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Trial registered on ANZCTR
Registration number
ACTRN12606000129583
Ethics application status
Approved
Date submitted
5/04/2006
Date registered
7/04/2006
Date last updated
29/11/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Plavix response in coronary intervention (PRINC)
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Scientific title
A randomised controlled trial to assess the antiplatelet effect of a 600mg (single-dose) and 1,200mg (split-dose) loading dose of clopidogrel and the impact of verapamil, a potent CYP3A4 inhibitor, on the incidence of clopidogrel resistance defined by the VerifyNow? (Accumetrics Ltd) P2Y12 platelet function analyzer in patients with coronary disease.
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Universal Trial Number (UTN)
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Trial acronym
PRINC
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Coronary artery disease
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Condition category
Condition code
Cardiovascular
1176
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients will be randomised to receive intravenously verapamil 5mg, orally 600mg clopidogrel or 1,200mg clopidogrel (split dose 600mg followed by 600mg 2 hours later, whilst in hospital). The drug effects will be monitored by platelet function analysis. Patients at discharge will be randomised to 75mg daily or 150mg daily of clopidogrel and platelet function measured at one week. Patients will receive standard dose clopidogrel 75mg once daily for either 3 weeks or 6 months depending on whether they receive bare metal coronary stents or drug eluting stents respectively.
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Intervention code [1]
970
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Treatment: Drugs
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Comparator / control treatment
Placebo
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Platelet function measured by VerifyNow? (Accumetrics Ltd) P2Y12 platelet function analyzer
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Assessment method [1]
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Timepoint [1]
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At 2, 4, 7 hours and 7 days from Percutaneous Coronary Intervention (PCI)
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Primary outcome [2]
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Peak troponin, Creatinine Kinase (CK)
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Assessment method [2]
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Timepoint [2]
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At 4 and 7 hours from PCI.
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Secondary outcome [1]
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Complications associated with PCI i.e. Vascular complications;
1. Haematoma
a. Assessed by clinical examination immediately prior to discharge.
2. Pseudoaneurysm
a. Diagnosed by vascular ultrasound. Ultrasound will be performed in any patient with a haematoma greater than 10cm in its largest dimension or any tender swellings in which the attending clinician has a high suspicion on pseudoaneurysm.
3. Retroperitoneal haemorrhage
a. Diagnosed by CT scan of the pelvis. CT will be perfomed it the haemoglobin drops unexpectedly or if the patient becomes shocked without cardiac cause.
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Assessment method [1]
2877
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Timepoint [1]
2877
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Secondary outcome [2]
2878
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Adverse drug reactions;
1. nausea, vomiting, rash, haematological dyscrasia.
P2Y12 receptor genetic haplotypes
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Assessment method [2]
2878
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Timepoint [2]
2878
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Eligibility
Key inclusion criteria
1. Signed informed consent2. All-comers (male and female of any age) with coronary disease on aspirin scheduled for elective PCI
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. A bleeding or platelet disorder2. Previous gastrointestinal bleeding or gastric ulcer/duodenal ulcer/gastritis3. Sensitivity/allergy to aspirin or clopidogrel or verapamil4. Renal failure Cr >0.12mmol/L 5. Anaemia Hb <115mg/dL6. Medication inhibiting CYP3A4.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Numerically Coded medication with matching placebo
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised random allocation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Factorial
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Other design features
2 x 2 factorial, two stage RCT
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/05/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
120
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
298
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New Zealand
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State/province [1]
298
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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National Heart Foundation (NZ)
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Address [1]
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Country [1]
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New Zealand
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Funding source category [2]
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Government body
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Name [2]
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Greenlane Research and Education Fund
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Address [2]
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Country [2]
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New Zealand
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Primary sponsor type
Hospital
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Name
Auckland City Hospital.
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Address
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Country
New Zealand
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Secondary sponsor category [1]
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Commercial sector/Industry
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Name [1]
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Environmental Science and Research Unit, NZ
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Address [1]
1137
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Country [1]
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Auckland City Hospital-Northern X Regional Ethics Committee
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Ethics committee address [1]
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
2619
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Approval date [1]
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22/12/2005
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Ethics approval number [1]
2619
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NTX/05/12/163
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Summary
Brief summary
This research project is designed to assess the response to a drug known as Plavix®. This drug reduces blood clotting by acting on small blood cells called platelets. A platelet rich blood clot is the cause of the blockage of the arteries of the heart that causes a heart attack. This study will hopefully determine the ideal dose that will give the maximum effect on clotting and help reduce the heart attacks related to the stenting opening of the heart arteries. We will also learn whether a drug called verapamil, given at the time of stenting has any effect on the clotting properties of Plavix®. Research assessing this drug interaction and higher doses of Plavix® has not been undertaken before. Both patients and investigators will be blinded to treatment allocation. One randomisation occurs at the outset, to one of four arms. Each study drug administered is coded to blind subjects and investigators.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr. Patrick Gladding
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Address
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17 Hoheria Rd
Onehunga Auckland
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Country
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New Zealand
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Phone
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+64 9 6369740
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr. Patrick Gladding
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Address
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17 Hoheria Rd
Onehunga Auckland
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Country
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New Zealand
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Phone
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+64 9 6369740
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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