ClinicalTrials.gg
Status unknownNCT04718025ELECTRA-SIRIOUpdated Apr 21, 2023

Evaluation of Safety and Efficacy of Two Ticagrelor-based De-escalation Antiplatelet Strategies in Acute Coronary Syndrome

A Phase 3 interventional study of Ticagrelor 90mg and Ticagrelor 60mg in STEMI, NSTEMI and Unstable Angina, sponsored by Collegium Medicum w Bydgoszczy. Status unknown at 1 site in Poland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-04-21.

Sponsored by Collegium Medicum w Bydgoszczy · Phase 3, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Apr 2023), so the status shown — last known as Recruiting — may be out of date.
Phase
Phase 3
Study type
Interventional
Enrollment
4,500
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 24 studies testing ticagrelor in ST Elevation Myocardial Infarction — none open to participants now, 1 under way, none of them phase 3. Ticagrelor · ST Elevation Myocardial Infarction.

Planned enrollment
Largest of 24
4,500 · median 94
Started
2022
the only one that year
Phase 3
6 of 24
none open now
Registered
22nd of 24
by date
Lead sponsor
1 of 24
Collegium Medicum w Bydgoszczy

Among the 24 studies testing ticagrelor in ST Elevation Myocardial Infarction, this one has the largest planned enrollment, is the only one that started in 2022, is one of 6 in phase 3, and was the 22nd registered.

By phase

24 studies; the count open now beside each. This study's row is marked.

Phase 413 · 0 open
Phase 3this study6 · 0 open
Phase 23 · 0 open
No phase2 · 0 open

By the year they started

First in 2012; this study’s year is marked. 1 started in 2022.

Size and results

Median enrollment 94 across the 24 interventional studies. Of the 16 that completed or were terminated, 4 (25%) have results posted.

Download CSVWith an account: the 24 studies testing ticagrelor in ST Elevation Myocardial Infarction as a file.
02

Study summary

The ELECTRA-SIRIO 2 study is a randomized, multicenter, double-blind, investigator-initiated clinical trial aimed to evaluate safety and efficacy of two ticagrelor-based de-escalation antiplatelet strategies in patients with acute coronary syndrome (ACS). During the hospitalization due to ACS, participants will be randomized in a 1:1:1 ratio into one of three arms: low-dose ticagrelor with aspirin (LDTA), low-dose ticagrelor with placebo (LDTP), and standard-dose ticagrelor with aspirin (SDTA), the latter being the control arm. Up to day 30, all enrolled patients will receive standard-dose ticagrelor (2x90mg) + aspirin (1x100mg). Starting from day 31 LDTA and LDTP patients will receive low-dose ticagrelor (2x60mg) + aspirin (1x100mg), SDTA - continuation of previous treatment. Starting from day 91 LDTP patients will receive low-dose ticagrelor (2x60mg) + placebo, SDTA and LDTA - continuation of previous treatment. The aim of the study is to evaluate the influence of ticagrelor maintenance dose reduction from 2x90mg to 2x60mg with or without continuation of aspirin versus dual antiplatelet therapy with standard dose ticagrelor in reducing clinically relevant bleeding and maintaining anti-ischemic efficacy in ACS patients.

03

Conditions studied

  • STEMI
  • NSTEMI
  • Unstable Angina

Keywords

  • ticagrelor
  • aspirin
  • acute coronary syndrome
04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • diagnosis of STEMI or NSTEMI or unstable angina
  • for patients with STEMI, the following three inclusion criteria will have to be met: 1) new ST-elevation at the J-point in two contiguous leads with the cut-point ≥1 mm in all leads other than leads V2-V3, where the following cut-points apply: ≥2mm in men ≥40 years; ≥2.5 mm in men \<40 years, or ≥1.5 mm in women regardless of age; or a new left bundle-branch block 2) the intention to perform primary PCI 3) detection of a rise and/or fall of cardiac troponin values with at least one value above the 99th percentile upper reference limit
  • for patients with NSTEMI or unstable angina, at least two of the following three criteria will have to be met:

