Secondary Prevention of Cardiovascular Disease in the Elderly Trial

• Status: Active, not recruiting
• Trial end date: 2021-12-01
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of this study is to evaluate the efficacy of a polypill strategy containing aspirin (100 mg), ramipril (2.5, 5 or 10 mgs), and atorvastatin (40 mgs) compared with the standard of care (usual care according to the local clinical practices at each participating country) in secondary prevention of major cardiovascular events (cardiovascular death, nonfatal myocardial infarction, nonfatal ischemic stroke, and urgent revascularization) in elderly patients with a recent myocardial infarction.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III
• Collaborators: Centre Hospitalier Universitaire de Besancon; Charite University, Berlin, Germany; Ferrer Internacional S.A.; General University Hospital, Prague; Istituto Di Ricerche Farmacologiche Mario Negri; London School of Hygiene and Tropical Medicine; Semmelweis University; Servicio Madrileño de Salud, Madrid, Spain; Wroclaw Medical University
• Treatments: Platelet Aggregation Inhibitors; Ramipril

Criteria

Inclusion Criteria:

1. Patients diagnosed with a type 1 myocardial infarction within the previous 6 months.

2. Subjects must be ≥65 years old, presenting with at least one of the following additional conditions:

• Documented diabetes mellitus or previous treatment with oral hypoglycemic drugs or insulin.

• Mild to moderate renal dysfunction: creatinine clearance 60-30 mL/min/1.73 m2.

• Prior myocardial infarction: defined as an AMI occurring before the index event documented in a medical report.

• Prior coronary revascularization: coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI).

• Prior stroke: history of a documented stroke, defined as an acute episode of focal cerebral, spinal, or retinal dysfunction caused by infarction of central nervous system tissue, not resulting in death.

• Age ≥ 75 years.

3. Signing informed consent.

Exclusion Criteria:

1. Unable to sign informed consent.

2. Contraindications to any of the components of the polypill.

3. Living in a nursing home.

4. Mental illness limiting the capacity of self-care.

5. Participating in another clinical trial.

6. Severe congestive heart failure (NYHA III-IV).

7. Severe renal disease (Creatinine Clearance (CrCl) <30ml/min/1.73 m2).

8. Need for oral anticoagulation at the time of randomization or planned in the future months.

9. Any condition limiting life expectancy <2 years, including but not limited to active malignancy.

10. Significant arrhythmias (including unresolved ventricular arrhythmias or atrial fibrillation).

11. Scheduled coronary revascularization (patients can be randomized after final revascularization is completed within the prespecified timeframe).

12. Do not agree to the filing, forwarding and use of his/ her pseudonymised data.