Effects of Beta-blockade on Platelet Aggregation in Acute Coronary Syndrome (PLATE-BLOCK)

Federico II University

Status and phase: Completed; Phase 4

Conditions: Acute Coronary Syndrome

Treatments: Drug: Metoprolol; Drug: Carvedilol

Study type: Interventional

Funder types: Other

Identifiers

NCT02809820

CE-9/14

Details and patient eligibility

About

The Investigators will test the hypothesis that nonselective beta-blockers would have a more pronounced effect on platelet aggregation than selective beta-blockers in patients with acute coronary syndrome treated with dual anti platelet therapy.

Full description

In patients with acute coronary syndrome (ACS) beta-blockers are recommended for secondary prevention. It is known that catecholamine levels can potentiate platelet reactivity and beta-blocking agents may also affect platelet aggregation. This effect is mainly mediated by adrenergic receptors on platelets. This suggests that nonselective beta-blockers would have a more pronounced effect on platelet aggregation than selective beta-blockers. However, little is known about the effect of beta-blockers on platelet aggregation in patients with cardiovascular disease and, to date, nothing is known in the setting of ACS.

The aim of the present study is to evaluate the effect of selective and nonselective beta-blockers on platelet aggregation in ACS patients treated with dual anti platelet therapy.

Enrollment: 100 patients

Sex: All

Ages: 18 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Acute Coronary Syndrome
• Current dual anti platelet treatment with acetylsalicylic acid and Ticagrelor

Exclusion criteria

• ongoing prasugrel, ticlopidine or clopidogrel therapy
• Creatinine Clearance < 30 ml/min/1.73mm2
• Moderate to severe anemia Hemoglobin < 10 mg/dl
• Platelet count >600000/mm3 or <150000/mm3 or hematocrit >50% or <25%
• concomitant neoplastic or immune-mediated pathologies
• severe pulmonary pathologies
• contraindication to beta blocker therapy.

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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100 participants in 2 patient groups

Carvedilol

Active Comparator group

Description:

Patients who have documented ACS, who are on dual antiplatelet therapy and are randomized to assume carvedilol.

Treatment:

Drug: Carvedilol

Metoprolol

Active Comparator group

Description:

Patients who have documented ACS, who are on dual antiplatelet therapy and are randomized to assume metoprolol.

Treatment:

Drug: Metoprolol