Ambulance or in-catheterization laboratory administration of ticagrelor for primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: Rationale and design of the randomized, double-blind Administration of Ticagrelor in the cath Lab or in the Ambulance for New ST elevation myocardial Infarction to open the Coronary artery (ATLANTIC) study - 27/03/13
, Jens Flensted Lassen, MD, PhD b, j, Christian W. Hamm, MD, PhD c, j, Frédéric Lapostolle, MD d, j, Johanne Silvain, MD, PhD a, j, Jurriën M. ten Berg, MD, PhD e, j, Warren J. Cantor, MD f, j, Shaun G. Goodman, MD, MSc g, j, Muriel Licour, MSc h, j, Anne Tsatsaris, MD h, j, Arnoud W. van't Hof, MD, PhD i, jRésumé |
Primary percutaneous coronary intervention (PCI) is the treatment of choice for patients presenting with acute ST-segment elevation myocardial infarction (STEMI). However, if catheterization facilities are not immediately available, the effectiveness of PCI can be affected by delays in transfer. Evidence suggests that antiplatelet therapy administered early, preferably in the ambulance during transfer, may provide better and earlier perfusion. Ticagrelor, a direct platelet P2Y12 receptor inhibitor, is indicated for the management of patients with acute coronary syndromes.
The ATLANTIC study (NCT01347580; EudraCT 2011-000214-19) is a 30-day international, randomized, parallel-group, placebo-controlled study in male and female patients (aged ≥18 years) who are diagnosed as having STEMI, with intended primary PCI. In total, 1770 patients will be randomized immediately after diagnosis to prehospital administration of ticagrelor 180 mg followed by matching placebo administered in hospital, or prehospital administration of placebo followed by ticagrelor 180 mg administered in hospital. All patients will then receive ticagrelor 90 mg twice daily for 30 days. The coprimary end point is the percentage of patients reaching thrombolysis in myocardial infarction flow grade 3 in the infarct-related artery at initial angiography or achieving ≥70% ST-segment elevation resolution pre-PCI. The primary safety end point is major, life-threatening, or minor bleeding after ticagrelor administration.
The results of this study may have an impact on future recommendations for treatment for patients with STEMI.
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| RCT reg #s: NCT01347580; EudraCT 2011-000214-19. |
Vol 165 - N° 4
P. 515-522 - avril 2013 Retour au numéro
Article précédent
- Rationale and design of the EMBRACE STEMI Study: A phase 2a, randomized, double-blind, placebo-controlled trial to evaluate the safety, tolerability and efficacy of intravenous Bendavia on reperfusion injury in patients treated with standard therapy including primary percutaneous coronary intervention and stenting for ST-segment elevation myocardial infarction
- Anjan K. Chakrabarti, Kristin Feeney, Cassandra Abueg, David A. Brown, Ewa Czyz, Michal Tendera, Andras Janosi, Robert P. Giugliano, Robert A. Kloner, W. Douglas Weaver, Christoph Bode, Jacek Godlewski, Bela Merkely, C. Michael Gibson
- Rationale and design of the ATTRACT Study: A multicenter randomized trial to evaluate pharmacomechanical catheter-directed thrombolysis for the prevention of postthrombotic syndrome in patients with proximal deep vein thrombosis
- Suresh Vedantham, Samuel Z. Goldhaber, Susan R. Kahn, Jim Julian, Elizabeth Magnuson, Michael R. Jaff, Timothy P. Murphy, David J. Cohen, Anthony J. Comerota, Heather L. Gornik, Mahmood K. Razavi, Lawrence Lewis, Clive Kearon
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