Antiplatelet Therapy Strategies for Coronary Artery Disease
(SWAP-8 Trial)
Trial Summary
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications, but it seems you need to be on a specific dual antiplatelet therapy (DAPT) with low-dose aspirin and either prasugrel or ticagrelor to participate. If you are on other medications, especially oral anticoagulants, you may not be eligible.
What data supports the effectiveness of the drugs Clopidogrel and Prasugrel for coronary artery disease?
Research shows that both Clopidogrel and Prasugrel are effective in preventing heart attacks and death in patients with acute coronary syndrome, a condition related to coronary artery disease. Prasugrel may work faster and more consistently than Clopidogrel, but it might also increase the risk of bleeding in some patients.12345
Is antiplatelet therapy with Clopidogrel and Prasugrel safe for humans?
How does the drug combination of Clopidogrel and Prasugrel differ from other treatments for coronary artery disease?
The combination of Clopidogrel and Prasugrel is unique because Prasugrel offers a faster onset of action and more consistent platelet inhibition compared to Clopidogrel, making it particularly effective for patients with acute coronary syndrome and those undergoing coronary interventions. However, it also carries a higher risk of bleeding, especially in older patients or those with lower body weight.1112131415
What is the purpose of this trial?
Dual antiplatelet therapy (DAPT) with low-dose aspirin and a P2Y12 inhibitor is the current standard of care in patients with coronary artery disease experiencing an acute event or undergoing percutaneous coronary intervention. However, the ischemic benefits are counterbalanced by a significant increase in bleeding events. Over time, different DAPT de-escalation strategies have been developed to reduce the bleeding risk while maintaining the ischemic protection, but there is currently no head-to-head comparison between them. The purpose of this clinical trial is to conduct a head-to-head comparison on the pharmacodynamic efficacy of DAPT de-escalation by dose reduction to low-dose prasugrel (5 mg od) and DAPT de-escation by switching from standard-dose more potent P2Y12 receptor inhibitor to standard-dose clopidogrel (75 mg). To determine if the PD profiles of these two strategies are comparable, we aim to conduct a non-inferiority study.
Eligibility Criteria
This trial is for patients with coronary artery disease who've had an acute event or a procedure to open their arteries. They must be on dual antiplatelet therapy but can't join if they have conditions that the study excludes, which aren't specified here.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants undergo DAPT de-escalation by either dose reduction or switching, following PCI
Follow-up
Participants are monitored for platelet reactivity and safety after treatment
Treatment Details
Interventions
- Clopidogrel
- Prasugrel
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of Florida
Lead Sponsor