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The purpose of this study is to determine whether a 6 month duration of clopidogrel therapy after DES implantation is not inferior to that of a 12 month therapy.
Drug elution from stent struts is associated with less smooth muscle cell proliferation and delayed stent strut re-endothelialization. Thus it seems conceivable that a longer duration of dual antiplatelet therapy (aspirin and clopidogrel) after DES implantation is needed. However, no studies have been done to investigate which is the optimal antiplatelet therapy duration after DES implantation. Therefore, the objective of the randomized, double-blind, placebo-controlled ISAR-SAFE study is to evaluate the safety and efficacy of a 6 month versus a 12 month duration of clopidogrel therapy after DES implantation.
Patients on clopidogrel therapy at least 6 months after DES implantation, who do not require a reintervention will be randomized to an additional 6 month period of clopidogrel or placebo. The patients will be followed-up for 9 months after randomization.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Clopidogrel | Active Comparator |
| |
| Placebo | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Clopidogrel | Drug | Patients on clopidogrel therapy at 6 months after implantation of a drug-eluting stent will be randomized to an additional 6 month period of clopidogrel 75mg per day |
| Measure | Description | Time Frame |
|---|---|---|
| Composite of death, myocardial infarction, stent thrombosis, stroke or TIMI major bleeding. | 9 months after randomization |
| Measure | Description | Time Frame |
|---|---|---|
| The individual components of the primary endpoint | 9 months after randomization |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Adnan Kastrati, MD | Deutsches Herzzentrum Muenchen | Study Chair |
| Adnan Kastrati, MD | Deutsches Herzzentrum Muenchen | Principal Investigator |
| Jurriёn M ten Berg, MD | St. Antonius Hospital Nieuwegein, Department of Cardiology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Florida, Health Science Center - Jacksonville | Jacksonville | Florida | 32209 | United States | ||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25616646 | Derived | Schulz-Schupke S, Byrne RA, Ten Berg JM, Neumann FJ, Han Y, Adriaenssens T, Tolg R, Seyfarth M, Maeng M, Zrenner B, Jacobshagen C, Mudra H, von Hodenberg E, Wohrle J, Angiolillo DJ, von Merzljak B, Rifatov N, Kufner S, Morath T, Feuchtenberger A, Ibrahim T, Janssen PW, Valina C, Li Y, Desmet W, Abdel-Wahab M, Tiroch K, Hengstenberg C, Bernlochner I, Fischer M, Schunkert H, Laugwitz KL, Schomig A, Mehilli J, Kastrati A; Intracoronary Stenting and Antithrombotic Regimen: Safety And EFficacy of 6 Months Dual Antiplatelet Therapy After Drug-Eluting Stenting (ISAR-SAFE) Trial Investigators. ISAR-SAFE: a randomized, double-blind, placebo-controlled trial of 6 vs. 12 months of clopidogrel therapy after drug-eluting stenting. Eur Heart J. 2015 May 21;36(20):1252-63. doi: 10.1093/eurheartj/ehu523. Epub 2015 Jan 23. |
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|
| Placebo | Drug | Patients randomized in this group will receive placebo for 6 months. |
|
| Spitali Gjerman |
| Tirana |
| Albania |
| Krankenanstalt Rudolfstiftung | Vienna | 1030 | Austria |
| Wilhelminenspital Wien | Vienna | 1160 | Austria |
| University Hospitals Leuven | Leuven | 3000 | Belgium |
| Shenyang Northern Hospital | Shenyang | 110016 | China |
| Aarhus University Hospital | Aarhus | 8200 | Denmark |
| Herzzentrum Bad Krozingen | Bad Krozingen | 79189 | Germany |
| Segeberger Kliniken GmbH | Bad Segeberg | 23795 | Germany |
| Charité Berlin, Campus Benjamin Franklin | Berlin | 12203 | Germany |
| Technische Universität Dresden | Dresden | 01309 | Germany |
| Universitätsklinikum Erlangen | Erlangen | 91054 | Germany |
| Klinikum Garmisch-Partenkirchen | Garmisch-Partenkirchen | 82467 | Germany |
| Universitätsmedizin Göttingen | Göttingen | 37075 | Germany |
| Klinikum Ingolstadt | Ingolstadt | 85049 | Germany |
| MediClin Herzzentrum Lahr/Baden | Lahr | 77933 | Germany |
| Krankenhaus Landshut-Achdorf | Landshut | 84036 | Germany |
| Herzzentrum Leipzig | Leipzig | 04289 | Germany |
| Universitätsklinikum Schleswig-Holstein, Campus Lübeck | Lübeck | 23538 | Germany |
| Deutsches Herzzentrum München | Munich | 81541 | Germany |
| 1st Medizinische Klinik, Klinikum rechts der Isar | Munich | 81675 | Germany |
| Klinikum Bogenhausen | Munich | 81925 | Germany |
| Klinikum München-Großhadern | München | 81377 | Germany |
| Städtisches Klinikum München-Neuperlach | München | 81737 | Germany |
| Lukaskrankenhaus GmbH, Städtische Kliniken Neuss | Neuss | 41464 | Germany |
| Universitätsklinikum Regensburg | Regensburg | 93042 | Germany |
| Klinikum Barmherzige Brüder Regensburg | Regensburg | 93049 | Germany |
| Universitätsklinik Rostock | Rostock | 18057 | Germany |
| Universitätsklinikum Ulm | Ulm | 89081 | Germany |
| HELIOS Klinikum Wuppertal-Herzzentrum | Wuppertal | 42117 | Germany |
| University College Hospital Galway | Galway | Ireland |
| Campus Biomedico University of Rome | Rome | 00128 | Italy |
| Tokai University School of Medicine | Isehara | 259 - 1193 | Japan |
| Kyoto University Hospital | Kyoto | 606-8507 | Japan |
| Catharina Hospital Eindhoven | Eindhoven | 5623 | Netherlands |
| St. Antonius Hospital Department of Cardiology | Nieuwegein | 3435 | Netherlands |
| Maasstad Ziekenhuis | Rotterdam | 3075 | Netherlands |
| Isala klinieken, locatie Weezenlanden | Zwolle | 8011 | Netherlands |
| Auckland City Hospital | Auckland | 1023 | New Zealand |
| Inselspital, Universitätsspital Bern | Bern | 3010 | Switzerland |
| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| D000077144 | Clopidogrel |
| ID | Term |
|---|---|
| D013988 | Ticlopidine |
| D058924 | Thienopyridines |
| D013876 | Thiophenes |
| D013457 | Sulfur Compounds |
| D009930 | Organic Chemicals |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
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