Efficacy and Safety in Patients With Acute Coronary Syndrome Without ST-Segment Elevation

Double-Blind Parallel Comparison Study of SR25990C Versus Standard Therapy in Japan(Ticlopidine) in Patients With Acute Coronary Syndrome Without ST-Segment Elevation Who Are Planned for Percutaneous Coronary Intervention

To evaluate the efficasy and safety of SR25990C(loading dose:300mg, maintenance dose:75mg/day) in comparison with the standard Japanese treatment(ticlopidine) in patients with acute coronary syndrome without ST-segment elevation and planned for percutaneous coronary intervention(including stenting).

Inclusion Criteria:

• Patients aged above 20, admitted to hospitals with symptoms suspected to represent an acute coronary syndrome defined as unstable angina or acute MI without ST segment elevation greater than 1 mm are eligible for the study if they meet the following criteria:

  • (1)Clinical history consistent with new onset or worsening pattern of characteristic ischemic chest pain occurring at rest or with minimal exercise (lasting longer than 5 minutes or requiring sublingual nitroglycerin for the relief of pain within 24 hours before registration).

  • (2)Patients who meet either of following criteria

    • ECG changes compatible with new ischemia [e.g. ST depression (at least 1 mm), T wave inversion (at least 2 mm), or hyperacute peaked T waves in 2 contiguous leads].
    • already elevated CK at least twice the upper limit of normal or CK-MB or Troponin I or T above the upper limit of normal or positive qualitative test for Troponin T.

  • (3)A percutaneous coronary intervention is planned within 96 hours after the first study drug administration

Exclusion Criteria:

• A)Factors that affect participation in study:

  • (1)Previous disabling stroke
  • (2)Previous intracranial hemorrhage or hemorrhagic stroke
  • (3)Severe co-morbid condition such that the patient is not expected to survive 1 month
  • (4)NYHA Class IV heart failure
  • (5)Uncontrolled hypertension
  • (6)Requirement for use of oral anticoagulants, non study antiplatelet agents (including ticlopidine) or NSAIDs (excluding unum sumatur), during study period,

• B)Factors related to ASA and/or ticlopidine treatment:

  • (1)Use of ticlopidine within 1 week prior to randomization
  • (2)History of ASA or ticlopidine intolerance or allergy
  • (3)Contraindications to ASA or ticlopidine