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Status unknownNCT03862651Updated Mar 5, 2019

Maintenance Of aNtiplatElet Therapy in Patients With Coronary Stenting Undergoing Surgery (MONET BRIDGE)

A Phase 2 interventional study of Cangrelor in Platelet Aggregation Inhibitors, sponsored by Ospedale Santa Croce-Carle Cuneo. Status unknown. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-03-05.

Sponsored by Ospedale Santa Croce-Carle Cuneo · Phase 2, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Mar 2019), so the status shown — last known as Not yet recruiting — may be out of date.
Phase
Phase 2
Study type
Interventional
Enrollment
140
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The MONET BRIDGE study is designed to assess the use of cangrelor as a platelet-inhibiting bridge for patients who discontinue DAPT before cardiac and non cardiac surgery within 12 months from coronary stent implantation. It seeks to determine if initiation of a prolonged cangrelor infusion maintains effective platelet inhibition after discontinuation of P2Y12 and whether a cangrelor infusion before cardiac and non cardiac procedures is safe.

Read the detailed description

This will be a randomized, double-blind, placebo-controlled study enrolling patients with coronary stent, still on DAPT, undergoing cardiac and non cardiac surgery within 12 months from coronary stent implantation.

The MONET BRIDGE study is designed to assess the use of cangrelor as a platelet-inhibiting bridge for patients who discontinue DAPT before cardiac and non cardiac surgery within 12 months from coronary stent implantation. It seeks to determine if initiation of a prolonged cangrelor infusion maintains effective platelet inhibition after discontinuation of P2Y12 and whether a cangrelor infusion before cardiac and non cardiac procedures is safe.

The primary efficacy objective of this study is to demonstrate that a cangrelor infusion will maintain levels of residual platelet reactivity (PRU \< 208) as measured by Accriva VerifyNow® P2Y12 assay.

The main safety objective is to demonstrate that patients receiving cangrelor infusion before cardiac and non cardiac surgery have an acceptable safety profile and can undergo surgery without excessive bleeding peri-operatively.

02

Conditions studied

  • Platelet Aggregation Inhibitors

Keywords

  • aNtiplatElet Therapy
  • cangrelor
  • randomized
  • DAPT
03

In context

Lead sponsor

Ospedale Santa Croce-Carle Cuneo is the lead sponsor of 12 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Provide written informed consent before initiation of any study related procedures.
  2. Be ≥ 18 years of age.
  3. Have received any dose of a P2Y12 inhibitor (clopidogrel, ticlopidine, prasugrel, or ticagrelor) at any dose within at least 48 hours prior to randomization.
  4. Patients undergoing non deferrable cardiac or non cardiac surgery which requires discontinuation of P2Y12 inhibitor due to a significant bleeding risk.

Exclusion criteria

Exclusion Criteria:

  1. Confirmed of suspected pregnancy (if woman of child-bearing potential) or lactating females
  2. Active bleeding with evident contraindications to DAPT
  3. Patients requiring oral anticoagulant therapy
  4. PCI within 1 month
  5. Intracranial neoplasm or history of intracranial surgery
  6. History of bleeding diathesis
  7. Thrombocytopenia (platelet count of less than 100,000/µL)
  8. Known International Normalized Ratio (INR) greater than 1.5 at screening.
  9. Requirement for dialysis treatment (hemodialysis or peritoneal)
  10. Estimated Glomeular filtration rate eGFR \<30 ml/min
  11. Administration of abciximab within 24 hours of randomization or administration of eptifibitide or tirofiban within 12 hours of randomization
  12. Plans to continue oral anticoagulant or P2Y12 inhibitors or cangrelor in the pre-operative period
  13. Refusal to receive blood transfusion
  14. Receipt of fibrinolytic therapy in the 12 hours preceding randomization
  15. Allergy, hypersensitivity, or contraindication to cangrelor, mannitol, sorbitol, or microcrystalline cellulose
  16. High likelihood of being unavailable for follow-up
  17. Participation in other clinical research studies involving the evaluation of other investigational drugs or devices within 30 days of randomization
  18. Any disease or condition which, in the judgment of the investigator, would place the patient at undue risk by being enrolled in the trial
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Single group
Masking
Double (Participant, Investigator)
Enrollment
140 participants (estimated)

