search
Back to results

A Clinical Trial to Demonstrate the Efficacy of Cangrelor (PCI)

Primary Purpose

Myocardial Infarction (MI), Acute Coronary Syndromes (ACS)

Status
Terminated
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Cangrelor (P2Y12 inhibitor)
clopidogrel (oral P2Y12 inhibitor)
Placebo bolus & placebo infusion
Placebo capsules - end of infusion
Placebo capsules - as soon as possible after randomization
Sponsored by
The Medicines Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myocardial Infarction (MI) focused on measuring Acute Coronary Syndrome (ACS), Percutaneous Coronary Intervention (PCI), non-ST-segment elevation myocardial infarction (NSTEMI), ST-segment elevation myocardial infarction (STEMI)

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

INCLUSION CRITERIA To be included in this study, subjects must meet the following criteria: Angiography demonstrating atherosclerosis amenable to treatment by percutaneous coronary intervention (PCI) with or without stent implantation and diagnosis of Acute Coronary Syndrome (ACS) by elevated cardiac markers or ischemic chest discomfort w/electrocardiogram changes + age > 65 or diabetes or ST-elevation MI. EXCLUSION CRITERIA Subjects will be excluded from the study if they present with any of the following: Not a candidate for PCI Increased bleeding risk: ischemic stroke within the last year or any previous hemorrhagic stroke, tumor, cerebral arteriovenous malformation, or intracranial aneurysm; recent (<1 month) trauma or major surgery (including by-pass surgery); currently receiving warfarin, active bleeding Impaired hemostasis: known International Normalized Ratio (INR) >1.5 at screening; past or present bleeding disorder (including congenital bleeding disorders such as von Willebrand's disease or hemophilia, acquired bleeding disorders, and unexplained clinically significant bleeding disorders), thrombocytopenia (platelet count <100,000/µL), or history of thrombocytopenia or neutropenia associated with clopidogrel Severe hypertension not adequately controlled by antihypertensive therapy at the time of randomization Receipt of fibrinolytic therapy in the 12 hours preceding randomization Receipt of clopidogrel dose exceeding maintenance dose (ie, >75 mg) at any time in the 5 days preceding randomization Inability to swallow study capsules Glycoprotein IIb/IIIa (GPI) Inhibitor usage within the previous 12 hours [applicable to unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI) patients] Subjects excluded for any of the above reasons may be re-screened for participation at any time if the exclusion characteristic has changed.

Sites / Locations

  • Pennsylvania Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Cangrelor

Clopidogrel

Arm Description

placebo capsules (to match) + cangrelor bolus (30 mcg/kg) & infusion (4 mcg/kg/min) administered from randomization for at least 2 hours, or until the end of the PCI, whichever is longer with the option to extend up to 4 hours maximum (per investigator discretion) + active clopidogrel (600mg) post infusion

clopidogrel capsules (600 mg) + placebo bolus & infusion (to match) + placebo capsules (to match) post infusion

Outcomes

Primary Outcome Measures

Incidence of All-cause Mortality, Myocardial Infarction (MI), and Ischemia-driven Revascularization (IDR)
(composite incidence)

Secondary Outcome Measures

Incidence of All-cause Mortality and MI
(composite incidence)
Individual Incidence of All-cause Mortality
Individual Incidence of IDR
Incidence of Stroke
Stroke is defined as a sudden, focal neurological defect resulting from a cerebrovascular cause that is not reversible within 24 hours and not due to a readily identifiable cause such as a tumor or trauma. All suspected strokes were reviewed and adjudicated by the Clinical Events Committee (CEC) who considered all clinically relevant information and imaging studies to classify all strokes as: primary hemorrhagic - stroke with focal collections of intracranial blood ischemic cerebral infarction - stroke without focal collections of intracranial blood infarction with hemorrhagic conversion - cerebral infarction with blood thought to represent hemorrhagic conversion and not primary bleeding uncertain - no imaging or autopsy data are available.
Incidence of Abrupt Closure, Threatened Abrupt Closure, Need for Urgent Coronary Artery Bypass Graft (CABG) Surgery, or Unsuccessful Procedure During the Index PCI
(a patient could have multiple procedural events)
Incidence of All-cause Mortality, MI or IDR
(composite incidence)
Incidence of All-cause Mortality or MI
(composite incidence)
Incidence of All-cause Mortality
Incidence of MI
Incidence of IDR
Incidence of Stroke
Incidence of All Cause Mortality
(excluding STEMI)
Incidence of GUSTO Severe / Life-threatening Bleeding
Major bleeding (non-CABG-related) - Safety population
Incidence of Thrombolysis in Myocardial Infarction (TIMI) Major Bleeding
Major bleeding (non-CABG-related) - Safety population
Incidence of ACUITY Major Bleeding
Major bleeding (non-CABG-related) - Safety population
Incidence of ACUITY Major Bleeding (Without Hematoma >/= 5 cm)
excludes ACUITY major bleeding for which the only qualifying event was hematoma >/= 5 cm

