Optimized Antithrombotic Therapy of Acute Myocardial Infarction With Left Ventricular Mural Thrombus (OATH-AMI)
Primary Purpose
Acute Myocardial Infarction, Left Ventricular Thrombus
Status
Unknown status
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Combination of antiplatelet drugs and anticoagulants for at least one month
Sponsored by
About this trial
This is an interventional treatment trial for Acute Myocardial Infarction
Eligibility Criteria
Inclusion Criteria:
- acute myocardial infarction with left ventricular mural thrombus
Exclusion Criteria:
- BARC bleedings ≥ 2
- atrial fibrillation
- acute stroke or other systemic circulation embolism
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Experimental
Experimental
Experimental
Arm Label
aspirin100mg qd+clopidogrel75mg qd+warfarin (INR1.8-2.2)
aspirin100mg qd+clopidogrel75mg qd+dabigatran110mg bid
aspirin100mg qd+ticagrelor60mg bid+warfarin(INR1.8-2.2)
aspirin100mg qd+ticagrelor60mg bid+dabigatran110mg bid
Arm Description
Outcomes
Primary Outcome Measures
Left ventricular mural thrombus-1
Number of Participants Without left ventricular mural thrombus as Assessed by echocardiograph at 1-month.
Left ventricular mural thrombus-3
Number of Participants Without left ventricular mural thrombus as Assessed by echocardiograph at 3-month.
Left ventricular mural thrombus-6
Number of Participants Without left ventricular mural thrombus as Assessed by echocardiograph at 6-month.
Secondary Outcome Measures
Death
Recurrent myocardial infarction
Stroke or other systemic circulation embolism
Stent restenosis
Target vessel revascularization
Major cardio-cerebral vascular events
Composite of any events from outcome 2 to 6
Full Information
NCT ID
NCT03415386
First Posted
January 11, 2018
Last Updated
February 9, 2020
Sponsor
The First Affiliated Hospital with Nanjing Medical University
1. Study Identification
Unique Protocol Identification Number
NCT03415386
Brief Title
Optimized Antithrombotic Therapy of Acute Myocardial Infarction With Left Ventricular Mural Thrombus
Acronym
OATH-AMI
Official Title
A Multi-center Study on the Optimized Antithrombotic Therapy of Acute Myocardial Infarction With Left Ventricular Mural Thrombus.
Study Type
Interventional
2. Study Status
Record Verification Date
February 2020
Overall Recruitment Status
Unknown status
Study Start Date
June 2020 (Anticipated)
Primary Completion Date
December 2020 (Anticipated)
Study Completion Date
June 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The First Affiliated Hospital with Nanjing Medical University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
A multi-center study will be done to explore the optimal regimen of antithrombotic therapy for acute myocardial infarction with left ventricular mural thrombus. The investigators will evaluate the different combinations of antiplatelet drugs and anticoagulants for at least one month, such as aspirin 100mg qd+clopidogrel 75mg qd+warfarin (INR1.8-2.2), aspirin 100mg qd+clopidogrel 75mg qd+dabigatran 110mg bid, aspirin 100mg qd+ticagrelor 60mg bid+warfarin (INR1.8-2.2), and aspirin 100mg qd+ticagrelor 60mg bid+dabigatran 110mg bid. Transthoracic two-dimensional echocardiography will be done at the 1-month, 3-month and 6-month follow-ups to evaluate the left ventricular mural thrombus and determinate whether the antithrombotic therapy regimen could be regulated to double antiplatelet or anticoagulant+clopidogrel 75mg qd/ticagrelor 60mg bid. Then the investigators will complete the 12-month follow-up to evaluate the efficacy and safety of the optimal antithrombotic therapy regimen for acute myocardial infarction with left ventricular mural thrombus.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myocardial Infarction, Left Ventricular Thrombus
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Sequential Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
120 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
aspirin100mg qd+clopidogrel75mg qd+warfarin (INR1.8-2.2)
Arm Type
Experimental
Arm Title
aspirin100mg qd+clopidogrel75mg qd+dabigatran110mg bid
Arm Type
Experimental
Arm Title
aspirin100mg qd+ticagrelor60mg bid+warfarin(INR1.8-2.2)
Arm Type
Experimental
Arm Title
aspirin100mg qd+ticagrelor60mg bid+dabigatran110mg bid
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Combination of antiplatelet drugs and anticoagulants for at least one month
Intervention Description
Combination of antiplatelet drugs and anticoagulants for at least one month, such as aspirin100mg qd+clopidogrel75mg qd+warfarin (INR1.8-2.2), aspirin100mg qd+clopidogrel75mg qd+dabigatran110mg bid, aspirin100mg qd+ticagrelor60mg bid+warfarin (INR1.8-2.2), and aspirin100mg qd+ticagrelor60mg bid+dabigatran110mg bid. Transthoracic two-dimensional echocardiography will be done at the 1-month, 3-month and 6-month follow-ups to evaluate the left ventricular mural thrombus and determinate whether the antithrombotic therapy regimen could be regulated to double antiplatelet or anticoagulant+clopidogrel75mg qd/ticagrelor60mg bid.
