P3AMI Antiplatelet Trial
Heart Attack
About this trial
This is an interventional treatment trial for Heart Attack focused on measuring STEMI, NSTEMI, PPCI
Eligibility Criteria
Inclusion Criteria:
- Patients presenting with STEMI for PCI (characterized by chest discomfort, and prominent STsegment elevation)
- Patients presenting with NSTEMI (characterized by chest discomfort, raised levels of myocardial enzymes and/or STsegment depression or prominent T wave inversion)
- Able to give verbal consent (STEMI patients pre procedure) and/or written consent (STEMI after procedure and NSTEMI patients prior to enrolment).
- Age>18 years of age
- Able to take Aspirin and either prasugrel or ticagrelor.
- Have no concurrent septic or inflammatory illness
- Thienopyridine naive
Exclusion Criteria:
- Be unable to provide verbal and written consent
- Allergic to aspirin or any of the P2Y12 antagonists in the trial
- Have preexisting cardiogenic shock
- Have a concurrent septic or inflammatory disease e.g. rheumatoid arthritis, lupus, pneumonia.
- Already taking a P2Y12 inhibitor
- Known bleeding diathesis
- Patients under 75 years of age or under 60 kg or those who have had a previous stroke/transient ischaemic attack, will not be eligible for prasugrel but rather ticagrelor.
- Patients with a history of intracranial haemorrhage will not receive prasugrel or ticagrelor but rather will receive treatment with clopidogrel.
Sites / Locations
- The Royal Wolverhampton NHS Trust
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Other
Other
Other
Other
Other
Other
STEMI prasugrel
STEMI clopidogrel
NSTEMI clopidogrel
Patients with NSTEMI
Patients admitted with STEMI receiving ticagrelor loading
Patients Admitted with NSTEMI receiving ticagrelor loading
Patients with diabetes mellitus admitted with STEMI who are under 75 years of age and greater than 60Kg in weight receiving Prasugrel Loading (60mg) and maintenance (10mg per day).
Patients admitted with STEMI over the age of 75 or under 60 Kg receiving clopidogrel loading (600 mg) and then maintenance (75mg per day).
Patients admitted with NSTEMI/UA over the age of 75 or under 60 Kg receiving clopidogrel loading (600 mg) and then maintenance (75mg per day).
who are under 75 years of age and greater than 60Kg in weight receiving Prasugrel loading (60mg) however: - i. After sample collection patients treated with intracoronary stent placement on the same day as loading will receive prasugrel maintenance dose (10mg per day) as per licensing agreement for prasugrel ii. After sample collection patients who are not stented after loading will receive clopidogrel maintenance dose (75mg per day).
Patients admitted with STEMI receiving ticagrelor loading (180 mg) and then maintenance (90mg bd per day)
Patients Admitted with NSTEMI receiving ticagrelor loading (180 mg) and then maintenance (90mg bd per day).