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Dual Antiplatelet Therapy For Shock Patients With Acute Myocardial Infarction (DAPT-SHOCK-AMI)

Primary Purpose

Acute Myocardial Infarction, Cardiogenic Shock

Status
Recruiting
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Cangrelor
Ticagrelor
Sponsored by
Faculty Hospital Kralovske Vinohrady
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myocardial Infarction focused on measuring Acute myocardial infarction, Cardiogenic shock, Primary percutaneous coronary intervention, Dual antiplatelet therapy, Cangrelor, Ticagrelor

Eligibility Criteria

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

Inclusion Criteria:

  1. Age over 18 years
  2. Acute myocardial infarction according to the definition of ESC/ACC/AHA, indicated for emergency percutaneous coronary intervention (primary PCI strategy)
  3. Cardiogenic shock present upon admission due to the AMI (≥ 2 of the criteria below are satisfied)24

    1. sBP < 90 mmHg with the absence of hypovolemia
    2. Need of vasopressor and/or inotropic therapy
    3. Presence of the signs of the organ hypoperfusion - cyanosis, cold acra, disorder of consciousness, congestive heart failure
  4. Informed consent form signed.

Exclusion Criteria:

  1. Contraindications of antiplatelet therapy with ticagrelor/cangrelor25

    • Recent (< 6 months) major bleeding
    • Recent (< 1 month) major surgery/injury
    • History of intracranial bleeding
    • History of stroke/TIA
    • Known intolerance to ticagrelor/cangrelor
    • Severe impairment of hepatic function
    • Concomitant administration of strong CYP3A4 inhibitors (for example, ketoconazole, clarithromycin, nefazodone, ritonavir and atazanavir)
  2. Administration of a loading dose of an oral P2Y12 inhibitor prior to admission (clopidogrel ≥ 300 mg, ticagrelor 180 mg, prasugrel 60 mg)
  3. Need of concomitant chronic anticoagulation therapy due to indications such as atrial fibrillation, artificial valve, thromboembolic disease, etc.

Sites / Locations

  • University Hospital Kralovske VinohradyRecruiting
  • St. Anne's University Hospital BrnoRecruiting
  • Department of Cardiology, University Hospital Brno-BohuniceRecruiting
  • Cardiology Department, Regional HospitalRecruiting
  • University Hospital Hradec KrálovéRecruiting
  • Cardiology department, Regional hospitalRecruiting
  • Cardiocenter, Regional HospitalRecruiting
  • Krajská nemocnice LiberecRecruiting
  • University Hospital OlomoucRecruiting
  • University Hospital OstravaRecruiting
  • Department of Cardiology, Regional Hospital,Recruiting
  • University Hospital PilsenRecruiting
  • General University Hospital in PragueRecruiting
  • Institute of Clinical and Experimental MedicineRecruiting
  • Na Homolce HospitalRecruiting
  • Cardiocenter, Hospital PodlesiRecruiting
  • Regional Hospital T. BatiRecruiting
  • Masaryk HospitalRecruiting
  • Pitié-Salpêtrière Hospital (AP-HP)Recruiting
  • Heart Center Freiburg UniversityRecruiting
  • University Medical CentreRecruiting
  • University Hospital TübingenRecruiting
  • Collegium Medicum University Hospital No. 1
  • Jagiellonianan University, University Hospital KrakowRecruiting
  • Medical University of Warsaw
  • Middle-Slovak Institute of Cardiovascular DiseasesRecruiting
  • Center of Interventional Neuroradiology and Endovascular TreatmentRecruiting
  • CardiocentreRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Cangrelor therapy

Ticagrelor therapy

Arm Description

Initiation of iv Cangrelor immediately upon arrival of the patient to the cardiac catheterization laboratory and after randomization into the study.

Initial dose Ticagrelor immediately upon arrival of the patient to the cardiac catheterization laboratory and after randomization into the study. In patients with a disorder of consciousness, initial dose of Ticagrelor will be administered immediately after nasogastric tube insertion.

