Impairment of Gastric Emptying During Acute Phase of Myocardial Infarction. Impact on Oral Antiplatelet Treatment Efficacy. The GASTRIM Study.
试验速览
- 阶段
- 4 期
- 状态
- 终止
- 发起方
- 入组人数
- 23
- 试验地点
- 1
- 主要终点
- Determination of the paracetamol concentration time curve 72 hours after time of STEMI Onset
研究概览
简要总结
Oral antiplatelet therapy is a key treatment of the STEMI (ST elevation myocardial infarction). Delayed action isn't suitable and has to be elucidated. If a delayed gastric emptying time is observed during STEMI, limiting the use of morphine and encourage the use of prokinetic agents can be a first answer to optimize coronary angioplasty environment.
Investigators propose a study to assess the gastric emptying times at the acute phase of myocardial infarction using a validated paracetamol absorption test. The STEMI group will be compared to in one hand, itself with measures performed 72 hours±12h after the event onset; and on the other hand, to a stable patient group referred for angioplasty for angina or non-ST-segment elevation myocardial infarction (NSTEMI). For STEMI group and stable patient group, the delay of apparition of Prasugrel or Ticagrelor efficacy will be determined by VerifyNow® test and correlated to gastric emptying times.
详细描述
Oral antiplatelet therapy is a key treatment of the STEMI (ST elevation myocardial infarction). Delayed action isn't suitable and has to be elucidated. If a delayed gastric emptying time is observed during STEMI, limiting the use of morphine and encourage the use of prokinetic agents can be a first answer to optimize coronary angioplasty environment.
Investigators propose a study to assess the gastric emptying times at the acute phase of myocardial infarction using a validated paracetamol absorption test. The STEMI group will be compared to in one hand, itself with measures performed 72 hours±12h after the event onset; and on the other hand, to a stable patient group referred for angioplasty for angina or non-ST-segment elevation myocardial infarction (NSTEMI). For STEMI group and stable patient group, the delay of apparition of Prasugrel or Ticagrelor efficacy will be determined by VerifyNow® test and correlated to gastric emptying times.
Paracetamol absorption test is a safe, cheap and well validated method to assess these times including during the STEMI period. This one consists in oral ingestion of 1.5g of paracetamol followed by the realization of the curve of concentration of paracetamol in plasma samples. These samples are taken at 15 min intervals during the first 2 hours.
In the same time the curve of Platelet reactivity Unit (PRU) obtained by VerifyNow® tests will be determined with the goal to establish a relation between gastric emptying times and delayed observed antiplatelet activity.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Basic Science
- 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
- •Patient over 18 years weighing between 65 and 85 Kg
- •Referred for STEMI within 6 hours from beginning of chest pain or stable coronary artery disease requiring a loading dose of Prasugrel or Ticagrelor according to the international recommendations.
- •No previous treatment with Clopidogrel, Prasugrel or Ticagrelor.
- •Patient fasting for at least 6 hours.
- •Affiliate or receiving a social security system.
- •Written informed consent.
排除标准
- •Allergy or contraindication to paracetamol, Prasugrel or Ticagrelor
- •Paracetamol ingestion in the previous 48 hours
- •Patient treated with drugs supposed to alter gastric emptying times (calcium antagonists, Alimentary tract treatments, opioid analgesics, tricyclic antidepressants, antibiotics).
- •Conditions or pathologies supposed to alter gastric emptying times (Thyroid dysfunction, chronic renal failure, Parkinson's disease, scleroderma, amyloidosis, any gastrointestinal disease, any not cured malignancy, and any advanced psychiatric or neurological disease).
- •Presence of vomiting
- •Cardiogenic shock, ventricular arrhythmia or resuscitated cardiac arrest
- •Hepatic insufficiency
- •Severe respiratory disease
- •Pregnant or breastfeeding women
研究组 & 干预措施
STEMI Group
干预措施: Paracetamol concentration time curve from 0 to 120 min (Drug)
Stable patient Group
Patient referred for angioplasty for angina or non-ST-segment elevation myocardial infarction (NSTEMI)
干预措施: Paracetamol concentration time curve from 0 to 120 min (Drug)
结局指标
主要结局
Determination of the paracetamol concentration time curve 72 hours after time of STEMI Onset
时间窗: Every 15 minutes since 72 hours after STEMI onset up to 120 minutes
Taking of blood samples every 15 minutes for patients of STEMI Group
Determination of the paracetamol concentration time curve at the time of STEMI Onset
时间窗: Every 15 minutes since inclusion (STEMI onset ) up to 120 minutes
Taking of blood samples every 15 minutes for patients of STEMI Group
Determination of the paracetamol concentration time curve for Stable patient Group
时间窗: Every 15 minutes since inclusion up to 120 minutes
Taking of blood samples every 15 minutes for Stable patient Group
次要结局
未报告次要终点