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临床试验/NCT02014753
NCT02014753已完成不适用

Multicenter Comparison of Early and Late Vascular Responses to Everolimus-eluting Cobalt-CHromium Stent and Platelet AggregatioN studIeS for TreatMent of Acute Myocardial Infarction: MECHANISM-AMI

Iwate Medical University1 个研究点 分布在 1 个国家目标入组 100 人开始时间: 2014年4月30日最近更新:
适应症

试验速览

阶段
不适用
状态
已完成
入组人数
100
试验地点
1
主要终点
The percentage of stent strut coverage by OCT

研究概览

简要总结

To treat patients with acute myocardial infarction, primary percutaneous coronary intervention (PCI) will be performed with the use of an everolimus-eluting cobalt- chromium stent (everolimus-eluting stent: EES, Xience Prime, Xpedition), which is the current standard drug-eluting stent (DES). Vascular responses at the site of stent placement will be evaluated by optical coherence tomography (OCT) at 2 weeks or 3 months and at 12 months after stent placement, along with observation of changes over time in the target vessel. The relationships between OCT findings and the time course of platelet aggregation and between OCT findings and the occurrence of major cardio- cerebrovascular events will also be elucidated.

研究设计

研究类型
Observational
观察模型
Cohort
时间视角
Prospective

入排标准

年龄范围
20 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • AMI definition is accordance with the third universal definition of ESC /ACCF/ AHA/ WHF Task Force10, detection of a rise and/or fall of cardiac biomarker values [preferably cardiac troponin (cTn) I or T] with at least one value above the 99th percentile upper reference limit (URL) and with at least one of the following: Symptoms of ischemia. New or presumed new significant ST-segment-T wave (ST-T) changes or new left bundlebranch block (LBBB).
  • Development of pathological Q waves in the ECG. Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality.
  • Identification of an intracoronary thrombus by angiography or autopsy Of the AMI patients who met the above definition, the criterial for inclusion is limited to STEMI patients. STEMI is defined as new ST elevation at the J point in at least 2 contiguous leads of equal or greater than2 mm (0.2 mV) in men equal or greater than1.5 mm (0.15 mV) in women in leads V2-V3 and/or of equal or greater than 1 mm (0.1 mV) in other contiguous chest leads or the limb leads
  • Patients having at least one de novo lesion in a coronary artery in whom PCI with a DES is indicated.
  • Patients aged 20 to less than 85 years at the time of informed consent
  • Patients who have provided informed consent written by themselves
  • Patients who are able to undergo OCT examinations of the site of stent placement at 2 weeks or 3 months and at 12 months.

排除标准

  • Patients who are judged incapable of undergoing clinical follow-up 12 months after PCI (Consider also the location of patients' residences)
  • Lack of specific findings of ACS by angiography (Left to the operator's decision.)
  • The culprit lesion is the left main coronary trunk
  • Lesion with the reference vascular diameter less than 2.0mm or not less than 4.5mm by visual evaluation.
  • Chronic renal failure with serum creatinine level not less than 2.0mg/dl on hospital visit
  • Patients on hemodialysis Cancer patients whose vital prognosis is expected to be within 2 years. Surgery that requires discontinuation of the antiplatelet agent is scheduled within 3 months
  • Patients who experienced adverse reaction to aspirin or clopidogrel (this shall not apply for patients in whom safety of ticlopidine is confirmed)
  • Patients who took warfarin before the onset
  • Patients under 20 years old
  • Pregnant women
  • AMI due to stent thrombosis at prior stented segment.

结局指标

主要结局

The percentage of stent strut coverage by OCT

时间窗: 2 weeks

To observe temporal course from the early stage, the rate of stent-strut coverage in the 3-months arm will also be evaluated in a complementary manner, separately from the 2-weeks arm.

次要结局

  • Any Target Vessel Revascularization (TVR)(1 year)
  • OCT Endpoint(2 weeks and 3 months)
  • Clinically-driven TLR(1 year)
  • Any revascularization(1 year)
  • Angiographic Quantitative analysis(12 month)
  • Angiographic Qualitative analysis(12 month)
  • All-cause Death, Cardiac death, Myocardial Infarction (MI), Stroke, Major bleeding(1 year)
  • Any Target Lesion Revascularization (TLR)(1 year)
  • Coronary-artery bypass surgery (CABG)(1 year)
  • Angiographic binary restenosis(1 year)
  • Patient-oriented composite(1 year)

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

Yoshihiro Morino

Professor

Iwate Medical University

研究点 (1)

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