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STOP due to recent data in literature questioning the need to continue DAP beyond six months in patients with stable coronary artery stenting with DES.
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Prospective, randomized, non-inferiority, multicenter, international study.In total 4000 patients (70 centers in Europe) with de novo lesions in native coronary arteries who meet the eligibility criteria randomized to 6 versus 12 month dual antiplatelet therapies following a second generation DES implantation.
Assuming that the true proportion of thrombotic events is equal to 2.3% for both regimens (6-month and 12-month clopidogrel) 2000 patients for each treatment group are necessary to demonstrate a non-inferiority of the 6-months regimen if the proportion of thrombotic events will be no more than 3.5% with a power of 0.80 and a significance level of 0.05 (one-tail).
If the non-inferiority hypothesis will be rejected, the superiority hypothesis (12-months regimen is superior to the 6-months-regimen) will be tested at a significance level of 0.05 (two-tails).
The maximal not clinically relevant difference for the non-inferiority hypothesis of 1.2 % more thrombotic events has to be considered together with the lower expected number of bleeding events in the 6-months regimen.
All the analysis will be done as "intention-to-treat" analysis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Clopidogrel 6 | Experimental | 6 month dual antiplatelet therapies in patients after second generation DES implantation |
|
| Clopidogrel 12 | Experimental | 12 month dual antiplatelet therapies in patients after second generation DES implantation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Clopidogrel | Drug | 300-600 loading dose 75 mg/die for 6 months |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Definite and/or probable stent thrombosis occurring between 6 and 24 months | 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Composite of major adverse cardiac events (MACE) defined as the occurrence at 24 months of cardiac death, or myocardial infarction, or urgent target vessel revascularization (cardiac bypass surgery, or repeat PTCA) | 24 months |
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Inclusion Criteria:
Exclusion Criteria:
Patients treated for lesions in venous or arterial grafts
Patients treated for in-stent restenosis
Patients treated for Unprotected Left Main lesions
ST elevation myocardial infarction in the 48 hours prior to the procedure
Non ST elevation myocardial infarction
Patients with LVEF≤30%
Women with known pregnancy or who are lactating
Patients with hypersensitivity or allergies to hepari, or any other analogue or derivative, cobalt, chromium, nickel, molybdenum or contrast media.
Patients with chronic renal insufficiency
Contraindication to the use of clopidogrel and/or ASA:
Current medical condition with a life expectancy of less than 24 months.
The subject is participating in another device or drug study
Subject must have completed the follow-up phase of any previous study at least 30 days prior to enrolment in this trial.
Patients with medical conditions that preclude the follow-up as defined in the protocol or that otherwise limits participation in this study
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Irccs Fondazione Centro S. Raffaele Del Monte Tabor - | Milano (mi) | 20132 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25236346 | Derived | Colombo A, Chieffo A, Frasheri A, Garbo R, Masotti-Centol M, Salvatella N, Oteo Dominguez JF, Steffanon L, Tarantini G, Presbitero P, Menozzi A, Pucci E, Mauri J, Cesana BM, Giustino G, Sardella G. Second-generation drug-eluting stent implantation followed by 6- versus 12-month dual antiplatelet therapy: the SECURITY randomized clinical trial. J Am Coll Cardiol. 2014 Nov 18-25;64(20):2086-97. doi: 10.1016/j.jacc.2014.09.008. Epub 2014 Sep 15. |
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| Clopidogrel |
| Drug |
300-600 loading dose 75 mg/die for 12 months |
|
| ID | Term |
|---|---|
| D000787 | Angina Pectoris |
| D000789 | Angina, Unstable |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
| D002637 | Chest Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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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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