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Effect of Indobufen and Aspirin on Platelet Aggregation and Long Term Prognosis in Patients With Coronary Heart Disease

Primary Purpose

Stable Coronary Heart Disease

Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Indobufen
Aspirin
Sponsored by
Henan Institute of Cardiovascular Epidemiology
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Stable Coronary Heart Disease

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. 18 years < age ≤ 85 years;
  2. Patients with confirmed stable coronary heart disease (must meet at least one of the following conditions);

    2.1 a stenosis confirmed by Coronary angiography or dual-source CT, but the stenosis of the Left Main Artery (LMA) diameter is less than 50%, the stenosis of the left anterior descending branch(LAD)is less than 70%, and the stenosis of the two or three coronary arteries diameter is less than 70%, patient has no corresponding evidence of ischemia;

    2.2 Patients after percutaneous coronary intervention (PCI): Dual antiplatelet therapy (DAPT) time is greater than 9 months, without cardiovascular events and ischemic symptoms; and currently receiving aspirin 100 mg/d with clopidogrel 75 mg/d or ticagrelor 90mg (bid) dual antiplatelet therapy.

    2.3 Patients after coronary artery bypass graft (CABG): Dual antiplatelet therapy (DAPT) time is greater than 9 months, without cardiovascular events and ischemic symptoms; and currently receiving aspirin 100 mg/d with clopidogrel 75 mg/d or ticagrelor 90mg (bid) dual antiplatelet therapy.

  3. Willing to sign the informed consent.

Exclusion Criteria:

  1. Acute coronary syndrome (ACS) occurred within 3 months before screening;
  2. Percutaneous coronary intervention or CABG surgery within 9 months before screening;
  3. Any other conditions (such as atrial fibrillation, pulmonary embolism, lower extremity venous thrombosis, artificial heart valve, etc.) who need oral or intravenous anticoagulation treatment;
  4. In the past 3 months, the Arachidonic acid-induced platelet aggregation rate≥ 50%; inhibition rate ≤ 20% in the aspirin combined with clopidogrel treated patients;
  5. Congestive heart failure or left ventricular ejection fraction <35%;
  6. A positive history of Chronic Obstructive Pulmonary Disease (COPD);
  7. bleeding tendency or severe lung disease;
  8. Active pathological bleeding;
  9. History of intracranial hemorrhage (less than 3 months);
  10. Allergic to indobufen / aspirin (or any of its ingredients);
  11. Severe liver injury (transaminases exceeding the upper limit of 2 times and above);
  12. Pregnancy, lactation and those who have a birth plan;
  13. Hematological diseases, platelet count <100000 / mm3 or hemoglobin <10g / dL;
  14. Have a history of drug or alcohol abuse in the past 2 years;
  15. Use of non-steroidal anti-inflammatory drugs (within 3 months);
  16. Creatinine clearance <30ml/min;

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Indobufen

    Aspirin

    Arm Description

    200 mg Indobufen, bid po, 90 days

    100 mg Aspirin, qd po, 90 days

    Outcomes

    Primary Outcome Measures

    Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates 7 days after taking the Indobufen or Aspirin
    Patients with stable coronary heart disease were treated with Indobufen or Aspirin for 90 days. Subsequently, the investigators used the Light transmission aggregation(LTA) and Thrombelastography (TEG) methods to detect the Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates on the 7 days.
    Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates 30 days after taking the Indobufen or Aspirin
    Patients with stable coronary heart disease were treated with Indobufen or Aspirin for 90 days. Subsequently, the investigators used the Light transmission aggregation(LTA) and Thrombelastography (TEG) methods to detect the Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates on the 30 days.
    Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates 90 days after taking the Indobufen or Aspirin
    Patients with stable coronary heart disease were treated with Indobufen or Aspirin for 90 days. Subsequently, the investigators used the Light transmission aggregation(LTA) and Thrombelastography (TEG) methods to detect the Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates on the 90 days.
    Concentration of Thromboxane B2 (TXB2) at baseline
    The fasting blood was collected after the subjects signed informed consent;And the concentration of TXB2 was detected by enzyme-linked immuno sorbent assay (ELISA)
    Concentration of Thromboxane B2 (TXB2) 7 days after taking the Indobufen or Aspirin
    The fasting blood was collected 7 days after taking the Indobufen or Aspirin;And the concentration of TXB2 was detected by enzyme-linked immuno sorbent assay (ELISA)
    Concentration of Thromboxane B2 (TXB2) 30 days after taking the Indobufen or Aspirin
    The fasting blood was collected 30 days after taking the Indobufen or Aspirin;And the concentration of TXB2 was detected by enzyme-linked immuno sorbent assay (ELISA)
    Concentration of Thromboxane B2 (TXB2) 90 days after taking the Indobufen or Aspirin
    The fasting blood was collected 90 days after taking the Indobufen or Aspirin;And the concentration of TXB2 was detected by enzyme-linked immuno sorbent assay (ELISA)

