Aspirin-free ticagrelor treatment for heart attack patients managed without revascularization

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a phase 3, randomized, placebo-controlled trial comparing ticagrelor monotherapy to standard dual antiplatelet therapy (ticagrelor plus aspirin) for 12 months in patients discharged after a type 1 myocardial infarction managed without revascularization. The trial's co-primary goals are to test whether ticagrelor alone reduces BARC type 2, 3, or 5 bleeding at 12 months and to show non-inferiority for a patient-centered ischemic composite (death, MI, stroke, or coronary revascularization) at 12 months. Secondary endpoints include other bleeding classifications (BARC 3/5, TIMI) and individual ischemic outcomes such as cardiovascular death and any revascularization. Participants receive either ticagrelor plus placebo or ticagrelor plus aspirin and are followed with scheduled study visits through the 12-month period.

Why it matters

Who can join: the full rules

Inclusion criteria:

* Age ≥18 years;
* Hospitalized for type 1 MI, according to the 4th Universal Definition of MI;
* Coronary angiogram performed;
* Planned for medical management alone, without revascularization;
* Willingness to participate and to attend study visits;
* Expected life expectancy ≥12 months.

Exclusion criteria:

* Patients hospitalized for type 2-5 MI, or unstable angina, according to the 4th Universal Definition of MI;
* Patients hospitalized for a STEMI with an acute thrombotic lesion of a major epicardial vessel;
* Elevations in cardiac biomarkers (troponins or CK-MB) that is believed by the investigator not to be of ischemic origin (e.g. myocardial injury, myocarditis, Takotsubo syndrome, etc.);
* Confirmed or suspected spontaneous coronary artery dissection;
* Concomitant indication for chronic oral anticoagulant;
* Concomitant non-coronary indication for dual antiplatelet therapy;
* Use of any non-trial antiplatelet drug that needs to be continued based on the judgement of the treating physician;
* Previous hospitalization for MI, PCI, or CABG within 12 months;
* Known hypersensitivity, intolerance, or contra-indication to ASA or ticagrelor;
* Unsuitability for either randomization treatment, based on the judgement of the treating physician

Where it's running

• Montreal Heart Institute
  Montreal, Quebec, Canada Recruiting

Study contacts

• Study coordinator: Guillaume Marquis-Gravel, MD
• Email: guillaume.marquis.gravel@umontreal.ca
• Phone: 1-514-376-3330

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Preventing reperfusion injury during ST-elevation heart attack using Xolatryp

  This will test whether a single 6-hour IV infusion of Xolatryp given during primary PCI helps people having their first ST-elevation heart attack reduce heart muscle damage and improve short-term heart function.

  Recruiting at 5 sites Phase 2 Nyrada Pty Ltd · Kingswood, New South Wales and 7 other locations · NCT07362446

• Optimal antithrombotic strategy for patients with atrial fibrillation undergoing PCI

  This study is testing whether a new blood-thinning treatment for patients with atrial fibrillation undergoing heart procedures is safer and just as effective as the traditional approach that includes more medications.

  Recruiting at 18 sites Phase 4 St. Antonius Hospital · Aalst and 19 other locations · NCT04436978

• Heart@Home: Safe, at-home care for people with acute heart problems compared with hospital care

  This trial tests whether hospital-level care at home can safely and effectively treat adults with acute heart conditions who would normally be in the hospital.

  Recruiting Tel-Aviv Sourasky Medical Center · Tel Aviv · NCT07913152

• Digital cardiac rehab to help heart attack patients improve function

  A digital health–supported cardiac rehabilitation program is being tested to see if it helps people after a heart attack improve fitness and stay engaged with rehab, compared with standard outpatient rehab.

  Recruiting Cairo University · Minya, Minya Province · NCT07867197

• NMR-based Risk Test and Digital Health Support for midlife adults in Eloisa

  This study tests whether an NMR metabolomics risk test can guide tailored digital health programs for midlife adults at risk of diabetes, heart disease, stroke, kidney disease, or fatty liver.

  Recruiting University of Eastern Finland · Savonlinna · NCT07820800

• See if stopping long-term aspirin is as good as continuing it in older adults with stable ischemic heart disease

  In adults 65 and older with stable ischemic heart disease, this trial tests whether stopping daily low-dose aspirin is not worse than continuing it.

  Recruiting at 2 sites Phase 4 Odense University Hospital · Copenhagen and 1 other locations · NCT07795398

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.