Selatogrel: Selatogrel is a reversible P2Y12 receptor antagonist for subcutaneous administration. Selatogrel will be administered as a liquid formulation in a sealed prefilled syringe in an autoinjector forming an integral ready-to-use, single-dose drug delivery system.
Participants will self-administer 16 mg of selatogrel subcutaneously with the autoinjector upon occurrence of symptoms suggestive of an acute myocardial infarction. Self-administration encompasses the use of the autoinjector by another person (e.g., partner, close relative, friend, caregiver) who may be called for help during the emergency situation of a suspected AMI.
Placebo: Placebo will be administered as a liquid formulation in a sealed prefilled syringe in an autoinjector forming an integral ready-to-use, single-dose drug delivery system.
Participants will self-administer placebo subcutaneously with the autoinjector upon occurrence of symptoms suggestive of an acute myocardial infarction. Self-administration encompasses the use of the autoinjector by another person (e.g., partner, close relative, friend, caregiver) who may be called for help during the emergency situation of a suspected AMI.
Study summary
This study will randomize patients recently discharged from the hospital with a confirmed diagnosis of type 1 acute myocardial infarction (Thygesen et al. 2018) and having additional cardiovascular risk factors.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Main Inclusion Criteria:
* Confirmed diagnosis of symptomatic type 1 acute myocardial infarction (AMI) ST-Elevation Myocardial Infarction (STEMI) or Non-ST-Elevation Myocardial Infarction (NSTEMI), no longer than 4 weeks prior to randomization.
* Diagnosis of multivessel coronary artery disease defined as ≥ 50% stenosis on 2 or more coronary artery territories, during a prior cardiac catheterization or cardiac catheterization during the qualifying AMI event and presence of at least 1 of the following risk factors:
* Second prior AMI,
* Diabetes mellitus defined by ongoing glucose lowering treatment,
* Chronic kidney disease defined as estimated glomerular filtration rate less than 60 mL/min/1.73 m2 and either known history of chronic kidney disease or a biomarker of chronic kidney damage,
* Peripheral artery disease at any time prior to randomization,
* Absence of, or unsuccessful coronary revascularization of the qualifying AMI.
* Successful self-administered placebo according to the autoinjector instruction for use training during screening.
Main Exclusion Criteria:
* Increased risk of serious bleeding including any of the following:
* History of intracranial bleed at any time.
* Known uncorrected intracranial vascular abnormality.
* Gastrointestinal bleed requiring hospitalization or transfusion within 1 year prior to screening.
* Already on oral triple antithrombotic therapy (i.e., Dual antiplatelet therapy and oral anticoagulant).
* Known liver impairment significantly affecting the hepatic function.
* Current dialysis.
* Ischemic stroke or transient ischemic attack within 3 months of screening.
* Chronic anemia with hemoglobin \< 10 g/dL.
* Chronic thrombocytopenia with platelet count \< 100,000/mm3.
* Known hypersensitivity to selatogrel, any of its excipients, or drugs of the P2Y12 class.
* Previous exposure to an investigational drug within 3 months prior to randomization.
* Participation in another clinical trial with an investigational product or device within 3 months prior to randomization.
Primary outcome measure(s)
Clinical status as assessed by a 6-point ordinal scale — Total duration: up to 7 days The clinical status will be assessed using a 6-point ordinal scale after any study treatment self-administration. Only the worst clinical outcome will be retained as the primary efficacy outcome. The 6 mutually exclusive outcomes ranked from worst to best are:
1. Death (all causes), within 7 days after study treatment administration.
2. Acute myocardial infarction with compromised electro-hemodynamics, within 2 days after study treatment administration.
3. ST-Elevation Myocardial Infarction (STEMI), within 2 days after study treatment administration.
4. High-risk Non-ST-Elevation Myocardial Infarction (NSTEMI), within 2 days after study treatment administration.
5. NSTEMI with peak cardiac troponin greater than 10 times upper limit of normal, within 2 days after study drug administration.
6. None of the above
Occurrence of Type 3 or 5 treatment-emergent bleeding events according to the Bleeding Academic Research Consortium (BARC) definition — Total duration: up to 2 days The number of:
* Type 3 treatment-emergent bleeding events and
* Type 5 treatment-emergent bleeding events
will be assessed according to the Bleeding Academic Research Consortium (BARC) definition (Mehran et al. 2011), within 2 days after study treatment administration.
The Bleeding Academic Research Consortium (BARC) definitions are:
* Type 3, bleeding is divided into 3 categories, a through c, and includes clinical, laboratory, and/or imaging evidence of bleeding with specific healthcare provider responses.
* Type 5, bleeding is fatal.
Trial sites (821)
Facility
City
Region
Status
Advanced Cardiovascular, LLC
Alexander City
Alabama
Birmingham VA Health Care System
Birmingham
Alabama
Cardiovascular Associates of the Southeast
Birmingham
Alabama
Grandview Medical Center and Affinity Cardiovascular Specialists, LCC
Birmingham
Alabama
Heart Center Research, LLC
Huntsville
Alabama
Dignity Health Mercy Gilbert Medical Center
Gilbert
Arizona
Mayo Clinic Arizona
Phoenix
Arizona
University of Arizona - Sarver Heart Center
Tucson
Arizona
Amicis Research Center.
Anaheim
California
John Muir Health
Concord
California
Profound Research LLC at San Diego Cardiovascular Associates
La Jolla
California
San Francisco VA Health Care System"
San Francisco
California
FOMAT Medical Research
Santa Maria
California
Lundquist Institute for Biomedical Innovation at Harbor - UCLA Medical Center
Torrance
California
Invivocure
Van Nuys
California
Interventional Cardiology Medical Group
West Hills
California
Colorado Heart and Vascular PC
Golden
Colorado
South Denver Cardiology Associates, PC
Littleton
Colorado
Christiana Care Health Services, Inc.
Newark
Delaware
MedStar Washington Hospital Center
Washington D.C.
District of Columbia
FWD Clinical Research
Boca Raton
Florida
Bay Area Cardiology Associates, P.A.
Brandon
Florida
Clearwater Cardiovascular Consultants
Clearwater
Florida
University of Florida Health Science Center at Jacksonville
Jacksonville
Florida
Pioneer Clinical Studies (PCS)
Miami
Florida
Baptist Health Care, Inc. d/b/a Baptist Hospital Cardiology
Pensacola
Florida
Ascension Sacred Heart
Pensacola
Florida
Clearwater Cardiovascular Consultants
Safety Harbor
Florida
St. Johns Center for Clinical Research
Saint Augustine
Florida
Centricity Research Columbus Georgia Multispecialty
Columbus
Georgia
Atlanta VA Medical Center
Decatur
Georgia
Endeavor Health
Glenview
Illinois
OSF HealthCare Cardiovascular Institute
Peoria
Illinois
Indiana University School of Medicine
Indianapolis
Indiana
Indiana University Health Ball Memorial Hospital
Muncie
Indiana
Reid Physician Associates
Richmond
Indiana
St. Elizabeth Healthcare
Edgewood
Kentucky
University of Louisville
Louisville
Kentucky
Grace Research, LLC
Bossier City
Louisiana
Heart Clinic of Hammond
Hammond
Louisiana
+ 781 more sites — see the full list on the official registry below.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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