Study arms

  • Experimental
    Cangrelor

    Cangrelor, 0.75 μg/Kg/min, a cangrelor infusion will be started in addition to SOC when the P2Y12 inhibitor has been discontinued after the need for surgery has been determined. The infusions (cangrelor or matching placebo) will continue throughout the pre-operative period

    Drug: Cangrelor

  • No intervention
    placebo

    patients will receive only standard of care, in which the P2Y12 inhibitor is discontinued after the need for surgery has been determined and a placebo infusion is administered

Interventions

  • DrugCangrelor

    Cangrelor is an intravenous analog of adenosine triphospate with a potent, selective and specific affinity for P2Y12 receptors.

    Also known as: KENGREXAL® (cangrelor)

06

What researchers measure

Primary outcomes

  1. LEVEL OF RESIDUAL PLATELET REACTIVITY

    Accriva VerifyNow P2Y12 assay

    Time frame: 1-2 hours

Secondary outcomes

  1. ischemic and hemorrhagic endpoints

    Bleeding Academic Research Consortium (BARC) grade \> 3

    Time frame: 30 days

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jimenez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation. 2017 Mar 7;135(10):e146-e603. doi: 10.1161/CIR.0000000000000485. Epub 2017 Jan 25. No abstract available. Erratum In: Circulation. 2017 Mar 7;135(10):e646. doi: 10.1161/CIR.0000000000000491. Circulation. 2017 Sep 5;136(10):e196. doi: 10.1161/CIR.0000000000000530. PubMed 28122885 ↗
  • Moschovitis A, Cook S, Meier B. Percutaneous coronary interventions in Europe in 2006. EuroIntervention. 2010 Jun;6(2):189-94. doi: 10.4244/EIJV7I6A31. PubMed 20562067 ↗
  • Brilakis ES, Banerjee S, Berger PB. Perioperative management of patients with coronary stents. J Am Coll Cardiol. 2007 Jun 5;49(22):2145-50. doi: 10.1016/j.jacc.2007.02.046. Epub 2007 May 23. PubMed 17543633 ↗
  • Schouten O, van Domburg RT, Bax JJ, de Jaegere PJ, Dunkelgrun M, Feringa HH, Hoeks SE, Poldermans D. Noncardiac surgery after coronary stenting: early surgery and interruption of antiplatelet therapy are associated with an increase in major adverse cardiac events. J Am Coll Cardiol. 2007 Jan 2;49(1):122-4. doi: 10.1016/j.jacc.2006.10.004. Epub 2006 Dec 18. No abstract available. PubMed 17207733 ↗
  • Albaladejo P, Marret E, Samama CM, Collet JP, Abhay K, Loutrel O, Charbonneau H, Jaber S, Thoret S, Bosson JL, Piriou V. Non-cardiac surgery in patients with coronary stents: the RECO study. Heart. 2011 Oct;97(19):1566-72. doi: 10.1136/hrt.2011.224519. Epub 2011 Jul 26. PubMed 21791513 ↗
  • Rossini R, Musumeci G, Capodanno D, Lettieri C, Limbruno U, Tarantini G, Russo N, Calabria P, Romano M, Inashvili A, Sirbu V, Guagliumi G, Valsecchi O, Senni M, Gavazzi A, Angiolillo DJ. Perioperative management of oral antiplatelet therapy and clinical outcomes in coronary stent patients undergoing surgery. Results of a multicentre registry. Thromb Haemost. 2015 Feb;113(2):272-82. doi: 10.1160/TH14-05-0436. Epub 2014 Oct 2. PubMed 25274620 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 5, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03862651
Lead sponsor
Ospedale Santa Croce-Carle Cuneo
Responsible party
ROBERTA ROSSINI (Principal Investigator, Ospedale Santa Croce-Carle Cuneo) — Principal investigator
First posted
Mar 5, 2019
Start date
Jun 1, 2019 (estimated)
Primary completion
Dec 31, 2020 (estimated)
Completion
Jan 1, 2021 (estimated)
Last update
Mar 5, 2019

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is status unknown, as verified in Mar 2019. You cannot join it, but the record below documents what was studied.

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