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Design and rationale of CURRENT-OASIS 7: a randomized, 2 x 2 factorial trial evaluating optimal dosing strategies for clopidogrel and aspirin in patients with ST and non-ST-elevation acute coronary syndromes managed with an early invasive strategy.
- Source :
- American Heart Journal; Dec2008, Vol. 156 Issue 6, p1080-1088, 9p
- Publication Year :
- 2008
-
Abstract
- <bold>Background: </bold>Antiplatelet therapy with clopidogrel and acetylsalicylic acid (ASA) reduces major cardiovascular events in patients with ST and non-ST-segment-elevation acute coronary syndromes (ACS). Recent mechanistic and clinical data suggest that higher loading and maintenance doses of clopidogrel may achieve a more rapid and greater degree of platelet inhibition that translates into improved clinical outcomes, but this is yet to be formally evaluated in an adequately powered randomized trial. <bold>Objectives: </bold>To evaluate the efficacy and safety of (1) a higher loading and initial maintenance dose of clopidogrel compared with the standard-dose regimen and (2) high-dose ASA compared with low-dose ASA in patients with ST or non-ST-segment-elevation ACS managed with an early invasive strategy. <bold>Design: </bold>Multicenter, international, randomized, 2 x 2 factorial design trial evaluating a clopidogrel high-dose regimen (600 mg loading dose on day 1 followed by 150 mg once daily on days 2 to 7, followed by 75 mg once daily on days 8-30) compared with the standard-dose regimen (300 mg loading dose on day 1, followed by 75 mg once daily on days 2-30) and high-dose ASA (300-325 mg daily) versus low-dose ASA (75-100 mg daily) in patients with ST or non-ST-segment-elevation ACS managed with an early invasive strategy. The clopidogrel dose comparison is double-blind and the ASA dose comparison is open-label. The primary outcome is the composite of death from cardiovascular causes, myocardial (re)infarction or stroke up to day 30. The primary safety outcome is major bleeding. The sample size is 18,000 to 20,000 patients. <bold>Conclusions: </bold>The CURRENT-OASIS 7 trial will help to define optimal dosing regimens for clopidogrel and ASA in patients with ST and non-ST-segment-elevation ACS treated with an early invasive strategy. [ABSTRACT FROM AUTHOR]
- Subjects :
- DRUG dosage
CORONARY disease
CLINICAL trials
ASPIRIN
ANTICOAGULANTS
HEALTH outcome assessment
MYOCARDIAL infarction
PATIENTS
MYOCARDIAL infarction-related mortality
STROKE-related mortality
COMBINED modality therapy
COMPARATIVE studies
CAUSES of death
DRUG administration
DOSE-effect relationship in pharmacology
ELECTROCARDIOGRAPHY
HEMORRHAGE
LONGITUDINAL method
RESEARCH methodology
MEDICAL cooperation
MYOCARDIAL revascularization
RESEARCH
TICLOPIDINE
TRANSLUMINAL angioplasty
DISEASE relapse
EVALUATION research
RANDOMIZED controlled trials
TREATMENT effectiveness
BLIND experiment
PLATELET aggregation inhibitors
ACUTE coronary syndrome
CORONARY angiography
Subjects
Details
- Language :
- English
- ISSN :
- 00028703
- Volume :
- 156
- Issue :
- 6
- Database :
- Supplemental Index
- Journal :
- American Heart Journal
- Publication Type :
- Academic Journal
- Accession number :
- 35550047
- Full Text :
- https://doi.org/10.1016/j.ahj.2008.07.026