Starting two antiplatelet medicines in the ER for acute coronary syndrome

Dual Antiplatelet Agents Therapy in the Emergency Department for Acute Coronary Syndrome (The DATES Study).

This chart review will see if giving two antiplatelet medicines in the emergency room changes major bleeding or major heart/stroke events in adults with acute coronary syndrome.

Quick facts

• Study type: Observational
• Enrollment: 200 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Jordan Collaborating Cardiology Group (other)
• Locations: 2 sites (Amman and 1 other locations)
• Trial ID: NCT07039149 on ClinicalTrials.gov

What this trial studies

This observational chart-review uses hospital records from two Amman centers to compare outcomes in adults with STEMI, NSTEMI, or unstable angina who received dual antiplatelet therapy (DAPT) in the emergency department versus the usual timing. Investigators will record antiplatelet use during the index hospitalization and track incidence of major bleeding and major adverse cardiovascular and cerebrovascular events (MACCE), with follow-up contact up to one year. Patients with non-cardiac chest pain or those who did not receive antiplatelet agents are excluded. The analysis focuses on real-world practice patterns in a younger regional ACS population with potentially lower baseline bleeding risk.

Who should consider this trial

Good fit: Adults admitted with acute coronary syndrome (STEMI, NSTEMI, or unstable angina) at the participating hospitals who received antiplatelet medication and agree to follow-up contact are ideal candidates.

Not a fit: Patients with non-cardiac chest pain, those who did not receive antiplatelet agents, or patients at high preexisting bleeding risk are unlikely to benefit from the study findings.

Why it matters

Potential benefit: If early DAPT in the ED appears safe in this population, the results could support earlier antiplatelet use to prevent ischemic events without adding excess bleeding.

How similar studies have performed: Previous randomized and observational studies of pretreatment with a second antiplatelet have shown mixed results, with some trials reporting increased bleeding, so the approach remains unsettled.

Eligibility criteria

Inclusion Criteria:

* Adult patients
* Presenting with acute coronary syndrome (ST segment elevation myocardial infarction, non ST segment elevation myocardial infarction, and unstable angina).
* Antiplatelet medication (s) prescribed during index admission to hospital.
* Willingness of the patient to be called for follow up up to 1 year after index hospitalization.

Exclusion Criteria:

* Non cardiac chest pain.
* No administration of antiplatelet agents during hospitalization.
* Refusal of contact for follow up.

Where this trial is running

Amman and 1 other locations

• Jordan University Hospital — Amman, Jordan (RECRUITING)
• Istishari Hospital — Amman, Jordan (NOT_YET_RECRUITING)

Study contacts

• Study coordinator: Ayman Hammoudeh, MD, FACC

Conditions: Major Bleeding, Major Adverse Cardiovascular and Cerebrovascular Events, Dual antiplatelet therapy, Pretreatment with DAPT, Acute coronary syndrome