    Secondary Outcome Measures

    Incidence of Bleeding
    During the study period, we used dual occult blood and questionnaire format to assess whether the subject experienced bleeding (the extent and location of the bleeding) and the degree of bleeding related to indobufen or aspirin (Certainly, likely, possible, suspicious, impossible)
    Incidence of Adverse Gastrointestinal reaction
    During the study period, we used dual occult blood and questionnaire format to assess whether the subject experienced adverse gastrointestinal reaction, such as nausea, vomiting, upper abdominal discomfort or pain, gastric mucosal damage, gastric ulcers and bleeding, etc
    Blood concentration
    The fasting blood was collected on the day of 7 days, 30 days, and 90 days;And the blood concentration of aspirin or indobufen or clopidogrel or ticagrelor was detected.
    Cyclooxygenase-1 gene phenotype
    The fasting blood was collected and saved on the day of enrollment, and then the gene phenotype of cyclooxygenase-1 would be detected, and their relationship with platelet aggregation also would be analyzed.
    Major adverse cardiovascular events
    Number of angina pectoris symptoms, non ST-segment elevation myocardial infarction (NSTEMI), ST-segment elevation myocardial infarction (STEMI), stroke, cardiovascular death, cerebrovascular death, all-cause death

    Full Information

    First Posted
    March 6, 2020
    Last Updated
    February 4, 2021
    Sponsor
    Henan Institute of Cardiovascular Epidemiology
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04308551
    Brief Title
    Effect of Indobufen and Aspirin on Platelet Aggregation and Long Term Prognosis in Patients With Coronary Heart Disease
    Official Title
    Effect of Indobufen and Aspirin on Platelet Aggregation and Long Term Prognosis in Patients With Stable Coronary Heart Disease. A Prospective, Randomized and Controlled,Single Blind, Single-center, Opening Study
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2021
    Overall Recruitment Status
    Unknown status
    Study Start Date
    December 30, 2021 (Anticipated)
    Primary Completion Date
    December 1, 2022 (Anticipated)
    Study Completion Date
    December 1, 2022 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Henan Institute of Cardiovascular Epidemiology

    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
    This study evaluates the effect of Indobufen and Aspirin on platelet aggregation and long term prognosis in patients with stable coronary heart disease.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Stable Coronary Heart Disease