Outcomes

Primary Outcome Measures

Primary Clinical Endpoint
Combined endpoint defined as Death/Myocardial infarction/Stroke
Primary Laboratory endpoint
Early achievement of efficient inhibition of ADP-induced platelet aggregation

Secondary Outcome Measures

Key secondary net-clinical endpoint
Death/Myocardial infarction/Urgent revascularization of the infarct-related artery /Stroke/Major bleeding BARC ≥ 3
Key safety endpoint
Incidence of bleeding according to the BARC definition
Key secondary endpoint
Cardiovascular death/Myocardial infarction/Urgent revascularization/Heart failure
Secondary endpoint
Individual components of the primary clinical endpoint
Other secondary endpoint
Death from cardiovascular causes
Secondary outcome
Definite stent thrombosis
Secondary safety outcome
Delaying the surgery due to bleeding

Full Information

First Posted
May 29, 2018
Last Updated
August 7, 2023
Sponsor
Faculty Hospital Kralovske Vinohrady
Collaborators
Charles University, Czech Republic
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1. Study Identification

Unique Protocol Identification Number
NCT03551964
Brief Title
Dual Antiplatelet Therapy For Shock Patients With Acute Myocardial Infarction
Acronym
DAPT-SHOCK-AMI
Official Title
Cangrelor Versus Ticagrelor In Patients With Acute Myocardial Infarction Complicated With Initial Cardiogenic Shock
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 1, 2018 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Faculty Hospital Kralovske Vinohrady
Collaborators
Charles University, Czech Republic

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Multicenter randomized double blind trial comparing intravenous cangrelor and oral ticagrelor in patients with acute myocardial infarction complicated by initial cardiogenic shock and treated with primary angioplasty.
Detailed Description
Randomization to study drugs shall be performed using an online database system for data collection; the assigned arm and the randomisation code will be generated after entering basic patient data based on a predefined randomization scheme. Concomitant therapy. Acetylsalicylic acid - 500 mg i.v. initial dose, and then 100 mg oral daily dose. Proton pump inhibitor. Additional therapies including further antithrombotic treatment (GP IIb/IIIa inhibitor, heparin) and mechanical support (IABP, ECMO) shall be fully in the competence of the treating doctor. Electronic database - eCRF. The data from individual follow-up assessments will be entered into an electronic database. The online instrument CLADE-IS will be used for data collection; this instrument provides robust options for electronic case report form (eCRF) design, hierarchical administration of user rights and a user-friendly web interface. The system provides predefined validation rules, conversions of variables, and it takes into account the relationships between variables; user access is controlled by the hierarchical system of user rights and user roles, and database operations are stored for the purpose of audits and tracking of changes. Data safety is ensured through physical security of the servers, authorised access and backup procedures. Laboratory collections. The efficacy of the antiaggregation drugs cangrelor and ticagrelor will be determined using the flow cytometry analysis of intracellular VASP (vasodilator-stimulated phosphoprotein) phosphorylation. Study Committees: Executive c., Steering c., Endpoint adjudication c., Data safety monitoring board. Monitoring. External monitor Clinical Research Associate (CRA) Definitions. Death is defined as death from all causes. Death from cardiovascular causes is defined as death with evidence of a cardiovascular cause or any death without clear evidence of a non-cardiovascular cause. All deaths are considered as cardiac unless a clear non-cardiac cause can be determined. Any unexpected death (for example, even in patients with a co-existing, potentially fatal non-cardiac disease - cancer, infection) is classified as a death from cardiovascular causes. Myocardial reinfarction is defined as a new (additional) MI that must differ from the MI based on which the patient was enrolled into the study, satisfying the Third Universal Definition of MI criteria. Urgent revascularisation of the infarct related artery is defined as a new emergent/urgent revascularisation of the artery intervened upon in the initial procedure, due to repeated manifestations of ischemia occurring after completion of the initial PCI. Stroke is defined as rapid onset of a new neurological deficit due to an ischemic or haemorrhagic lesion in the central nervous system with the symptoms lasting for at least 24 hours from their onset or resulting in death. Definitive stent thrombosis is defined according to the Academic Research Consortium criteria. Bleeding is defined according to the Bleeding Academic Research Consortium (BARC) criteria. External collaborating centre for statistical analyses. Institute of Biostatistics and Analyses at the Faculty of Medicine of the Masaryk University in Brno, Czech Republic

