulante oral crónico. 6. Hemorragia mayor activa o cirugía mayor en los últimos 30 días. 7. Antecedentes conocidos de hemorragia intracraneal, infarto cerebral o aneurisma intracraneal. 8. Infarto cerebral conocido (de cualquier tipo) en los últimos 30 días. 9. Embarazo conocido en el momento de la aleatorización. 10. Estar participando actualmente en otro ensayo que todavía no ha alcanzado su criterio principal de valoración. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The composite of overall mortality or non-fatal new Q-wave MI up to 2 years post-randomization. |
El compuesto de mortalidad por cualquier causa y nuevo IM con onda Q no mortal hasta 2 años después de la aleatorización. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
2 years post-randomization. |
2 años despues de la randomizacion |
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E.5.2 | Secondary end point(s) |
The composite of BARC3 or BARC5 bleeding according to BARC definitions up to 2 years post-randomization. |
El compuesto de hemorragia BARC3 o BARC5 notificado por el investigador según las definiciones de BARC hasta 2 años después de la aleatorización. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
2 years post-randomization. |
2 años despues de la randomizacion |
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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) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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 | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 55 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Austria |
Belgium |
Brazil |
Canada |
Denmark |
France |
Germany |
Italy |
Netherlands |
Poland |
Singapore |
Spain |
Sweden |
Switzerland |
United Kingdom |
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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
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |