NCT02505399

TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement

TIcagrelor in Rotational Atherectomy to Reduce TROPonin Enhancement: the TIRATROP Study, a Randomized Controlled Trial

• Status: Completed
• Phase: Phase 4
• Study type: Interventional
• Enrollment: 180 (actual)
• Sponsor: University Hospital, Toulouse · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

Rotational atherectomy (RA) prior to angioplasty is the reference treatment for highly calcified atherosclerotic coronary lesions. It aims at fragmenting calcium deposits into microscopic particulates to allow less hazardous coronary revascularization and stenting. The main drawback associated with the procedure is the subsequent enhancement of platelet aggregation which promotes the distal embolization of micro-thrombi and atherosclerotic fragments. In order to limit these complications, a double antiplatelet therapy is required (generally Clopidogrel + Aspirin) when RA procedures are performed. Clopidogrel inhibits the protein P2Y12 which is a cornerstone in platelet aggregation. Ticagrelor is a new antiplatelet agent that provides faster and greater P2Y12 inhibition than Clopidogrel. It is currently indicated to reduce risk of cardiovascular events in patients hospitalized for coronary revascularization after an acute coronary syndrome. Ticagrelor has never been evaluated so far in stable coronary patients treated with rotational atherectomy prior to angioplasty.

Detailed description

Rotational atherectomy (RA) prior to angioplasty is the reference treatment for highly calcified atherosclerotic coronary lesions. It aims at fragmenting calcium deposits into microscopic particulates to allow less hazardous coronary revascularization and stenting. The main drawback associated with the procedure is the subsequent enhancement of platelet aggregation which promotes the distal embolization of micro-thrombi and atherosclerotic fragments. In order to limit these complications, a double antiplatelet therapy is required (generally Clopidogrel + Aspirin) when RA procedures are performed. Clopidogrel inhibits the protein P2Y12 which is a cornerstone in platelet aggregation. It is characterized by a slow and variable transformation of a prodrug into an active metabolite and by a remaining risk of thrombosis and myocardial infarction. Ticagrelor is a new antiplatelet agent that provides faster and greater P2Y12 inhibition than Clopidogrel. It is currently indicated to reduce risk of cardiovascular events in patients hospitalized for coronary revascularization after an acute coronary syndrome. Ticagrelor has never been evaluated so far in stable coronary patients treated with rotational atherectomy prior to angioplasty.

Conditions

• Atherosclerosis

Interventions

Type	Name	Description
DRUG	ticagrelor	Ticagrelor will be administered orally, according to the following scheme: * 180 mg the evening preceding (and at least 6 hours before) rotational atherectomy (Day -1), * 90 mg the following morning (D Day before rotational atherectomy and angioplasty), * 90 mg the following evening (D Day after rotational atherectomy and angioplasty), * 90 mg twice daily the day after the procedure of rotational atherectomy and angioplasty (Day +1).
DRUG	clopidogrel	Clopidogrel will be administered orally, according to the following scheme: * 300 mg the evening preceding (and at least 6 hours before) rotational atherectomy (Day -1), * 75 mg the following morning (D Day before rotational atherectomy and angioplasty), * 0 mg the following evening (D Day after rotational atherectomy and angioplasty), * 75 mg once daily the day after the procedure of rotational atherectomy and angioplasty (Day +1).

Timeline

• Start date: 2015-11-01
• Primary completion: 2018-05-24
• Completion: 2018-05-30
• First posted: 2015-07-22
• Last updated: 2025-12-05

Locations

4 sites across 1 country: France