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myocardial Infarction, Cardiogenic Shock
Keywords
Acute myocardial infarction, Cardiogenic shock, Primary percutaneous coronary intervention, Dual antiplatelet therapy, Cangrelor, Ticagrelor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
550 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cangrelor therapy
Arm Type
Experimental
Arm Description
Initiation of iv Cangrelor immediately upon arrival of the patient to the cardiac catheterization laboratory and after randomization into the study.
Arm Title
Ticagrelor therapy
Arm Type
Active Comparator
Arm Description
Initial dose Ticagrelor immediately upon arrival of the patient to the cardiac catheterization laboratory and after randomization into the study. In patients with a disorder of consciousness, initial dose of Ticagrelor will be administered immediately after nasogastric tube insertion.
Intervention Type
Drug
Intervention Name(s)
Cangrelor
Other Intervention Name(s)
intravenous P2Y12 inhibitor
Intervention Description
Cangrelor: IV bolus 30 μg/kg (application < 1 minute), immediately followed by continuous infusion in the dose of 4 μg/kg/min. To accelerate the initiation of therapy, tables containing calculations of the bolus dose in ml and the speed of infusion therapy for individual weights will be prepared. Cangrelor therapy will be stopped after circulatory stabilization - when sBP > 100 mmHg persists for one hour / when IABP will be terminated / when vasoactive treatment with norepinephrine, dopamine (in the dose ≥ 5 μg/kg/min) will be stopped, but not later than 4 hours after PCI 30 minutes before stopping Cangrelor infusion, administration of initial dose of crushed Ticagrelor 180 mg and then Ticagrelor maintenance dose 90 mg twice a day for 12 months.
Intervention Type
Drug
Intervention Name(s)
Ticagrelor
Other Intervention Name(s)
oral P2Y12 inhibitor
Intervention Description
Initial dose crushed Ticagrelor 180 mg. Maintenance dose Ticagrelor 90 mg twice daily for 12 months.
Primary Outcome Measure Information:
Title
Primary Clinical Endpoint
Description
Combined endpoint defined as Death/Myocardial infarction/Stroke
Time Frame
Within 30 days after randomization
Title
Primary Laboratory endpoint
Description
Early achievement of efficient inhibition of ADP-induced platelet aggregation
Time Frame
Periprocedural (periPCI) period
Secondary Outcome Measure Information:
Title
Key secondary net-clinical endpoint
Description
Death/Myocardial infarction/Urgent revascularization of the infarct-related artery /Stroke/Major bleeding BARC ≥ 3
Time Frame
Within 30 days after randomization
Title
Key safety endpoint
Description
Incidence of bleeding according to the BARC definition
Time Frame
Within 30 days after randomization
Title
Key secondary endpoint
Description
Cardiovascular death/Myocardial infarction/Urgent revascularization/Heart failure
Time Frame
Within 30 days and one year after randomization
Title
Secondary endpoint
Description
Individual components of the primary clinical endpoint
Time Frame
Within 30 days and one year after randomization
Title
Other secondary endpoint
Description
Death from cardiovascular causes
Time Frame
Within 30 days and one year after randomization
Title
Secondary outcome
Description
Definite stent thrombosis
Time Frame
Within 30 days after randomization
Title
Secondary safety outcome
Description
Delaying the surgery due to bleeding
Time Frame
Within 30 days after randomization
Other Pre-specified Outcome Measures:
Title
Pre-specified Outcome
Description
Duration of vasoactive pharmacotherapy and/or mechanical circulatory support
Time Frame
Index event Hospitalization
Title
Other Pre-specified Outcome
Description
Duration of hospitalisation
Time Frame
Index event Hospitalization
Title
Cost analysis
Description
Cost-effectiveness analysis
Time Frame
Within 30 day and one year after randomization
Title
MRI sub-study endpoints
Description
Magnetic Resonance Imaging sub-study
Time Frame
Within one year after randomization

