Angioplasty and Heart Stents to Treat Individuals With an Occluded Artery Following a Heart Attack

NCT ID: NCT00025766

Last Updated: 2013-11-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

380 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-09-30

Study Completion Date

2011-12-31

Brief Summary

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The purpose of this study is to evaluate arterial patency and left ventricular ejection fraction by examining angiographic data one year following a heart attack and treatment with late revascularization.

Detailed Description

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BACKGROUND:

The Occluded Artery Trial (OAT) is an international study with 3200 participants. Its goal is to determine if delayed mechanical reperfusion by means of percutaneous transluminal coronary angioplasty (PTCA) and stenting reduces death, heart attacks, and hospitalization in individuals with New York Heart Association (NYHA) Class IV heart failure and a persistently occluded infarct-related artery (IRA) 3 to 28 days following a heart attack. While left ventricular (LV) function improvement has been suggested as a benefit of late reperfusion, solid evidence to support this claim is lacking. Furthermore, while stenting has reduced reocclusion rates after total occlusion PTCA, the reocclusion rate after a recent heart attack is unknown.

DESIGN NARRATIVE:

This study is a substudy of OAT and will enroll 380 participants. The primary aims of the study include the following: 1) to compare long-term patency rates between the two treatment groups (conventional medical therapy or PTCA and stenting) by means of follow-up coronary angiography one year after enrollment; and 2) to compare the change in global LV ejection fraction between the two treatment groups utilizing baseline and follow-up contrast LV angiograms. Secondary aims include the following: 1) comparison of regional wall motion and LV volumes; 2) study of the effect of reocclusion and spontaneous recanalization on LV function; and 3) study of the effect of duration of occlusion on changes in LV function after Percutaneous Coronary Intervention (PCI). The substudy will be conducted at 21 OAT study sites. The Substudy Coordinating Center (SCC) is at the University of Alberta in Edmonton, Canada. The Data Coordinating Center (DCC) is at the Maryland Medical Research Institute, which is the DCC for the OAT study. The Angiographic Core Laboratory is at the University of British Columbia.

Conditions

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Cardiovascular Diseases Coronary Disease Heart Diseases Myocardial Infarction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1

PCI with stenting of the occluded culprit infarct-related artery plus optimal medical therapy

Group Type EXPERIMENTAL

PCI with stenting

Intervention Type DEVICE

PCI with stenting of the occluded culprit infarct-related artery

Optimal Medical Therapy

Intervention Type BEHAVIORAL

Participants will receive optimal medical therapy.

2

Optimal medical therapy alone without PCI of the occluded culprit artery

Group Type ACTIVE_COMPARATOR

Optimal Medical Therapy

Intervention Type BEHAVIORAL

Participants will receive optimal medical therapy.

Interventions

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PCI with stenting

PCI with stenting of the occluded culprit infarct-related artery

Intervention Type DEVICE

Optimal Medical Therapy

Participants will receive optimal medical therapy.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Has experienced a heart attack 3 to 28 days prior to study entry
* Has a persistently occluded IRA
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

University Health Network, Toronto

OTHER

Sponsor Role lead

Responsible Party

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University Health Network, Toronto, ON, Canada

Principal Investigators

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Vladimir Dzavik, MD

Role: STUDY_CHAIR

University Health Network - Toronto General Hospital

Locations

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University Health Network - Toronto General Hospital

Toronto, Ontario, Canada

Site Status

Countries

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Canada

References

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Dzavik V, Buller CE, Lamas GA, Rankin JM, Mancini GB, Cantor WJ, Carere RJ, Ross JR, Atchison D, Forman S, Thomas B, Buszman P, Vozzi C, Glanz A, Cohen EA, Meciar P, Devlin G, Mascette A, Sopko G, Knatterud GL, Hochman JS; TOSCA-2 Investigators. Randomized trial of percutaneous coronary intervention for subacute infarct-related coronary artery occlusion to achieve long-term patency and improve ventricular function: the Total Occlusion Study of Canada (TOSCA)-2 trial. Circulation. 2006 Dec 5;114(23):2449-57. doi: 10.1161/CIRCULATIONAHA.106.669432. Epub 2006 Nov 14.

Reference Type RESULT
PMID: 17105848 (View on PubMed)

Steigen TK, Buller CE, Mancini GB, Jorapur V, Cantor WJ, Rankin JM, Thomas B, Webb JG, Kronsberg SS, Atchison DJ, Lamas GA, Hochman JS, Dzavik V. Myocardial perfusion grade after late infarct artery recanalization is associated with global and regional left ventricular function at one year: analysis from the Total Occlusion Study of Canada-2. Circ Cardiovasc Interv. 2010 Dec;3(6):549-55. doi: 10.1161/CIRCINTERVENTIONS.109.918722. Epub 2010 Nov 9.

Reference Type RESULT
PMID: 21062997 (View on PubMed)

Dzavik V, Buller CE, Devlin G, Carere RG, Mancini GB, Cantor WJ, Buszman PE, Rankin JM, Vozzi C, Ross JR, Forman S, Barton BA, Lamas AG, Hochman JS. Angiographic and clinical outcomes of drug-eluting versus bare metal stent deployment in the Occluded Artery Trial. Catheter Cardiovasc Interv. 2009 May 1;73(6):771-9. doi: 10.1002/ccd.21930.

Reference Type RESULT
PMID: 19309733 (View on PubMed)

Other Identifiers

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R01HL067683

Identifier Type: NIH

Identifier Source: secondary_id

View Link

989

Identifier Type: -

Identifier Source: org_study_id