Full Information

First Posted
March 17, 2006
Last Updated
April 22, 2014
Sponsor
The Medicines Company
search

1. Study Identification

Unique Protocol Identification Number
NCT00305162
Brief Title
A Clinical Trial to Demonstrate the Efficacy of Cangrelor
Acronym
PCI
Official Title
A Clinical Trial Comparing Cangrelor to Clopidogrel in Subjects Who Require Percutaneous Coronary Intervention (PCI).
Study Type
Interventional

2. Study Status

Record Verification Date
April 2014
Overall Recruitment Status
Terminated
Why Stopped
Insufficient evidence of the clinical effectiveness of cangrelor
Study Start Date
April 2006 (undefined)
Primary Completion Date
May 2009 (Actual)
Study Completion Date
June 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The Medicines Company

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary objective of this study is to demonstrate that the efficacy of cangrelor is superior, or at least non-inferior, to that of clopidogrel in subjects requiring PCI.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myocardial Infarction (MI), Acute Coronary Syndromes (ACS)
Keywords
Acute Coronary Syndrome (ACS), Percutaneous Coronary Intervention (PCI), non-ST-segment elevation myocardial infarction (NSTEMI), ST-segment elevation myocardial infarction (STEMI)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
8882 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cangrelor
Arm Type
Experimental
Arm Description
placebo capsules (to match) + cangrelor bolus (30 mcg/kg) & infusion (4 mcg/kg/min) administered from randomization for at least 2 hours, or until the end of the PCI, whichever is longer with the option to extend up to 4 hours maximum (per investigator discretion) + active clopidogrel (600mg) post infusion
Arm Title
Clopidogrel
Arm Type
Active Comparator
Arm Description
clopidogrel capsules (600 mg) + placebo bolus & infusion (to match) + placebo capsules (to match) post infusion
Intervention Type
Drug
Intervention Name(s)
Cangrelor (P2Y12 inhibitor)
Intervention Description
IV bolus (30 mcg/kg) & infusion (4 mcg/kg/min) initiated prior to PCI, as soon as possible following randomization (after need for PCI is confirmed) but not more than 30 minutes prior to placement of arterial access. Infusion is to continue for at least 2 hours, or until the end of the PCI, whichever is longer with the option to extend up to 4 hours maximum (per investigator discretion).
Intervention Type
Drug
Intervention Name(s)
clopidogrel (oral P2Y12 inhibitor)
Other Intervention Name(s)
Plavix
Intervention Description
600 mg active clopidogrel administered as soon as possible following randomization (after need for PCI confirmed), but not more than 30 minutes prior to the placement of the arterial access.
Intervention Type
Drug
Intervention Name(s)
Placebo bolus & placebo infusion
Intervention Description
placebo bolus (30 mcg/kg) & placebo infusion (4 mcg/kg/min) administered from randomization for at least 2 hours, or until the end of the PCI, whichever is longer with the option to extend up to 4 hours maximum (per investigator discretion)
Intervention Type
Drug
Intervention Name(s)
Placebo capsules - end of infusion
Intervention Description
Placebo capsules given at the end of infusion to mimic 600mg clopidogrel dosing
Intervention Type
Drug
Intervention Name(s)
Placebo capsules - as soon as possible after randomization
Intervention Description
Placebo capsules given as soon as possible after randomization to mimic 600mg clopidogrel dosing
Primary Outcome Measure Information:
Title
Incidence of All-cause Mortality, Myocardial Infarction (MI), and Ischemia-driven Revascularization (IDR)
Description
(composite incidence)
Time Frame
randomization through 48 hours after randomization
Secondary Outcome Measure Information:
Title
Incidence of All-cause Mortality and MI
Description
(composite incidence)
Time Frame
randomization through 48 hours after randomization
Title
Individual Incidence of All-cause Mortality
Time Frame
randomization through 48 hours after randomization
Title
Individual Incidence of IDR
Time Frame
randomization through 48 hours after randomization
Title
Incidence of Stroke
Description
Stroke is defined as a sudden, focal neurological defect resulting from a cerebrovascular cause that is not reversible within 24 hours and not due to a readily identifiable cause such as a tumor or trauma. All suspected strokes were reviewed and adjudicated by the Clinical Events Committee (CEC) who considered all clinically relevant information and imaging studies to classify all strokes as: primary hemorrhagic - stroke with focal collections of intracranial blood ischemic cerebral infarction - stroke without focal collections of intracranial blood infarction with hemorrhagic conversion - cerebral infarction with blood thought to represent hemorrhagic conversion and not primary bleeding uncertain - no imaging or autopsy data are available.
Time Frame
randomization through 48 hours after randomization
Title
Incidence of Abrupt Closure, Threatened Abrupt Closure, Need for Urgent Coronary Artery Bypass Graft (CABG) Surgery, or Unsuccessful Procedure During the Index PCI
Description
(a patient could have multiple procedural events)
Time Frame
during index PCI
Title
Incidence of All-cause Mortality, MI or IDR
Description
(composite incidence)
Time Frame
randomization through 30 days after randomization
Title
Incidence of All-cause Mortality or MI
Description
(composite incidence)
Time Frame
randomization through 30 days after randomization
Title
Incidence of All-cause Mortality
Time Frame
randomization through 30 days after randomization
Title
Incidence of MI
Time Frame
randomization through 30 days after randomization
Title
Incidence of IDR
Time Frame
randomization through 30 days after randomization
Title
Incidence of Stroke
Time Frame
randomization through 30 days after randomization
Title
Incidence of All Cause Mortality
Description
(excluding STEMI)
Time Frame
randomization through 1 year after randomization
Title
Incidence of GUSTO Severe / Life-threatening Bleeding
Description
Major bleeding (non-CABG-related) - Safety population
Time Frame
randomization through 48 hours after randomization
Title
Incidence of Thrombolysis in Myocardial Infarction (TIMI) Major Bleeding
Description
Major bleeding (non-CABG-related) - Safety population
Time Frame
randomization through 48 hours after randomization
Title
Incidence of ACUITY Major Bleeding
Description
Major bleeding (non-CABG-related) - Safety population
Time Frame
randomization through 48 hours after randomization
Title
Incidence of ACUITY Major Bleeding (Without Hematoma >/= 5 cm)
Description
excludes ACUITY major bleeding for which the only qualifying event was hematoma >/= 5 cm
Time Frame
randomization through 48 hours after randomization

