Ticagrelor in Remote Ischemic Preconditioning Study (TRIP)
Periprocedural Myocardial Infarction
About this trial
This is an interventional treatment trial for Periprocedural Myocardial Infarction
Eligibility Criteria
Inclusion Criteria:
- Provision of informed consent prior to any study specific procedures
- Patients (Female and male) ≥ 18 of age
- Patients with NSTE-ACS undergoing coronary angiography, eligible for PCI
Exclusion Criteria:
- Women of childbearing potential
- Severe comorbidity (estimated life expectancy <6 months)
- Baseline cTnI before PCI that is not stable or falling or is > 5 ×99th percentile URL.
- End-stage renal disease(eGFR<15 ml/min/1.73 m2)
- CRUSADE Bleeding Score >50
- Patients with an indication for oral anticoagulation
- On maintenance therapy with ticagrelor or those that have received clopidogrel for less than 3 days
- Use of nicorandil or glibenclamide
- Concomitant theophylline/aminophylline use
- Known contraindications to the use of ticagrelor Hypersensitivity to the active substance or to any of the excipients
- Active pathological bleeding
- History of intracranial haemorrhage
- Moderate to severe hepatic impairment
- Co-administration of ticagrelor with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, nefazodone, ritonavir, and atazanavir).
- Patients meeting criteria for immediate or early (<24h) invasive strategy based on the current relevant European Society of Cardiology guidelines
Sites / Locations
- Athens Red Cross Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Other
Active Comparator
Other
Ticagrelor - Remote Ischemic Preconditioning
Ticagrelor - Control
Clopidogrel - Remote Ischemic Preconditioning
Clopidogrel - Control
Ticagrelor 180mg loading dose, and 90mg b.i.d thereafter. 3 cycles of 5-minute ischemia/5-minute reperfusion using a BP cuff around the non-dominant arm
Ticagrelor 180mg loading dose, and 90mg b.i.d thereafter. BP-cuff uninflated around the non-dominant arm
Clopidogel 300mg loading dose, and 75mg q.d. thereafter. 3 cycles of 5-minute ischemia/5-minute reperfusion using a BP cuff around the non-dominant arm
Clopidogel 300mg loading dose, and 75mg q.d. thereafter. BP-cuff uninflated around the non-dominant arm