NCT00440895已完成4 期
A Randomized Trial of Early Discharge After Trans-Radial Stenting of Coronary Arteries in Acute Myocardial Infarction and RESCUE-PCI: The EASY-RESCUE Pilot Study
Olivier F. Bertrand1 个研究点 分布在 1 个国家目标入组 74 人开始时间: 2007年2月最近更新:
适应症
干预措施
相关药物
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 发起方
- 入组人数
- 74
- 试验地点
- 1
- 主要终点
- TIMI score and myocardial blush grade after rescue-PCI at baseline and at 6-month follow-up
研究概览
简要总结
- Abciximab administration is safe and reduces ischemic complications in patients undergoing rescue PCI after failed thrombolysis compared to placebo.
- Abciximab improves angiographic scores and ventricular function after rescue-PCI compared to placebo.
- Intracoronary abciximab administration is more effective than intravenous route of administration in terms of acute and mid-term angiographic and clinical results.
- Intracoronary and intravenous bolus administration of abciximab dose provides similar platelet aggregation inhibition (PAI).
- There is a significant relationship between PAI after abciximab administration and indexes of myocardial perfusion.
- Routine use of Sirolimus-eluting stents (Cypher, Cordis, US) in rescue-PCI is associated with a low rate of target vessel revascularization.
- Cardiac MRI early and late after rescue-PCI provides detailed information on myocardial injury and irreversible necrosis, which are correlated with angiographic perfusion scores.
- After uncomplicated trans-radial rescue PCI, patients can be retransferred early to their referring center.
详细描述
OBJECTIVES AND END-POINTS
The objectives of the present pilot study are to assess 1) the benefits and safety of abciximab i.c. or i.v. compared to placebo in rescue PCI and trans-radial approach, 2) the relationship between platelet aggregation inhibition and perfusion scores and to demonstrate 3) better perfusion scores with i.c. abciximab as compared to i.v. abciximab or placebo.
The Primary ANGIOGRAPHIC end-point will be the TIMI score and myocardial blush grade after rescue-PCI at baseline and at 6-months follow-up.
The Secondary CLINICAL end-point will be:
- the composite of death, stroke, repeat-myocardial infarction, urgent target vessel revascularization and major bleedings at 30 days after rescue PCI.
- composite of death, repeat-myocardial infarction, repeat target vessel revascularization at 6 months following rescue PCI.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patient with acute myocardial infarction eligible for rescue PCI within 24 hrs of symptoms.
- •Failed thrombolysis (defined as less than 50% reduction of ST-elevation at 90 min ECG in the lead with previous maximal ST-segment elevation).
- •Patient > 18 years old.
- •Patient and treating interventional cardiologist agree for randomization.
- •Patient will be informed of the randomization process and will sign an informed consent.
- •Diagnostic and therapeutic intervention performed through transradial/transulnar approach.
- •The culprit lesion in a native coronary artery can identified and is suitable for immediate angioplasty and stent implantation.
排除标准
- •Age > 75 years old
- •Body weight < 65 kg
- •Concurrent participation in other investigational study
- •Intolerance or allergy to ASA, clopidogrel or ticlopidine precluding treatment for 12 months
- •Any significant blood dyscrasia, diathesis or INR > 2.
- •Any clinical contraindication to abciximab administration i.e. known structural intracranial lesion, thrombocytopenia (< 100,000), hemoglobin level < 10 g/dl
- •Patient has received more than one dose of thrombolytic within 24 hours of symptoms
- •Previous treatment with glycoproteins IIb-IIIa inhibitors within 30 days
- •Perceived increased risk of intracranial or severe bleeding i.e. previous stroke/TIA, alteration of consciousness, recent trauma or major surgery.
- •Uncontrolled high blood pressure i.e. systolic blood pressure ≥ 180 mmHg and/or diastolic blood pressure ≥ 100 mmHg.
- •Life expectancy less than 6 months owing to non-cardiac cause
- •Evident cardiogenic shock
研究组 & 干预措施
1 intracoronary + infusion
Experimental
Bolus abciximab i.c. (0.25 mg/kg) followed by 12 h infusion at 0.125 µg/kg/min (max 10µg/min).
干预措施: Abciximab (Drug)
2 intravenous
Active Comparator
Bolus abciximab i.v. (0.25 mg/kg) followed by 12 h infusion at 0.125 µg/kg/min (max 10µg/min).
干预措施: Abciximab (Drug)
3 Placebo
Placebo Comparator
Bolus of placebo followed by 12 h infusion (placebo).
干预措施: Abciximab (Drug)
结局指标
主要结局
TIMI score and myocardial blush grade after rescue-PCI at baseline and at 6-month follow-up
时间窗: 6 months
次要结局
- 1 Composite of death, stroke, repeat-MI, urgent target vessel revascularization and major bleedings at 30 days after rescue PCI(1 month)
- 2 Composite of death, repeat-MI, repeat target vessel revascularization at 6 months following rescue PCI(6 months)
- 3 Proportion of patients with platelet aggregation inhibition ≥ 95% and mean platelet aggregation inhibition 10 min post-bolus administration(10 min post PCI)
- 4 Angiographic late loss and restenosis rate (diameter stenosis ≥ 50%) in the culprit artery(6 months)
- 5 Exploratory end-points include the feasibility and safety of early transfer to the referring hospital after uncomplicated primary PCI, cardiac MRI measurements and PAI 6 h after bolus administration(6-hr post PCI to hospital discharge)
研究者
Olivier F. Bertrand
MD PhD
Laval University
研究点 (1)
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