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA To be included in this study, subjects must meet the following criteria: Angiography demonstrating atherosclerosis amenable to treatment by percutaneous coronary intervention (PCI) with or without stent implantation and diagnosis of Acute Coronary Syndrome (ACS) by elevated cardiac markers or ischemic chest discomfort w/electrocardiogram changes + age > 65 or diabetes or ST-elevation MI. EXCLUSION CRITERIA Subjects will be excluded from the study if they present with any of the following: Not a candidate for PCI Increased bleeding risk: ischemic stroke within the last year or any previous hemorrhagic stroke, tumor, cerebral arteriovenous malformation, or intracranial aneurysm; recent (<1 month) trauma or major surgery (including by-pass surgery); currently receiving warfarin, active bleeding Impaired hemostasis: known International Normalized Ratio (INR) >1.5 at screening; past or present bleeding disorder (including congenital bleeding disorders such as von Willebrand's disease or hemophilia, acquired bleeding disorders, and unexplained clinically significant bleeding disorders), thrombocytopenia (platelet count <100,000/µL), or history of thrombocytopenia or neutropenia associated with clopidogrel Severe hypertension not adequately controlled by antihypertensive therapy at the time of randomization Receipt of fibrinolytic therapy in the 12 hours preceding randomization Receipt of clopidogrel dose exceeding maintenance dose (ie, >75 mg) at any time in the 5 days preceding randomization Inability to swallow study capsules Glycoprotein IIb/IIIa (GPI) Inhibitor usage within the previous 12 hours [applicable to unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI) patients] Subjects excluded for any of the above reasons may be re-screened for participation at any time if the exclusion characteristic has changed.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Deepak L. Bhatt, MD
Organizational Affiliation
The Cleveland Clinic
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Robert A. Harrington, MD
Organizational Affiliation
Duke University Medical Center and Duke Clinical Research Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Simona Skerjanec, PharmD
Organizational Affiliation
The Medicines Company
Official's Role
Study Director
Facility Information:
Facility Name
Pennsylvania Hospital
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107-6192
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
19915221
Citation
Harrington RA, Stone GW, McNulty S, White HD, Lincoff AM, Gibson CM, Pollack CV Jr, Montalescot G, Mahaffey KW, Kleiman NS, Goodman SG, Amine M, Angiolillo DJ, Becker RC, Chew DP, French WJ, Leisch F, Parikh KH, Skerjanec S, Bhatt DL. Platelet inhibition with cangrelor in patients undergoing PCI. N Engl J Med. 2009 Dec 10;361(24):2318-29. doi: 10.1056/NEJMoa0908628.
Results Reference
result
PubMed Identifier
35196863
Citation
