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Clevidipine in the Perioperative Treatment of Hypertension (ECLISPE-SNP)

Phase 3
Completed
Conditions
Hypertension
Interventions
Registration Number
NCT00093912
Lead Sponsor
The Medicines Company
Brief Summary

The purpose of this study is to establish the safety of clevidipine in the treatment of perioperative hypertension. Approximately 250-500 patients with perioperative hypertension undergoing coronary artery bypass grafting (CABG), off-pump coronary artery bypass (OPCAB) or minimally invasive direct coronary artery bypass (MIDCAB) surgery and/or valve replacement/repair procedures were anticipated to be randomly assigned to one of two treatment groups: clevidipine or sodium nitroprusside.

Detailed Description

The primary objective was to establish the safety of clevidipine in the treatment of perioperative hypertension, as assessed by comparing the incidences of death, stroke, MI and renal dysfunction in the clevidipine and sodium nitroprusside treatment groups from the initiation of study drug infusion through postoperative Day 30. Secondary objectives were to evaluate the efficacy of study drug, assessed by the blood pressure (BP) lowering effect and additional safety variables.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
739
Inclusion Criteria
  • Provide written informed consent before initiation of any study related procedures.
  • Be at least 18 years of age
  • Be scheduled for Coronary Artery Bypass Grafting (CABG), Off Pump Coronary Artery Bypass (OPCAB), Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) surgery, and/or valve replacement/repair surgery

Prerandomization

Exclusion Criteria
  • Women of child-bearing potential (unless they have a negative pregnancy test)
  • Recent cerebrovascular accident (within 3 months before randomization)
  • Known intolerance to calcium channel blockers
  • Known or suspected hypersensitivity to sodium nitroprusside
  • Allergy to soybean oil or egg lecithin (components of the lipid vehicle)
  • Pre-existing permanent ventricular pacing
  • Any other disease or condition, which, in the judgment of the investigator would place a patient at undue risk by being enrolled in the trial
  • Participation in another therapeutic drug or therapeutic device trial within 30 days of starting study

Postrandomization Inclusion Criteria:

  • Determined to be hypertensive perioperatively as determined by the investigator

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
sodium nitroprussidesodium nitroprussideSodium nitroprusside (SNP) was initiated after insertion of an arterial line upon the occurrence of perioperative hypertension, as determined by the investigator, and was administered intravenously as per institutional practice. Treatment was maintained as long as was deemed clinically necessary or until discharge from the ICU.
clevidipineclevidipineClevidipine (0.5 mg/mL in 20% lipid emulsion) was initiated after insertion of an arterial line upon the occurrence of perioperative hypertension, as determined by the investigator, and was administered intravenously (IV) at an initial infusion rate of 0.4 μg/kg/min (non weight-based equivalent is 2 mg/h). Clevidipine was titrated to blood pressure lowering effect by doubling increments approximately every 90 seconds up to a maximum infusion rate of 3.2 μg/kg/min (16 mg/h). Infusion rates above 3.2 μg/kg/min were permitted up to the maximum infusion rate of 8.0 μg/kg/min. Treatment was maintained as long as was deemed clinically necessary or until discharge from the ICU. Infusion rates between 4.4 and 8.0 μg/kg/min were to be administered for no more than 2 hours.
Primary Outcome Measures
NameTimeMethod
Incidence of death, stroke, MI and renal dysfunctionInitiation of study drug infusion through post-operative Day 30
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (29)

International Heart Institute/St. Patrick Hospital

🇺🇸

Missoula, Montana, United States

Mt. Sinai Medical Center

🇺🇸

New York, New York, United States

Jackson-Madison County General Hospital

🇺🇸

Jackson, Tennessee, United States

Wesley Medical Center

🇺🇸

Wichita, Kansas, United States

Kaiser Permanente

🇺🇸

Honolulu, Hawaii, United States

St. Francis Hospital and Health Center

🇺🇸

Blue Island, Illinois, United States

Baptist Medical Center, South

🇺🇸

Montgomery, Alabama, United States

Drug Research and Analysis Corporation

🇺🇸

Montgomery, Alabama, United States

Stanford University Medical Center

🇺🇸

Stanford, California, United States

Hospital of the University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Massachussettes General Hospital

🇺🇸

Boston, Massachusetts, United States

Houston Northwest Medical Center

🇺🇸

Houston, Texas, United States

St. Joseph Medical Center

🇺🇸

Towson, Maryland, United States

LDS Hospital

🇺🇸

Salt Lake City, Utah, United States

The Christ Hospital

🇺🇸

Cincinnati, Ohio, United States

Baptist Medical Center, Montclair

🇺🇸

Birmingham, Alabama, United States

Portland VA Medical Center

🇺🇸

Portland, Oregon, United States

Saint Vincents Hospital

🇺🇸

Birmingham, Alabama, United States

Brookwood Medical Center

🇺🇸

Birmingham, Alabama, United States

St. Francis Hospital of Evanston

🇺🇸

Evanston, Illinois, United States

Providence Saint Joseph Medical Center

🇺🇸

Burbank, California, United States

Health First Holmes Regional Medical Center

🇺🇸

Melbourne, Florida, United States

Saint Lukes Hospital

🇺🇸

Duluth, Minnesota, United States

Henry Ford Health System

🇺🇸

Detroit, Michigan, United States

Virginia Commonwealth University Medical Center

🇺🇸

Richmond, Virginia, United States

Shands Hospital at the University of Florida

🇺🇸

Gainesville, Florida, United States

Ochsner Clinic Foundation

🇺🇸

New Orleans, Louisiana, United States

Touro Infirmary

🇺🇸

New Orleans, Louisiana, United States

Medical College of Wisconsin VAMC - Milwaukee

🇺🇸

Milwaukee, Wisconsin, United States

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