Personalization of Long-Term Antiplatelet Therapy - RAPID EXTEND
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Key facts
- Where
- Ottawa, KanadaSee the site
- Phase
- 4. fázis
Where in Kanada
- University of Ottawa Heart InstituteOttawa, KanadaNo longer taking part
Trial details
- Who runs it
- Ottawa Heart Institute Research Corporation
- Trial code
- NCT03729401
- Record updated
- 2026. május 6.
- Original description
In patients after myocardial infarction (MI) (heart attacks) and treated with percutaneous coronary intervention (PCI), the current standard is dual antiplatelet therapy (DAPT), with aspirin and a P2Y12 receptor inhibitor, for 1 year of treatment. At 1 year, there are several options including: i) Ongoing DAPT (with aspirin and ticagrelor), ii) Selective treatment use of a P2Y12 inhibitor based on risk profiles.Read full original descriptionShow less
Personalization of Long-Term Antiplatelet Therapy Using a Novel Combined Demographic/Pharmacogenomic Strategy - The RAPID EXTEND Randomized Study
In patients after myocardial infarction (MI) (heart attacks) and treated with percutaneous coronary intervention (PCI), the current standard is dual antiplatelet therapy (DAPT), with aspirin and a P2Y12 receptor inhibitor, for 1 year of treatment. At 1 year, there are several options including: i) Ongoing DAPT (with aspirin and ticagrelor), ii) Selective treatment use of a P2Y12 inhibitor based on risk profiles.
This study is a pilot vanguard study to evaluate several strategies for choosing anti-platelet regimen among patients post MI and PCI at 1 year.
Inclusion: >50 years old at 1-year after myocardial infarction (non-ST-elevation myocardial infarction (NSTEMI) or ST-elevation myocardial infarction (STEMI)) during which they had percutaneous coronary intervention (PCI); Compliant with dual antiplatelet therapy (DAPT) for ≥ 1 year without an ischemic or bleeding complication after PCI; Still on DAPT regimen at enrollment; Patients must have 1 of the following atherothrombotic risk enrichment criteria:; Age≥ 65 years ii) Diabetes iii) 2nd Prior MI (>1 year ago) iv) multi-vessel coronary disease v) creatinine clearance (CrCl) <60 mL/min.
Exclusion: Requirement of a P2Y12 inhibitor; Take concurrent CYP3A inducing drugs which may interact with ticagrelor (e.g. anti-epileptic drugs); Recent GI bleed or major surgery; >18 months post percutaneous coronary intervention (PCI) and myocardial infarction (MI); History of stroke, TIA or intracranial bleed; Bleeding diathesis; Severe liver disease; Platelet count < 100,000/μl; Intolerance to ticagrelor or clopidogrel; Requirement of oral anticoagulation; Life expectancy of < 1 year; On dialysis; At risk for bradycardia.