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age over 18 years Acute myocardial infarction according to the definition of ESC/ACC/AHA, indicated for emergency percutaneous coronary intervention (primary PCI strategy) Cardiogenic shock present upon admission due to the AMI (≥ 2 of the criteria below are satisfied)24 sBP < 90 mmHg with the absence of hypovolemia Need of vasopressor and/or inotropic therapy Presence of the signs of the organ hypoperfusion - cyanosis, cold acra, disorder of consciousness, congestive heart failure Informed consent form signed. Exclusion Criteria: Contraindications of antiplatelet therapy with ticagrelor/cangrelor25 Recent (< 6 months) major bleeding Recent (< 1 month) major surgery/injury History of intracranial bleeding History of stroke/TIA Known intolerance to ticagrelor/cangrelor Severe impairment of hepatic function Concomitant administration of strong CYP3A4 inhibitors (for example, ketoconazole, clarithromycin, nefazodone, ritonavir and atazanavir) Administration of a loading dose of an oral P2Y12 inhibitor prior to admission (clopidogrel ≥ 300 mg, ticagrelor 180 mg, prasugrel 60 mg) Need of concomitant chronic anticoagulation therapy due to indications such as atrial fibrillation, artificial valve, thromboembolic disease, etc.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Zuzana Motovska, MD. PhD.
Phone
+420731573253
Email
motovska.zuzana@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zuzana Motovska, MD. PhD.
Organizational Affiliation
University Hospital Kralovske Vinohrady, Prague, Czech Republic
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital Kralovske Vinohrady
City
Prague
State/Province
Please Select
ZIP/Postal Code
10034
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zuzana Motovska, MD PhD
Phone
+420731573253
Email
motovska.zuzana@gmail.com
First Name & Middle Initial & Last Name & Degree
Tamilla Muzafarova, MD
First Name & Middle Initial & Last Name & Degree
Martin Kozel, MD
Facility Name
St. Anne's University Hospital Brno
City
Brno
ZIP/Postal Code
656 91
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ota Hlinomaz, MD PhD
Phone
+42054318 5470
Email
ota.hlinomaz@fnusa.cz
First Name & Middle Initial & Last Name & Degree
Ota Hlinomaz, MD PhD
Facility Name
Department of Cardiology, University Hospital Brno-Bohunice
City
Brno
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Petr Kala, MD. PhD.
Facility Name
Cardiology Department, Regional Hospital
City
Ceske Budejovice
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Frantisek Tousek, MD. FESC.
Email
tousek@nemcb.cz
Facility Name
University Hospital Hradec Králové
City
Hradec Králové
ZIP/Postal Code
500 05
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Josef Bis, MD PhD
Phone
+420495834239
Email
josef.bis@fnhk.cz
First Name & Middle Initial & Last Name & Degree
Josef Bis, MD PhD
First Name & Middle Initial & Last Name & Degree
Jaroslav Dusek, MD PhD
Facility Name
Cardiology department, Regional hospital
City
Jihlava
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zdenek Klimsa, MD
Email
klimsaz@nemji.cz
First Name & Middle Initial & Last Name & Degree
Petr Simek, MD
Email
simekp@nemji.cz
Facility Name
Cardiocenter, Regional Hospital
City
Karlovy Vary
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alexander Schee, MD
Email
alexandr.schee@gmail.com
Facility Name
Krajská nemocnice Liberec
City
Liberec
ZIP/Postal Code
460 63
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Pavol Tomasov, MD
Email
pavol.tomasov@nemlib.cz
First Name & Middle Initial & Last Name & Degree
Pavol Tomasov
Facility Name
University Hospital Olomouc
City
Olomouc
ZIP/Postal Code
77900
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jan Precek, MD PhD
Phone
+420 588 443 214
Email
jan.precek@seznam.cz
First Name & Middle Initial & Last Name & Degree
Jan Precek, MD PhD
Facility Name
University Hospital Ostrava
City
Ostrava
ZIP/Postal Code
70852
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jan Mrozek, MD
Phone
+420 596 920 115
Email
honzamrozek@email.cz
First Name & Middle Initial & Last Name & Degree
Jan Mrozek, MD
Facility Name
Department of Cardiology, Regional Hospital,
City
Pardubice
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jan Matejka, MD. PhD.
