Dual Antiplatelet Therapy For Shock Patients With Acute Myocardial Infarction (DAPT-SHOCK-AMI)
Acute Myocardial Infarction, Cardiogenic Shock
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
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.
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
Experimental
Active Comparator
Cangrelor therapy
Ticagrelor therapy
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.