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Effect of Evolocumab on Saphenous Vein Graft Patency Following Coronary Artery Bypass Surgery

Phase 4
Conditions
Vein Occlusion
Coronary Artery Bypass Graft Surgery
Atherosclerosis
Interventions
Other: Placebo
Registration Number
NCT03900026
Lead Sponsor
Unity Health Toronto
Brief Summary

The purpose of this study is to determine if evolocumab added to regular statin therapy improves vein graft patency after coronary artery bypass graft (CABG) surgery.

Detailed Description

Coronary artery bypass graft (CABG) surgery is a procedure in which an artery or vein from the body is grafted to a critically narrowed coronary artery to restore flow of oxygenated blood to the heart. Statins are frequently prescribed after CABG surgery in order to lower LDL cholesterol levels and reduce the chances of coronary artery obstruction recurring. Despite this preventive measure, new vein grafts do end up becoming blocked in a significant proportion of patients. Evolocumab (Repatha®) is a recently approved medication that has been shown to effectively lower LDL cholesterol levels in the blood.

NEWTON-CABG is an investigator-initiated multicenter, double-blind, randomized, placebo-controlled, parallel group study of evolocumab \[140mg administered subcutaneously (SC) every two weeks (Q2W)\] added to statin therapy for 24 months postoperatively in a broad population of patients undergoing CABG surgery. Eligible subjects will be randomized to receive evolocumab or placebo within 21 days of index CABG. Prior to randomization, post-operative patients will be on moderate or high intensity statin therapy (atorvastatin 40-80mg, rosuvastatin 20-40mg or simvastatin 40mg daily unless another statin/dose or non-statin alternative is clinically justified). A CTAngiogram will be conducted at 24 months following CABG. Routine study visits will be done 3, 6, 12, 18 and 24 months post-surgery.

This study is supported by Amgen Inc.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
766
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo TreatmentPlaceboParticipants will receive subcutaneous injections of the placebo Q2W (every 2 weeks)
Evolocumab TreatmentEvolocumabParticipants will receive subcutaneous injections of 140mg of evolocumab Q2W (every two weeks)
Primary Outcome Measures
NameTimeMethod
Saphenous vein graft disease rate (VGDR)24 months post CABG

Saphenous vein graft disease rate (VGDR) is defined as the proportion of vein grafts with significant stenosis or total occlusion (≥50%) on 64-slice (or greater) cardiac CT angiography (CTA) or clinically indicated coronary angiography.

Secondary Outcome Measures
NameTimeMethod
The proportion of patients with at least 1 vein graft totally (100%) occluded.24 months post CABG

Proportion of patients who have at least 1 totally (100%) occluded vein graft at 24 months post CABG.

The percentage of vein grafts which are totally (100%) occluded grafts.24 months post CABG

Percentage of vein grafts that are totally (100%) occluded at 24 months post CABG.

Trial Locations

Locations (9)

Jacksonville Center for Clinical Research

🇺🇸

Jacksonville, Florida, United States

Hamilton Health Sciences

🇨🇦

Hamilton, Ontario, Canada

University of Alberta

🇨🇦

Edmonton, Alberta, Canada

Kingston Health Sciences Centre

🇨🇦

Kingston, Ontario, Canada

Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval

🇨🇦

Québec, Quebec, Canada

Foothills Medical Centre

🇨🇦

Calgary, Canada

St. Michael's Hospital

🇨🇦

Toronto, Ontario, Canada

Maine Medical Center

🇺🇸

Portland, Maine, United States

Yale University School of Medicine

🇺🇸

New Haven, Connecticut, United States

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