Key result
EPIC17-VERONICA trial tests VerifyNow-guided clopidogrel de-escalation for net adverse clinical events in ACS.
Why the study?
Does VerifyNow-guided de-escalation to clopidogrel reduce net adverse cardiovascular events in ACS patients with very low platelet reactivity on potent P2Y12 inhibitors?
RCT (n=634)
1:1 ratio using an electronic system
Yes
Does VerifyNow-guided de-escalation to clopidogrel reduce net adverse cardiovascular events in ACS patients with very low platelet reactivity on potent P2Y12 inhibitors?
Answers are grounded in this paper and cite their sources.
The EPIC17-VERONICA trial will determine if VerifyNow-guided de-escalation to clopidogrel safely reduces bleeding in ACS patients with very low platelet reactivity on potent P2Y12 inhibitors.
Introduction and objectives: De-escalation from prasugrel and ticagrelor to clopidogrel in patients undergoing percutaneous coronary intervention after acute coronary syndrome (ACS) is a strategy aimed at reducing bleeding. This study evaluates whether VerifyNow (Werfen, Spain)-guided de-escalation, based on platelet aggregation measurement, provides a therapeutic benefit in ACS management. Methods: This ongoing multicenter, prospective, randomized 1:1 trial will enroll 634 patients with ACS who underwent revascularization with a sirolimus-eluting stent and were discharged on dual antiplatelet therapy with ticagrelor or prasugrel. Only those patients with a very low platelet reactivity level (platelet reactivity units ≤ 30) based on VerifyNow 1 month after discharge will be included. The primary endpoint is a composite of cardiovascular death, nonfatal acute myocardial infarction, nonfatal stroke, and bleeding at 1-year follow-up. Results: The EPIC17-VERONICA study (NCT04654052) will reveal the efficacy profile of the de-escalation strategy, based on the VerifyNow platelet aggregation test, and determine the role of this device in the selection of patients who are eligible to benefit from this strategy. Conclusions: This study will determine whether platelet function testing provide clinical benefit in the management of patients with ACS.
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Cámara et al. (2026) conducted an RCT in Acute coronary syndrome (n=634). VerifyNow-guided de-escalation to clopidogrel vs. Continued ticagrelor or prasugrel was evaluated on Composite of cardiac death, nonfatal acute myocardial infarction, nonfatal stroke, and bleeding (BARC grade ≥ 2) at 1-year follow-up. VerifyNow-guided de-escalation to clopidogrel is being evaluated in the ongoing EPIC17-VERONICA trial to determine its efficacy in reducing net adverse cardiovascular events in 634 ACS patients.
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