Primary Outcome Measure Information:
Title
Left ventricular mural thrombus-1
Description
Number of Participants Without left ventricular mural thrombus as Assessed by echocardiograph at 1-month.
Time Frame
1-month
Title
Left ventricular mural thrombus-3
Description
Number of Participants Without left ventricular mural thrombus as Assessed by echocardiograph at 3-month.
Time Frame
3-month
Title
Left ventricular mural thrombus-6
Description
Number of Participants Without left ventricular mural thrombus as Assessed by echocardiograph at 6-month.
Time Frame
6-month
Secondary Outcome Measure Information:
Title
Death
Time Frame
12 months
Title
Recurrent myocardial infarction
Time Frame
12 months
Title
Stroke or other systemic circulation embolism
Time Frame
12 months
Title
Stent restenosis
Time Frame
12 months
Title
Target vessel revascularization
Time Frame
12 months
Title
Major cardio-cerebral vascular events
Description
Composite of any events from outcome 2 to 6
Time Frame
12 months
Other Pre-specified Outcome Measures:
Title
Major bleeding
Description
Bleeding Academic Research Consortium (BARC) bleedings ≥ 2
Time Frame
12 months
Title
Minor bleeding
Description
BARC bleedings < 2
Time Frame
12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
acute myocardial infarction with left ventricular mural thrombus
Exclusion Criteria:
BARC bleedings ≥ 2
atrial fibrillation
acute stroke or other systemic circulation embolism
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Liansheng Wang, Doctor
Phone
86 25 68303125
Email
drlswang@njmu.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Haoyu Meng, Doctor
Phone
86 25 68303126
Email
haoyu_meng@163.com
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Citations:
PubMed Identifier
26320110
Citation
Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, Bax JJ, Borger MA, Brotons C, Chew DP, Gencer B, Hasenfuss G, Kjeldsen K, Lancellotti P, Landmesser U, Mehilli J, Mukherjee D, Storey RF, Windecker S; ESC Scientific Document Group. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016 Jan 14;37(3):267-315. doi: 10.1093/eurheartj/ehv320. Epub 2015 Aug 29. No abstract available.
Results Reference
background
PubMed Identifier
28886621
Citation
Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, Caforio ALP, Crea F, Goudevenos JA, Halvorsen S, Hindricks G, Kastrati A, Lenzen MJ, Prescott E, Roffi M, Valgimigli M, Varenhorst C, Vranckx P, Widimsky P; ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018 Jan 7;39(2):119-177. doi: 10.1093/eurheartj/ehx393. No abstract available.
Results Reference
background
PubMed Identifier
7464234
Citation
Reeder GS, Lengyel M, Tajik AJ, Seward JB, Smith HC, Danielson GK. Mural thrombus in left ventricular aneurysm: incidence, role of angiography, and relation between anticoagulation and embolization. Mayo Clin Proc. 1981 Feb;56(2):77-81.
Results Reference
background
PubMed Identifier
2643772
Citation
Turpie AG, Robinson JG, Doyle DJ, Mulji AS, Mishkel GJ, Sealey BJ, Cairns JA, Skingley L, Hirsh J, Gent M. Comparison of high-dose with low-dose subcutaneous heparin to prevent left ventricular mural thrombosis in patients with acute transmural anterior myocardial infarction. N Engl J Med. 1989 Feb 9;320(6):352-7. doi: 10.1056/NEJM198902093200604.
Results Reference
background
PubMed Identifier
8821415
Citation
Keeley EC, Hillis LD. Left ventricular mural thrombus after acute myocardial infarction. Clin Cardiol. 1996 Feb;19(2):83-6. doi: 10.1002/clc.4960190203.
Results Reference
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Optimized Antithrombotic Therapy of Acute Myocardial Infarction With Left Ventricular Mural Thrombus
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