Field Implementation of the autoRIC Device in STEMI
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,622
- 试验地点
- 4
- 主要终点
- 90-day MACCE
研究概览
简要总结
This is a "before and after" observational study of a therapeutic strategy to treat patients with confirmed ST-segment myocardial infarction (STEMI) with remote ischemic conditioning (RIC) before undergoing primary percutaneous coronary intervention (PCI). RIC is the purposeful application of brief, intermittent cycles of limb occlusion by inflation/deflation of a pneumatic cuff. The autoRIC device is an automatic RIC delivery device (the autoRIC® Device; CellAegis Devices Inc, Toronto, ON) that has received clearance from Health Canada for this use under the direction of a health care professional. Paramedics in the Peel and Halton regional emergency services and the Emergency department (ED) staff of Brampton Civic Hospital and Mississauga Hospital will treat patients experiencing STEMI with autoRIC, and study data will be collected from existing patient records.
The 'before' group will include up to 900 patients who were treated before autoRIC implementation in the services and hospitals. These patients would have had a STEMI and undergone PCI, but did not receive the autoRIC device. The 'after' group will include up to 900 eligible patients who have had RIC treatment with the autoRIC device at the two participating sites following implementation in the services and hospitals.
The primary analyses will compare the short-term and long-term outcomes of eligible patients who have received completed primary PCI for STEMI in the time period before the implementation and following the implementation of this RIC strategy. In addition, a health economic analysis will be conducted to determine the cost-effectiveness of the therapeutic strategy to treat STEMI patients with RIC prior to PCI.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •18 years of age and older;
- •patients diagnosed with STEMI in the prehospital environment by responding paramedics from Peel Regional Paramedic Services or Halton Emergency Medical Service and transported to the PCI laboratory of Brampton Civic Hospital or Trillium Health Partners;
- •walk-in patients diagnosed with STEMI in the ED of either of these two facilities.
排除标准
- •left-bundle branch block;
- •Lymphedema on either arm
- •PICC Line on either arm
- •AV fistula or no palpable pulse on either arm;
- •patient has a known bleeding disorder or known abnormality of blood flow to the left arm;
- •patient has peripheral nerve injury, abnormal nerve supply, peripheral neuropathy or pre- existing traumatic injury to the limb to be treated (left-arm).
研究组 & 干预措施
'Before' group
Patients who underwent primary PCI for STEMI prior to implementation of the RIC protol. These patients were not treated with the autoRIC device prior to PCI.
'After' group
Patients who underwent primary PCI for STEMI after implementation of the RIC protocol. These patients were treated with the autoRIC device prior to PCI.
干预措施: autoRIC (Device)
结局指标
主要结局
90-day MACCE
时间窗: Within 90 days of PCI
Major adverse cardiovascular and cerebrovascular events (MACCE) in-hospital and within 90 days of PCI.
次要结局
- 30, 60, and 180-day cardiovascular-related readmission(30, 60 and 180 days after index hospitalization)
- Cardiovascular-related death(Time from hospital admission to hospital discharge, up to 180 days of admission)
- Infarct size(Time from hospital admission to hospital discharge, up to 180 days of admission)
- LOS(Time from hospital admission to hospital discharge, up to 180 days of admission)
- 30, 60 and 180-day MACCE(Within 30, 60 and 180 days of admission)
研究者
Dr. Sheldon Cheskes
Medical Director
Sunnybrook Health Sciences Centre