DIAMOND - Dual Antiplatelet Therapy to Reduce Myocardial Injury
Research type
Research Study
Full title
Dual Antiplatelet Therapy to Inhibit Coronary Atherosclerosis and Myocardial Injury in Patients with Necrotic High-risk Coronary Plaque Disease
IRAS ID
148432
Contact name
Philip Adamson
Contact email
Sponsor organisation
University of Edinburgh
Eudract number
2014-000952-26
Clinicaltrials.gov Identifier
Clinicaltrials.gov Identifier
ISSBRIL0250, AstraZeneca Reference Number; 14/SS/0089, REC Number; WT103782AIA, Wellcome Trust Reference Number
Research summary
Heart attacks are most commonly caused by rupture of fatty deposits (plaques) within the wall of heart blood vessels. It appears that this process can also frequently occur without causing any symptoms and these events likely explain the development of narrowing within the heart arteries which can subsequently produce symptoms of angina (chest pain). Previous research has shown a specialised scanner known as a PET (positron emission tomography) scan can identify these recently ruptured plaques in patients without symptoms of a heart attack and these patients have changes on a blood test (troponin) which suggest that they are at higher risk of having a heart attack in the future. We aim to identify these patients using the PET scan and then see if the markers of increased heart attack risk can be reduced by the use of a blood thinning medication (ticagrelor) which is already a well recognised treatment for people who have suffered a recent heart attack.
The study will involve patients from the Edinburgh Heart Centre who are already being treated for known heart disease. Participants will undergo CT and PET scans at the start of the study to identify if they have high risk features or not. They will then be randomised to take ticagrelor or a matching placebo for 1 year. They will have ongoing follow up over that year with clinical assessments as well as blood tests to check for evidence of heart damage. A second CT scan will be performed at the end of the year to identify if there is any difference between the groups in terms of the degree of worsening of their heart disease.
In addition a sub-group of patients will undergo repeat PET scans to see if we can identify how long their ruptured plaques remain in a vulnerable state.REC name
Scotland A REC
REC reference
14/SS/0089
Date of REC Opinion
27 Jun 2014
REC opinion
Further Information Favourable Opinion