Title

Study on Safety and Effectiveness of Three Doses of Argatroban as Anticoagulant in Percutaneous Coronary Intervention (PCI)
A Randomised, Open, Parallel-group, Multicentre Study to Examine the Safety and Effectiveness of Three Doses of Argatroban as Anticoagulant in Combination With Clopidogrel and Aspirin in Patients Undergoing Elective Percutaneous Coronary Intervention in Comparison With Unfractionated Heparin, Clopidogrel and Aspirin
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    heparin argatroban ...
  • Study Participants

    140
This is a phase II multi-centre study in 140 patients undergoing elective PCI to obtain the information on dose-response of argatroban in pharmacodynamic markers and to assess the anticoagulation, safety and efficacy of argatroban in reference to unfractionated heparin, in combination with dual antiplatelet therapy.
This is a phase II multi-centre study in Europe in patients with stable coronary artery disease or troponin negative unstable angina undergoing elective PCI, to obtain the information on the safety and effects on various pharmacodynamic markers, of three doses of argatroban in combination with clopidogrel and aspirin, and to assess the results of argatroban and unfractionated heparin, both used in combination with clopidogrel and aspirin, on clinical outcomes, adequacy of anticoagulation, various pharmacodynamic markers (approximately 35 patients per group).
Study Started
Aug 31
2005
Study Completion
Oct 31
2006
Results Posted
Dec 05
2012
Estimate
Last Update
Dec 05
2012
Estimate

Drug Argatroban

Drug Argatroban

Drug Argatroban

Drug Heparin

ARG250 Experimental

ARG300 Experimental

ARG350 Experimental

Heparin Placebo Comparator

Criteria

Inclusion Criteria:

Male or female (women of child bearing potential must have a negative pregnancy test prior to entry into the study)
Aged over 18 years
Diagnosis of stable coronary artery disease (CAD) or unstable angina (troponin negative, i.e. within the normal range for the study site) with low to moderate anatomic risk and a requirement for elective percutaneous coronary angioplasty or stent insertion with an approved device in one or more de novo-treated or re-stenotic lesions in native vessels
Signed written informed consent

Exclusion Criteria:

Any condition which, in the investigator's opinion, contraindicates the use of argatroban, heparin or clopidogrel or endangers the patient if he/she participated in this study.
Known cirrhosis, hepatitis, clinically significant hepatic disorder, or history of hepatic disorder. Hepatic disorder is defined as having levels of liver function tests (bilirubin, Aspartate Aminotransferase (Serum Glutamate Oxaloacetate Transaminase)(AST (SGOT)), Alanine Aminotransferase (Serum Glutamate Pyruvate Transaminase)(ALT (SGPT)) greater than 3.0 times above the upper limit of the normal range of local laboratory.
Patients not currently taking aspirin
Renal insufficiency, defined as serum creatinine greater than 2.0 mg/dL (greater than 177mmol/L)
Platelets less than 125,000/ml
If already taking any form of heparin prior to study enrolment, Activated Partial Thromboplastin Time(aPTT) equal or greater than 35 sec or ACT greater than 160 sec
Use of low molecular heparin (LMWH) during 12 h prior to PCI
If taking oral anticoagulant medication prior to study enrolment, International Normalised Ratio(INR) greater than 1.2
Q wave MI with cardiogenic shock or thrombolytic therapy within 72 h of study dosing
Use of Glycoprotein IIb / IIIa(GPIIb/IIIa) inhibitors within prior 3 weeks
Documented coagulation disorder or bleeding diathesis
Lumbar puncture within the past 2 weeks
History of previous cerebral aneurysm, haemorrhagic stroke, or thrombotic stroke within the past 6 months
Active, uncontrolled peptic ulcer disease or any gastrointestinal bleeding or genitourinary bleeding within 3 months prior to study enrolment
Major surgery, serious trauma, puncture of non-compressible vessel, or biopsy of parenchymal organ within prior 2 months
Planned staged procedure, planned rotational atherectomy, directional coronary atherectomy, brachytherapy, or thrombectomy catheters
Planned surgical intervention other than study procedure within next 7 days
Presence of greater than 50% stenosis of unprotected left main coronary artery
Severe peripheral vascular disease, precluding femoral access
History of vasculitis
Uncontrolled hypertension defined as greater than 180/120 mmHg
Pregnancy (exclusion by routine urine test)
Lactating woman
Woman of children bearing age who are or were not using accepted contraceptive methods
Participation in other clinical trials of investigational products within 3 months prior to study enrolment
Terminally ill patients with a life expectancy of < 3 months

Summary

ARG250

ARG300

ARG350

Heparin

All Events

Event Type Organ System Event Term ARG250 ARG300 ARG350 Heparin

Activated Clotting Time (ACT) Value After the First Dosing of Study Treatment.

ARG250

301.0
second (Median)
Inter-Quartile Range: 262.8 to 330.0

ARG300

330.0
second (Median)
Inter-Quartile Range: 270.0 to 365.0

ARG350

354.0
second (Median)
Inter-Quartile Range: 307.0 to 391.0

Heparin

237.5
second (Median)
Inter-Quartile Range: 198.0 to 284.0

Composite and Each of Death, Myocardial Infarction, and Urgent Revascularisation at Day 30, and Major Bleeding Events During Hospital Stay.

Composite end point (a): all cause death, myocardial infarction and urgent revascularization at Day30 Composite end point (b): all cause death, myocardial infarction and urgent revascularization at Day30 as well as major bleeding events during hospital stay

ARG250

All cause death

Composite end point (a)

1.0
participants

Composite end point (b)

1.0
participants

Major bleeding

Myocardial infarction

Urgent revascularization

1.0
participants

ARG300

All cause death

Composite end point (a)

Composite end point (b)

Major bleeding

Myocardial infarction

Urgent revascularization

ARG350

All cause death

Composite end point (a)

1.0
participants

Composite end point (b)

1.0
participants

Major bleeding

Myocardial infarction

1.0
participants

Urgent revascularization

1.0
participants

Heparin

All cause death

Composite end point (a)

1.0
participants

Composite end point (b)

2.0
participants

Major bleeding

1.0
participants

Myocardial infarction

1.0
participants

Urgent revascularization

Total

140
Participants

Age Continuous

65.7
years (Mean)
Standard Deviation: 9.2

Sex: Female, Male

Overall Study

ARG250

ARG300

ARG350

Heparin

Drop/Withdrawal Reasons

ARG350

Heparin