Sequential MonotherApy of TicagrElor and Clopidogrel After Coronary Intervention (MATE)
Acute Coronary Syndrome, Percutaneous Coronary Intervention
About this trial
This is an interventional treatment trial for Acute Coronary Syndrome focused on measuring ticagrelor, monotherapy
Eligibility Criteria
Inclusion Criteria:
- Age 18-80 years old;
- Acute coronary syndrome was diagnosed upon admission;
- Administered ticagrelor for at least 30 days after successful PCI with implantation of a current-generation drug-eluting stent(s)
- Agree to the study protocol and the schedule of clinical follow-up, and provides informed, written consent
Exclusion Criteria:
- Implanted with first-generation DES or bioabsorbable stent(s) during hospitalization;
- Patients with active pathological bleeding (such as peptic ulcer or intracranial hemorrhage);
- High potential risk of major bleeding, such as acute or chronic gastrointestinal ulcers or other gastrointestinal diseases, alignant tumors, history of intracranial bleeding, etc.;
- Thrombolytic therapy within 24 hours of index PCI;
- Planned major surgery within 1 year;
- Planned coronary revascularization (surgical or percutaneous) within 30 days;
- Allergic to ticagrelor, clopidogrel or aspirin and any excipients;
- Inability to tolerate 12-month DAPT (ticagrelor+aspirin) for any reason;
- Cardiogenic shock or hemodynamic instability;
- Diagnosed as active hepatitis or liver cirrhosis upon admission;
- Estimated survival time<12 months
- Suffer from a known serious progressive disease (e.g. progressive cancer, chronic obstructive lung disease, etc.;) or extremely exhausted;
- Platelet count<100000 /mm3;
- Dialysis-dependent renal failure;
- Required use of oral anticoagulation (warfarin or other factor II or factor X inhibitors);
- Pregnant or plan to be pregnant within 1 year;
- Any condition that may interfere with any study procedures, such as dementia, immobility, alcohol use, etc;
- Participating in any other clinical trial of an investigational drug or device that has not met its primary endpoint.
Sites / Locations
- 2nd Affiliated Hospital, School of Medicine at Zhejiang UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Standard-DAPT of Ticagrelor plus aspirin (DAPT)
Sequential monotherapy of Ticagrelor and Clopidogrel (SAPT)
Patients will receive Standard-DAPT of Ticagrelor plus aspirin for 1month after PCI and continue to receive standard-DAPT till 1 year in this arm after as followed: Ticagrelor 90mg bid+Aspirin 100mg qd for 1month; Ticagrelor 90mg bid+Aspirin 100mg qd for another 11 months;
Patients will receive Standard-DAPT of Ticagrelor plus aspirin for 1month after PCI and switch to ticagrelor monotherapy in the following 5 months, and then further de-escalated to clopidogrel monotherapy till 1 year in this arm as followed: Ticagrelor 90mg bid+Aspirin 100mg qd for 1 month; Ticagrelor 90mg bid, for 5 months; clopidogrel 75mg qd, for 6 months.