Peterson BE, Harrington RA, Stone GW, Steg PG, Gibson CM, Hamm CW, Price MJ, Lopes RD, Leonardi S, Prats J, Deliargyris EN, Mahaffey KW, White HD, Bhatt DL. Effect of Platelet Inhibition by Cangrelor Among Obese Patients Undergoing Coronary Stenting: Insights From CHAMPION. Circ Cardiovasc Interv. 2022 Mar;15(3):e011069. doi: 10.1161/CIRCINTERVENTIONS.121.011069. Epub 2022 Feb 24.
Results Reference
derived
PubMed Identifier
29632238
Citation
Groves EM, Bhatt DL, Steg PG, Deliargyris EN, Stone GW, Gibson CM, Hamm CW, Mahaffey KW, White HD, Angiolillo DJ, Prats J, Harrington RA, Price MJ. Incidence, Predictors, and Outcomes of Acquired Thrombocytopenia After Percutaneous Coronary Intervention: A Pooled, Patient-Level Analysis of the CHAMPION Trials (Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition). Circ Cardiovasc Interv. 2018 Apr;11(4):e005635. doi: 10.1161/CIRCINTERVENTIONS.117.005635. Erratum In: Circ Cardiovasc Interv. 2018 Sep;11(9):e000036. Angiolillo, Dominick [corrected to Angiolillo, Dominick J].
Results Reference
derived
PubMed Identifier
28988157
Citation
Vaduganathan M, Harrington RA, Stone GW, Steg G, Gibson CM, Hamm CW, Price MJ, Lopes RD, Leonardi S, Deliargyris EN, Prats J, Mahaffey KW, White HD, Bhatt DL. Short- and long-term mortality following bleeding events in patients undergoing percutaneous coronary intervention: insights from four validated bleeding scales in the CHAMPION trials. EuroIntervention. 2018 Feb 2;13(15):e1841-e1849. doi: 10.4244/EIJ-D-17-00723.
Results Reference
derived
PubMed Identifier
28382371
Citation
Parker WA, Bhatt DL, Prats J, Day JRS, Steg PG, Stone GW, Hamm CW, Mahaffey KW, Price MJ, Gibson CM, White HD, Storey RF; CHAMPION PHOENIX Investigators. Characteristics of dyspnoea and associated clinical outcomes in the CHAMPION PHOENIX study. Thromb Haemost. 2017 Jun 2;117(6):1093-1100. doi: 10.1160/TH16-12-0958. Epub 2017 Apr 6.
Results Reference
derived
PubMed Identifier
27902833
Citation
Vaduganathan M, Harrington RA, Stone GW, Deliargyris EN, Steg PG, Gibson CM, Hamm CW, Price MJ, Menozzi A, Prats J, Elkin S, Mahaffey KW, White HD, Bhatt DL. Evaluation of Ischemic and Bleeding Risks Associated With 2 Parenteral Antiplatelet Strategies Comparing Cangrelor With Glycoprotein IIb/IIIa Inhibitors: An Exploratory Analysis From the CHAMPION Trials. JAMA Cardiol. 2017 Feb 1;2(2):127-135. doi: 10.1001/jamacardio.2016.4556.
Results Reference
derived
PubMed Identifier
22305835
Citation
White HD, Chew DP, Dauerman HL, Mahaffey KW, Gibson CM, Stone GW, Gruberg L, Harrington RA, Bhatt DL. Reduced immediate ischemic events with cangrelor in PCI: a pooled analysis of the CHAMPION trials using the universal definition of myocardial infarction. Am Heart J. 2012 Feb;163(2):182-90.e4. doi: 10.1016/j.ahj.2011.11.001.
Results Reference
derived

Learn more about this trial

A Clinical Trial to Demonstrate the Efficacy of Cangrelor

We'll reach out to this number within 24 hrs