    7. Study Design

    Primary Purpose
    Other
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    Outcomes Assessor
    Masking Description
    The treatment in this study was open. Optical density turbidimetric platelet aggregation (LTA) and thromboelastography (TEG) were used to detect the platelet aggregation rate induced by AA and ADP, and the metabolites were measured by ELISA. All were done by the laboratory personnel, and they were unaware of the setting of treatment medication (blind method).
    Allocation
    Randomized
    Enrollment
    594 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Indobufen
    Arm Type
    Experimental
    Arm Description
    200 mg Indobufen, bid po, 90 days
    Arm Title
    Aspirin
    Arm Type
    Active Comparator
    Arm Description
    100 mg Aspirin, qd po, 90 days
    Intervention Type
    Drug
    Intervention Name(s)
    Indobufen
    Intervention Description
    Indobufen Tablets
    Intervention Type
    Drug
    Intervention Name(s)
    Aspirin
    Intervention Description
    Aspirin Tablets
    Primary Outcome Measure Information:
    Title
    Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates 7 days after taking the Indobufen or Aspirin
    Description
    Patients with stable coronary heart disease were treated with Indobufen or Aspirin for 90 days. Subsequently, the investigators used the Light transmission aggregation(LTA) and Thrombelastography (TEG) methods to detect the Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates on the 7 days.
    Time Frame
    7 days
    Title
    Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates 30 days after taking the Indobufen or Aspirin
    Description
    Patients with stable coronary heart disease were treated with Indobufen or Aspirin for 90 days. Subsequently, the investigators used the Light transmission aggregation(LTA) and Thrombelastography (TEG) methods to detect the Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates on the 30 days.
    Time Frame
    30 days
    Title
    Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates 90 days after taking the Indobufen or Aspirin
    Description
    Patients with stable coronary heart disease were treated with Indobufen or Aspirin for 90 days. Subsequently, the investigators used the Light transmission aggregation(LTA) and Thrombelastography (TEG) methods to detect the Arachidonic acid and Adenosine diphosphate-induced platelet aggregation rates on the 90 days.
    Time Frame
    90 days
    Title
    Concentration of Thromboxane B2 (TXB2) at baseline
    Description
    The fasting blood was collected after the subjects signed informed consent;And the concentration of TXB2 was detected by enzyme-linked immuno sorbent assay (ELISA)
    Time Frame
    baseline
    Title
    Concentration of Thromboxane B2 (TXB2) 7 days after taking the Indobufen or Aspirin
    Description
    The fasting blood was collected 7 days after taking the Indobufen or Aspirin;And the concentration of TXB2 was detected by enzyme-linked immuno sorbent assay (ELISA)
    Time Frame
    7 days
    Title
    Concentration of Thromboxane B2 (TXB2) 30 days after taking the Indobufen or Aspirin
    Description
    The fasting blood was collected 30 days after taking the Indobufen or Aspirin;And the concentration of TXB2 was detected by enzyme-linked immuno sorbent assay (ELISA)
    Time Frame
    30 days
    Title
    Concentration of Thromboxane B2 (TXB2) 90 days after taking the Indobufen or Aspirin
    Description
    The fasting blood was collected 90 days after taking the Indobufen or Aspirin;And the concentration of TXB2 was detected by enzyme-linked immuno sorbent assay (ELISA)
    Time Frame
    90 days
    Secondary Outcome Measure Information:
    Title
    Incidence of Bleeding
    Description
    During the study period, we used dual occult blood and questionnaire format to assess whether the subject experienced bleeding (the extent and location of the bleeding) and the degree of bleeding related to indobufen or aspirin (Certainly, likely, possible, suspicious, impossible)
    Time Frame
    baseline, 7, 30 and 90 days
    Title
    Incidence of Adverse Gastrointestinal reaction
    Description
    During the study period, we used dual occult blood and questionnaire format to assess whether the subject experienced adverse gastrointestinal reaction, such as nausea, vomiting, upper abdominal discomfort or pain, gastric mucosal damage, gastric ulcers and bleeding, etc
    Time Frame
    7, 30 and 90 days
    Title
    Blood concentration
    Description
    The fasting blood was collected on the day of 7 days, 30 days, and 90 days;And the blood concentration of aspirin or indobufen or clopidogrel or ticagrelor was detected.
    Time Frame
    7, 30 and 90 days
    Title
    Cyclooxygenase-1 gene phenotype
    Description
    The fasting blood was collected and saved on the day of enrollment, and then the gene phenotype of cyclooxygenase-1 would be detected, and their relationship with platelet aggregation also would be analyzed.
    Time Frame
    baseline
    Title
    Major adverse cardiovascular events
    Description
    Number of angina pectoris symptoms, non ST-segment elevation myocardial infarction (NSTEMI), ST-segment elevation myocardial infarction (STEMI), stroke, cardiovascular death, cerebrovascular death, all-cause death
    Time Frame
    7, 30 and 90 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    85 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: 18 years < age ≤ 85 years; Patients with confirmed stable coronary heart disease (must meet at least one of the following conditions); 2.1 a stenosis confirmed by Coronary angiography or dual-source CT, but the stenosis of the Left Main Artery (LMA) diameter is less than 50%, the stenosis of the left anterior descending branch(LAD)is less than 70%, and the stenosis of the two or three coronary arteries diameter is less than 70%, patient has no corresponding evidence of ischemia; 2.2 Patients after percutaneous coronary intervention (PCI): Dual antiplatelet therapy (DAPT) time is greater than 9 months, without cardiovascular events and ischemic symptoms; and currently receiving aspirin 100 mg/d with clopidogrel 75 mg/d or ticagrelor 90mg (bid) dual antiplatelet therapy. 2.3 Patients after coronary artery bypass graft (CABG): Dual antiplatelet therapy (DAPT) time is greater than 9 months, without cardiovascular events and ischemic symptoms; and currently receiving aspirin 100 mg/d with clopidogrel 75 mg/d or ticagrelor 90mg (bid) dual antiplatelet therapy. Willing to sign the informed consent. Exclusion Criteria: Acute coronary syndrome (ACS) occurred within 3 months before screening; Percutaneous coronary intervention or CABG surgery within 9 months before screening; Any other conditions (such as atrial fibrillation, pulmonary embolism, lower extremity venous thrombosis, artificial heart valve, etc.) who need oral or intravenous anticoagulation treatment; In the past 3 months, the Arachidonic acid-induced platelet aggregation rate≥ 50%; inhibition rate ≤ 20% in the aspirin combined with clopidogrel treated patients; Congestive heart failure or left ventricular ejection fraction <35%; A positive history of Chronic Obstructive Pulmonary Disease (COPD); bleeding tendency or severe lung disease; Active pathological bleeding; History of intracranial hemorrhage (less than 3 months); Allergic to indobufen / aspirin (or any of its ingredients); Severe liver injury (transaminases exceeding the upper limit of 2 times and above); Pregnancy, lactation and those who have a birth plan; Hematological diseases, platelet count <100000 / mm3 or hemoglobin <10g / dL; Have a history of drug or alcohol abuse in the past 2 years; Use of non-steroidal anti-inflammatory drugs (within 3 months); Creatinine clearance <30ml/min;
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    junhui zhang, MD
    Phone
    +86 0371-58681033
    Email
    09junhuizhang@163.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    chuanyu gao, MD
    Organizational Affiliation
    central china fuwai hospital
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Effect of Indobufen and Aspirin on Platelet Aggregation and Long Term Prognosis in Patients With Coronary Heart Disease

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