Email
jan.matejka@nempk.cz
Facility Name
University Hospital Pilsen
City
Pilsen
ZIP/Postal Code
304 60
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Milan Hromadka, MD PhD
Phone
+00420377 103 3166
Email
hromadka@fnplzen.cz
First Name & Middle Initial & Last Name & Degree
Milan Hromadka, MD PhD
Facility Name
General University Hospital in Prague
City
Prague
ZIP/Postal Code
12808
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jana Smalcova, MD
Phone
+420224962504
Email
jana.smalcova@vfn.cz
First Name & Middle Initial & Last Name & Degree
Jana Smalcova, MD
First Name & Middle Initial & Last Name & Degree
Jan Belohlavek, MD PhD
First Name & Middle Initial & Last Name & Degree
Tomas Kovarnik, MD PhD
Facility Name
Institute of Clinical and Experimental Medicine
City
Prague
ZIP/Postal Code
14021
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jiri Kettner, MD CSc
Phone
+42023 605 5007
Email
jiri.kettner@ikem.cz
First Name & Middle Initial & Last Name & Degree
Jiri Kettner, MD CSc
Facility Name
Na Homolce Hospital
City
Prague
ZIP/Postal Code
150 30
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Petr Ostadal, MD PhD
Phone
+420 257 272 208
Email
petr.ostadal@homolka.cz
First Name & Middle Initial & Last Name & Degree
Petr Ostadal
Facility Name
Cardiocenter, Hospital Podlesi
City
Trinec
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Libor Sknouril, MD. PhD.
Email
libor.sknouril@nempodlesi.cz
Facility Name
Regional Hospital T. Bati
City
Zlin
ZIP/Postal Code
762 75
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zdenek Coufal, MD
Phone
+420577 552 138
Email
coufal@bnzlin.cz
First Name & Middle Initial & Last Name & Degree
Zdenek Coufal, MD
First Name & Middle Initial & Last Name & Degree
Martin Griva, MD PhD
Facility Name
Masaryk Hospital
City
Ústí Nad Labem
ZIP/Postal Code
40011
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Pavel Cervinka, MD PhD
Phone
+420 477 117 886
Email
pavel.cervinka@kzcr.eu
First Name & Middle Initial & Last Name & Degree
Pavel Cervinka, MD PhD
First Name & Middle Initial & Last Name & Degree
Vladimir Hrabos, MD
Facility Name
Pitié-Salpêtrière Hospital (AP-HP)
City
Paris
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gilles Montalescot, Prof. MD. PhD.
Email
gilles.montalescot@aphp.fr
Facility Name
Heart Center Freiburg University
City
Freiburg
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Christoph Olivier, MD
Facility Name
University Medical Centre
City
Mannheim
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ibrahim Akin
Email
Ibrahim.Akin@umm.de
Facility Name
University Hospital Tübingen
City
Tübingen
ZIP/Postal Code
72076
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tobias Geisler, Prof. MD.
Email
Tobias.Geisler@med.uni-tuebingen.de
Facility Name
Collegium Medicum University Hospital No. 1
City
Bydgoszcz
Country
Poland
Individual Site Status
Active, not recruiting
Facility Name
Jagiellonianan University, University Hospital Krakow
City
Kraków
Country
Poland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stanislav Bartus, Prof. MD.
Email
mbbartus@cyfronet.pl
Facility Name
Medical University of Warsaw
City
Warsaw
Country
Poland
Individual Site Status
Active, not recruiting
Facility Name
Middle-Slovak Institute of Cardiovascular Diseases
City
Banska Bystrica
Country
Slovakia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Martin Hudec, MD. PhD.
Email
hudec@suscch.eu
First Name & Middle Initial & Last Name & Degree
Marek Strachan, MD
Facility Name
Center of Interventional Neuroradiology and Endovascular Treatment
City
Bratislava
Country
Slovakia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ivan Vulev, MD.
Email
ivan.vulev@cinre.sk
First Name & Middle Initial & Last Name & Degree
David Líška, MD
Email
david.liska@cinre.sk
Facility Name
Cardiocentre
City
Nitra
Country
Slovakia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Peter Obona, MD
Email
pobona@centrum.sk
First Name & Middle Initial & Last Name & Degree
Andrea Andrasova, MD
Email
andrea.andrasova@gmail.com

12. IPD Sharing Statement

Plan to Share IPD
Yes

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Dual Antiplatelet Therapy For Shock Patients With Acute Myocardial Infarction

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