    1. symptoms indicating myocardial ischaemia
    2. ST-segment changes on electrocardiography indicating myocardial ischaemia
    3. detection of a rise and/or fall of cardiac troponin values with at least one value above the 99th percentile upper reference limit in addition to at least one of the following:

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    1. ≥60 years of age;
    2. previous MI or coronary artery by-pass grafting;
    3. ≥50% stenosis in ≥2 coronary arteries;
    4. previous ischaemic stroke or ;
    5. ≥50% carotid stenosis or cerebral revascularisation;
    6. diabetes mellitus;
    7. peripheral artery disease;
    8. chronic kidney disease with \<60 mL/min.

Exclusion criteria

Exclusion Criteria:

  • to ticagrelor or/and aspirin
  • indications for oral anticoagulation therapy
  • second or third grade atrio-ventricular block
  • previous stent thrombosis on treatment with ticagrelor
  • end stage kidney disease with \<15 mL/min or on haemodialysis
  • administration of prasugrel during the index event
  • pregnancy
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
4,500 participants (estimated)

Study arms

  • Experimental
    Low-dose ticagrelor with aspirin (LDTA)

    Patients with ACS in this arm will be subject to reduction of ticagrelor maintenance dose from 2x90mg to 2x60mg after the first month post-ACS, and will receive the following antiplatelet therapy: 1. ticagrelor 2x90mg + aspirin 1x100mg during the first 30 days after ACS; 2. ticagrelor 2x60mg + aspirin 1x100mg starting from day 31 until 12 months after ACS.

    Drug: Ticagrelor 60mg · Drug: Aspirin

  • Experimental
    Low-dose ticagrelor with placebo (LDTP)

    Patients with ACS in this arm will be subject to reduction of ticagrelor maintenance dose from 2x90mg to 2x60mg after the first month post-ACS, followed by discontinuation of aspirin after 3 months post-ACS, and will receive the following antiplatelet therapy: 1. ticagrelor 2x90mg + aspirin 1x100mg during the first 30 days after ACS; 2. ticagrelor 2x60mg + aspirin 1x100mg starting from day 31 until day 90 after ACS; 3. ticagrelor 2x60mg + placebo starting from day 91 until 12 months after ACS.

    Drug: Ticagrelor 60mg

  • Active comparator
    Standard-dose ticagrelor with aspirin (SDTA)

    Patients with ACS in this arm will receive standard dual antiplatelet therapy including ticagrelor 2x90mg + aspirin 1x100mg during the whole 12 months after ACS.

    Drug: Ticagrelor 90mg · Drug: Aspirin

Interventions

  • Up to day 30 after ACS, all enrolled patients will receive standard-dose ticagrelor 2x90mg as a part of dual antiplatelet therapy. Participants in SDTA arm will continue treatment with ticagrelor 2x90mg until 12 months post-ACS, while patients in LDTA and LDTP will be switched to low-dose ticagrelor 2x60 mg starting on day 31.

    Also known as: Brilique

  • Starting from day 31, LDTA and LDTP patients will receive low-dose ticagrelor 2x60mg until 12 months post-ACS.

    Also known as: Brilique

  • Up to day 90 after ACS, all enrolled patients will receive aspirin 1x100mg as a part of dual antiplatelet therapy. Starting from day 91, LDTP patients will discontinue aspirin and proceed with low-dose ticagrelor monotherapy until 12 months post-ACS, while patients in LDTA and SDTA will continue aspirin 1x100 mg until 12 months post-ACS.

    Also known as: acetylsalicylic acid

06

What researchers measure

Primary outcomes

  1. BARC type 2, 3 or 5 bleeding

    The primary safety composite end point of this study is the first occurrence of type 2, 3 or 5 bleeding according to the BARC criteria, occurring during the first 12 months after ACS.

    Time frame: 12 months after ACS

  2. Death from any cause, nonfatal MI or nonfatal stroke.

    The primary efficacy end point is the composite of death from any cause, first nonfatal MI, or first nonfatal stroke.

