Dual Antiplatelet Therapy For Shock Patients With Acute Myocardial Infarction

• Status: Recruiting
• Trial end date: 2024-05-01
• Target enrollment: 0
• Participant gender: All

Summary

Multicenter randomized double blind trial comparing intravenous cangrelor and oral ticagrelor in patients with acute myocardial infarction complicated by initial cardiogenic shock and treated with primary angioplasty.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Faculty Hospital Kralovske Vinohrady
• Collaborator: Charles University, Czech Republic
• Treatments: Cangrelor; Ticagrelor

Criteria

Inclusion Criteria:

1. Age over 18 years

2. Acute myocardial infarction according to the definition of ESC/ACC/AHA, indicated for emergency percutaneous coronary intervention (primary PCI strategy)

3. Cardiogenic shock present upon admission due to the AMI (≥ 2 of the criteria below are satisfied)24

1. sBP < 90 mmHg with the absence of hypovolemia

2. Need of vasopressor and/or inotropic therapy

3. Presence of the signs of the organ hypoperfusion - cyanosis, cold acra, disorder of consciousness, congestive heart failure

4. Informed consent form signed.

Exclusion Criteria:

1. Contraindications of antiplatelet therapy with ticagrelor/cangrelor25

• Recent (< 6 months) major bleeding

• Recent (< 1 month) major surgery/injury

• History of intracranial bleeding

• History of stroke/TIA

• Known intolerance to ticagrelor/cangrelor

• Severe impairment of hepatic function

• Concomitant administration of strong CYP3A4 inhibitors (for example, ketoconazole, clarithromycin, nefazodone, ritonavir and atazanavir)

2. Administration of a loading dose of an oral P2Y12 inhibitor prior to admission (clopidogrel ≥ 300 mg, ticagrelor 180 mg, prasugrel 60 mg)

3. Need of concomitant chronic anticoagulation therapy due to indications such as atrial fibrillation, artificial valve, thromboembolic disease, etc.