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A Study to Investigate the Procoagulant Effect of Tenecteplase (TNK-tPA), Alteplase (Rt-PA) and Streptokinase (SK) Administered to Patients With Acute Myocardial Infarction (AMI)

Phase 3
Completed
Conditions
Myocardial Infarction
Interventions
Registration Number
NCT02182011
Lead Sponsor
Boehringer Ingelheim
Brief Summary

Primary objective: to evaluate the procoagulant effect of TNK-tPA compared to rt-PA and streptokinase, administered to patients with AMI, by measuring the concentration of TAT at 2 hours after the start of treatment versus baseline values.

Secondary objective: change from baseline in concentration of TAT at 6 and 24 hours; change from baseline in concentration of D-dimers, F1+2, PAI-1, PAP at 2, 6 and 24 hours. Incidence of adverse events (AE's), in -hospital complications, major or minor bleedings and serious adverse events.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
49
Inclusion Criteria
  • Onset of symptoms of AMI within 6 hours from randomisation
  • A twelve-lead electrocardiogram (ECG) showing ST-segment elevation ≥ 0.1 millivolt (mV) in two or more limb leads, or ≥ 0.2 mV in two or more contiguous precordial leads indicative of AMI, or new left bundle-branch block
  • Age ≥ 18
Exclusion Criteria
  • Hypertension defined as blood pressure > 180/110 mmHg (systolic BP > 180 mmHg and/or diastolic BP > 110 mmHg) on repeated measurements during current admission prior to randomisation
  • Use of abciximab (ReoPro®) within the preceding 7 days or eptifibatide (Integrilin®) or tirofiban (aggrastat®) within the past 48 hours
  • Use of heparin within the preceding 12 hours
  • Current therapeutic oral anticoagulation
  • Major surgery, biopsy of a parenchymal organ, or significant trauma within 2 months
  • Any minor head trauma and any other trauma occurring after the onset of the current myocardial infarction
  • Any known history of stroke or transient ischemic attack or dementia
  • Any known structural damage of the central nervous system
  • Ruptured aortic aneurism
  • Active bleeding
  • Prolonged cardiopulmonary resuscitation (> 10 minutes) in the previous two weeks
  • Pregnancy or lactation, parturition within the previous 30 days. Women of childbearing potential must have a negative pregnancy test
  • Any known active participation in another investigative drug study or device protocol in the past 30 days
  • Previous enrolment in this study
  • Any other condition that the investigator feels would place the patient at increased risk if the investigational therapy were initiated
  • Inability to follow the protocol and comply with follow-up requirements

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
AlteplaseAlteplaseSingle i.v. bolus followed by infusion
TenecteplaseTenecteplaseSingle i.v. bolus followed by infusion, weight adjusted
StreptokinaseStreptokinaseI.V. infusion
Primary Outcome Measures
NameTimeMethod
Changes from baseline in concentration of thrombin anti-thrombin complex (TAT)Baseline, 2 hours after start of treatment
Secondary Outcome Measures
NameTimeMethod
Changes from baseline in TATBaseline, 6 and 24 hours after start of treatment
Changes from baseline in D-dimersBaseline, 2, 6 and 24 hours after start of treatment
Changes from baseline in prothrombin fragments 1+2 (F1+F2)Baseline, 2, 6 and 24 hours after start of treatment
Changes from baseline in plasminogen-activator inhibitor-1 (PAI-1)Baseline, 2, 6 and 24 hours after start of treatment
Changes from baseline in plasmin-antiplasmin complex (PAP)Baseline, 2, 6 and 24 hours after start of treatment
Occurrence of adverse events (AE's)Up to 30 days
Occurrence of major bleedingsUp to 30 days
Occurrence of minor bleedingsUp to 30 days
Occurrence of serious adverse events (SAE's)Up to 30 days
Occurrence of in-hospital complicationsStart of treatment until discharge from hospital
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