    Time frame: 12 months after ACS

Secondary outcomes

  1. Death from any cause, nonfatal MI, nonfatal stroke, BARC type 2, 3, or 5 bleeding.

    The key secondary endpoint, net clinical effect, was defined as composite of death from any cause, nonfatal MI, or nonfatal stroke, and the first occurrence of BARC type 2, 3, or 5 bleeding.

    Time frame: 12 months after ACS

  2. BARC type 3 or 5 bleeding

    Composite of the first occurrence of type 3 or 5 bleeding according to the BARC criteria.

    Time frame: 12 months after ACS

  3. TIMI major or minor bleeding

    Composite of the first occurrence of major or minor bleeding according to the TIMI criteria.

    Time frame: 12 months after ACS

  4. GUSTO moderate, severe, or life-threatening bleeding

    Composite of the first occurrence of moderate, severe, or life-threatening bleeding according to the GUSTO criteria.

    Time frame: 12 months after ACS

  5. ISTH major bleeding

    The first occurrence of major bleeding according to the ISTH criteria.

    Time frame: 12 months after ACS

  6. Death from any cause

    Death from any cause.

    Time frame: 12 months after ACS

  7. Death from cardiovascular causes

    Death from cardiovascular causes.

    Time frame: 12 months after ACS

  8. Myocardial infarction

    Occurrence of myocardial infarction.

    Time frame: 12 months after ACS

  9. Ischemic stroke

    Occurrence of ischemic stroke.

    Time frame: 12 months after ACS

  10. Definite or probable stent thrombosis

    Occurrence of definite or probable stent thrombosis

    Time frame: 12 months after ACS

  11. Dyspnea

    Occurrence of dyspnea

    Time frame: 12 months after ACS

07

Study locations

1 of 1 sites recruiting
  • Antoni Jurasz University Hospital No. 1
    Bydgoszcz, Poland
    Recruiting
08

References and documents

Publications

  • Kubica J, Adamski P, Niezgoda P, Kubica A, Podhajski P, Baranska M, Uminska JM, Pietrzykowski L, Ostrowska M, Siller-Matula JM, Badariene J, Bartus S, Budaj A, Dobrzycki S, Fidor L, Gasior M, Gessek J, Gierlotka M, Gil R, Goracy J, Grzelakowski P, Hajdukiewicz T, Jaguszewski M, Janion M, Kasprzak J, Kern A, Klecha A, Kleinrok A, Kochman W, Krakowiak B, Legutko J, Lesiak M, Nosal M, Piotrowski G, Przybylski A, Roleder T, Skonieczny G, Sobieszek G, Tycinska A, Wojciechowski D, Wojakowski W, Wojcik J, Zielinska M, Zurakowski A, Specchia G, Gorog DA, Navarese EP. A new approach to ticagrelor-based de-escalation of antiplatelet therapy after acute coronary syndrome. A rationale for a randomized, double-blind, placebo-controlled, investigator-initiated, multicenter clinical study. Cardiol J. 2021;28(4):607-614. doi: 10.5603/CJ.a2021.0056. Epub 2021 Jun 7. PubMed 34096012 ↗
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 21, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04718025
Lead sponsor
Collegium Medicum w Bydgoszczy
Collaborators
Medical Research Agency, Poland
Responsible party
Jacek Kubica (Prof. dr hab., Collegium Medicum w Bydgoszczy) — Principal investigator
First posted
Jan 22, 2021
Start date
Feb 7, 2022
Primary completion
Jun 30, 2024 (estimated)
Completion
Jun 30, 2024 (estimated)
Last update
Apr 21, 2023

Study contacts

Piotr Adamski, MD, PhD
Contact
piotr.adamski@cm.umk.pl
+48 52 585 4023
Jacek Kubica, MD, PhD
principal investigator · Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
Eliano Navarese, MD, PhD
principal investigator · Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

Oversight

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

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Studies of the drugs tested here: Ticagrelor · Aspirin

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