Utilization of Ticagrelor in the Upstream Setting for Non-ST-Segment Elevation Myocardial Infarction (UPSTREAM): An ED-Based Clinical Registry
Completed
Conditions studied: Acute Coronary Syndromes
In brief
The primary objective of the UPSTREAM Registry is to address the data gap regarding the course of NSTEMI (Non-ST-Elevation Myocardial Infarction)between ED (Emergency Department) arrival and diagnostic angiography in detail, by characterizing and following the ED and peri-ED use of advanced OAP (Oral Anti-Platelet) agents. In addition to exploring ED treatment patterns and success of both ischemic and bleeding risk stratification prior to definition of the coronary anatomy, data generated via the UPSTREAM registry will allow plausible attribution of ischemic and bleeding outcomes to pre-catheterization antiplatelet therapy in the management of NSTEMI. This registry further seeks to demonstrate that contemporary use of upstream ticagrelor is associated with an economically-sound utilization of hospital resources, and smooth transition of care into the outpatient, secondary prevention setting for the first 30 days after hospitalization. Finally, it will allow characterization of patient selection factors and processes for ticagrelor vs alternative OAP agents, carrying out that descriptive comparison through discharge. Patients transferred in to an UPSTREAM hospital are eligible for inclusion, but the timing for OAP agent administration and diagnostic catheterization begin with ED care at the first hospital.
Key facts
- Study ID
- NCT02271022
- Run by
- AstraZeneca
- People needed
- 2000
- Starts
- 2015-02-17
- Expected to finish
- 2019-10-31
- Last updated by the study team
- 2020-11-03
Who can join
Age: 18 and older, up to 99. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Patients (≥18 years of age) with a working diagnosis of NSTEMI and treatment with an OAP agent (ticagrelor, clopidogrel, or prasugrel) either in the ED, or in any case within the timeframe that emergency physicians consider to be "upstream"- i.e., within the first 72 hours of care and at least 4 hours before diagnostic angiography. In addition, only those patients who undergo a diagnostic coronary angiography within 72 hours of ED arrival will be eligible for UPSTREAM.
You may not qualify if…
- Life expectancy less than 90 days in opinion of treating clinician;
- Not undergoing diagnostic angiography within 72 hours of ED arrival;
- Refusal of consent; or
- Unlikely to comply with follow-up by telephone.
Where it is running
- Research Site — Mobile, Alabama, United States
- Research Site — Little Rock, Arkansas, United States
- Research Site — Sacramento, California, United States
- Research Site — Bridgeport, Connecticut, United States
- Research Site — Hartford, Connecticut, United States
- Research Site — Washington D.C., District of Columbia, United States
- Research Site — Gainesville, Florida, United States
- Research Site — Hialeah, Florida, United States
- Research Site — Miami, Florida, United States
- Research Site — Tampa, Florida, United States
- Research Site — Atlanta, Georgia, United States
- Research Site — Macon, Georgia, United States
- Research Site — Peoria, Illinois, United States
- Research Site — Richmond, Indiana, United States
- Research Site — Baltimore, Maryland, United States
- Research Site — Baltimore, Maryland, United States
- Research Site — Baltimore, Maryland, United States
- Research Site — Boston, Massachusetts, United States
- Research Site — Worcester, Massachusetts, United States
- Research Site — Bloomfield, Michigan, United States
- Research Site — Grand Blanc, Michigan, United States
- Research Site — Royal Oak, Michigan, United States
- Research Site — Duluth, Minnesota, United States
- Research Site — Saint Paul, Minnesota, United States
- Research Site — Birmingham, Alabama, United States
Full record on ClinicalTrials.gov
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