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TicagRelor Or Clopidogrel in severe or terminal chronic kidney patients Undergoing PERcutaneous coronary intervention for acute coronary syndrome: The TROUPER trial
- Source :
- American Heart Journal, American Heart Journal, 2020, 225, pp.19-26. ⟨10.1016/j.ahj.2020.04.013⟩, American Heart Journal, Elsevier, 2020, 225, pp.19-26. ⟨10.1016/j.ahj.2020.04.013⟩
- Publication Year :
- 2020
- Publisher :
- HAL CCSD, 2020.
-
Abstract
- International audience; Chronic kidney disease (CKD) is associated with an increased risk of acute coronary syndrome (ACS) and cardiovascular death. CKD patients suffering from ACS are exposed to an increased risk of thrombotic recurrences and a higher bleeding rate than patients with normal renal function. However, CKD patients are excluded or underrepresented in clinical trials. Therefore, determining the optimal antiplatelet strategy in this population is of utmost importance. We designed the TicagRelor Or Clopidogrel in severe or terminal chronic kidney patients Undergoing PERcutaneous coronary intervention for acute coronary syndrome (TROUPER) trial: a prospective, controlled, multicenter, randomized trial to investigate the optimal P2Y12 antagonist in CKD patients with ACS. Patients with stage >= 3b CKD are eligible if the diagnosis of ACS is made and invasive strategy scheduled. Patients are randomized 1:1 between a control group with a 600-mg loading dose of clopidogrel followed by a 75-mg/d maintenance dose for 1 year and an experimental group with a 180-mg loading dose of ticagrelor followed by a 90-mg twice daily maintenance dose for the same duration. The primary end point is defined by the rate of major adverse cardiovascular events, including death, myocardial infarction, urgent revascularization, and stroke at 1 year. Safety will be evaluated by the bleeding rate (Bleeding Academic Research Consortium). To demonstrate the superiority of ticagrelor on major adverse cardiovascular events, we calculated that 508 patients are required. The aim of the TROUPER trial is to compare the efficacy of ticagrelor and clopidogrel in stage >3b CKD patients presenting with ACS and scheduled for an invasive strategy.
- Subjects :
- Male
Ticagrelor
EVIDENCE-BASED THERAPIES
IMPACT
medicine.medical_treatment
[SDV]Life Sciences [q-bio]
030204 cardiovascular system & hematology
0302 clinical medicine
Secondary Prevention
ARTERY-DISEASE
030212 general & internal medicine
Myocardial infarction
TREATMENT PLATELET REACTIVITY
OUTCOMES
Maintenance dose
Middle Aged
Clopidogrel
3. Good health
[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
[SDV] Life Sciences [q-bio]
Female
REVASCULARIZATION
Cardiology and Cardiovascular Medicine
medicine.drug
Adult
Acute coronary syndrome
medicine.medical_specialty
RENAL-FUNCTION
Adolescent
Hemorrhage
Loading dose
03 medical and health sciences
Young Adult
Percutaneous Coronary Intervention
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
RISK-FACTOR
Internal medicine
medicine
Humans
Acute Coronary Syndrome
Renal Insufficiency, Chronic
Aged
business.industry
ELEVATION MYOCARDIAL-INFARCTION
Percutaneous coronary intervention
Thrombosis
DIABETES-MELLITUS
medicine.disease
business
Platelet Aggregation Inhibitors
Kidney disease
Subjects
Details
- Language :
- English
- ISSN :
- 00028703 and 10976744
- Database :
- OpenAIRE
- Journal :
- American Heart Journal, American Heart Journal, 2020, 225, pp.19-26. ⟨10.1016/j.ahj.2020.04.013⟩, American Heart Journal, Elsevier, 2020, 225, pp.19-26. ⟨10.1016/j.ahj.2020.04.013⟩
- Accession number :
- edsair.doi.dedup.....f7d1a6858b96ea43f36c67d9d7c09e1a