E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Spontaneous Coronary Artery Dissection |
Disección espontánea de la arteria coronaria |
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E.1.1.1 | Medical condition in easily understood language |
Spontaneous Coronary Artery Dissection |
Disección espontánea de la arteria coronaria |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cardiovascular Diseases [C14] |
MedDRA Classification |
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 evaluate the clinical efficacy of the two most widely used pharmacological therapeutic strategies in patients with SCAD in clinical practice. Namely, to assess the role of beta-blockers and the optimal antiplatelet regimen (short duration of antiplatelet therapy [1 month] versus DAPT for 1 year) in these patients. The consistency of the treatment effect will be examined among 10-predefined relevant clinical variables after adjusting for multiple comparisons. |
Evaluar la eficacia clínica de las dos estrategias terapéuticas farmacológicas más utilizadas en la práctica clínica en pacientes con disección coronaria espontánea. En concreto, evaluar el papel de los betabloqueantes y el tratamiento antiplaquetario (tratamiento antiplaquetario de corta duración [1 mes] frente a larga duración durante 1 año) en estos pacientes. Se examinará la consistencia del efecto del tratamiento entre 10 variables clínicas relevantes predefinidas tras ajustar por comparaciones múltiples. |
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E.2.2 | Secondary objectives of the trial |
A number of secondary objectives will be also addressed using well-defined predefined ancillary studies: 1) Angiographic and Quantitative Coronary Analyses 2) Coronary revascularization 3) Intracoronary imaging (optical coherence tomography and intravascular ultrasound 4) Cardiac CT 5) Magnetic resonance imaging 6) Pharmacogenetics 7) Inflammatory, immunologic, genetic and micro-RNA analyses |
También se abordará una serie de objetivos secundarios mediante estudios auxiliares bien definidos: 1) Análisis angiográficos y coronarios cuantitativos 2) Revascularización coronaria 3) Imágenes intracoronarias (tomografía de coherencia óptica y ecografía intravascular) 4) TAC cardíaco 5) Resonancia magnética 6) Farmacogenética 7) Análisis inflamatorios, inmunológicos, genéticos y de micro-ARN |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Written informed consent - Patients admitted for ACS or any other manifestation of myocardial ischemia - Diagnosis of SCAD on a coronary angiography during index hospitalization |
- Consentimiento informado por escrito - Pacientes ingresados por SCA o cualquier otra manifestación de isquemia miocárdica - Diagnóstico de SCAD en una angiografía coronaria durante la hospitalización índice |
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E.4 | Principal exclusion criteria |
- Cardiogenic shock or severe hemodynamic instability - Concomitant severe heart disease requiring surgical correction (in <2 years) - Any major medical condition seriously limiting life expectancy (<2 years) - Participation in another clinical trial |
- Shock cardiogénico o inestabilidad hemodinámica grave - Enfermedad cardíaca grave concomitante que requiera corrección quirúrgica (en <2 años) - Cualquier condición médica importante que limite seriamente la esperanza de vida (<2 años) - Participación en otro ensayo clínico |
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E.5 End points |
E.5.1 | Primary end point(s) |
Death, MI, stroke, coronary revascularization, recurrent dissection and hospital admission for ACS or heart failure |
Muerte, infarto de miocardio, ictus, revascularización coronaria, disección recurrente e ingreso hospitalario por SCA o insuficiencia cardíaca |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
Death, MI, stroke, coronary revascularization, and recurrent dissection, hospital admission for ACS or heart failure or bleeding |
Muerte, infarto de miocardio, ictus, revascularización coronaria, disección recurrente, ingreso hospitalario por SCA o insuficiencia cardíaca o hemorragia |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | Yes |
E.6.11 | Pharmacogenomic | Yes |
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 | No |
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 | No |
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) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 4 |
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 | 39 |
E.8.5 | The trial involves multiple Member States | No |
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 | No |
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 | 3 |
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 | 3 |