The Safety of Ticagrelor Monotherapy After Primary Percutaneous Coronary Intervention for ST-elevation Myocardial Infarction and the Effect on Intramyocardial Haemorrhage

NL82646.091.22

The main goal of this clinical trial is to assess the safety of direct omission of aspirin after Percutaneous Coronary Intervention (PCI) in patients with ST elevation myocardial infarction (STEMI). The secondary objectives are to demonstrate the reduction of intramyocardial haemorrhage and infarct size, which will be measured after 1 week; to compare clinical bleeding outcomes and to compare platelet reactivity and inflammatory response in STEMI patients receiving ticagrelor monotherapy versus dual antiplatelet therapy. Patients will be treated with either ticagrelor monotherapy or dual antiplatelet therapy (aspirin plus ticagrelor) after PCI. They will be compared to see if the omission of aspirin is safe in terms of major adverse cardiac and cerebral events at 13 months follow-up.

2023-07-06

2025-07-06

2025-07-06

Recruiting

200

Inclusion Criteria: * Clinical and electrocardiographical diagnosis of STEMI * Successful PCI (according to the treating physician) of the infarct-related vessel with a modern DES Exclusion Criteria: * Known allergy or contraindication for aspirin, ticagrelor or prasugrel. * Previous PCI or MI less than 12 months ago * Previous cardiac surgery * Participation in another clinical cardiology study or study concerning platelet aggregation/ thrombosis. * Pregnancy and breast feeding * Concurrent use of oral anticoagulants (OAC) * The periprocedural use of GPIIb/IIIa inhibitors * Planned surgical intervention within 12 months of PCI * Creatinine clearance \<30mL/min or dialysis * PCI of stent thrombosis * Suboptimal stent result as judged by the interventional cardiologist. * Contra-indications for MRI or unable to undergo MRI (only applicable for the CMR subgroup population).

{'studyType': 'INTERVENTIONAL', 'phases': ['NA'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 200, 'type': 'ESTIMATED'}}

2023-08-14