Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment Thrombolysis in Myocardial Infarction - Study 25 (ExTRACT-TIMI25)

NCT ID: NCT00077792

Last Updated: 2009-04-20

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

PHASE3

Total Enrollment

20506 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-10-31

Study Completion Date

2006-12-31

Brief Summary

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The primary objective of the study is to determine whether enoxaparin compared to unfractionated heparin will reduce the composite endpoint of all-cause mortality and non-fatal myocardial re-infarction within 30 days after randomization in patients with acute ST-segment elevation myocardial infarction who are eligible to receive fibrinolytic therapy

Detailed Description

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Conditions

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Myocardial Infarction Acute ST-Segment Elevation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators

Interventions

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Enoxaparin sodium (XRP4563)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Patients with ST-segment elevation acute myocardial infarction meeting all of the following criteria:

* Male or non-pregnant female greater than or equal to 18 years of age (depending on local regulations, minimal age can vary between 18 and 21 years)
* Onset of prolonged (greater than or equal to 20 min) ischemic symptoms at rest less than or equal to 6 hours prior to randomization
* ST-segment elevation of 0.1 mV in 2 or more limb leads, or 0.2 mV in two (2) or more contiguous precordial leads, or left bundle-branch block
* Planned reperfusion therapy with streptokinase, tenecteplase, alteplase or reteplase
* Written informed consent will be obtained

Exclusion Criteria

Cardiovascular

* Evidence of cardiogenic shock at randomization
* Acute pericarditis
* History or symptoms suggestive of aortic dissection
* MI precipitated by obvious provoking factors such as arrhythmia, infection, severe anemia, hyperthyroidism, cocaine, or amphetamine

Hemorrhagic Risk

* Any minor head trauma or any other trauma occurring after the index acute myocardial infarction
* Active or recent (\< 3 months) bleeding including gastrointestinal bleeding, known presence of occult blood in the stool, or gross hematuria.
* Any history of bleeding diathesis, coagulopathy, platelet disorder, or thrombocytopenia
* Any single reliable recording of systolic blood pressure \>180 mm Hg and/or diastolic blood pressure \>110 mm Hg prior to randomization
* Any history of stroke or transient ischemic attack; any history of hemorrhagic cerebrovascular disease
* Any known structural damage or other pathologic process involving the central nervous system
* Any head trauma within 6 months prior to randomization
* Major surgery (including CABG), any ophthalmologic surgery, or non-cutaneous biopsy, or substantial trauma within 3 months prior to randomization
* Traumatic or prolonged cardiopulmonary resuscitation (\> 2 minutes) within 2 weeks prior to randomization
* Puncture of a non-compressible vessel (artery or vein) within the 24 hours prior to randomization
* Acute peptic ulcer disease within 3 months prior to randomization

Prior or Concomitant Pharmacologic Therapy

* Administration of abciximab (ReoPro), within the previous 7 days or eptifibatide (Integrilin), or tirofiban (Aggrastat) within the previous 24 hours prior to randomization
* Current therapy with oral anticoagulants, or an International Normalized Ratio of \>1.5
* Administration of a low molecular weight heparin within 8 hours prior to randomization.
* Known hypersensitivity to low molecular weight heparins, unfractionated heparin or heparin-like products; allergy to pork or pork products
* Known hypersensitivity and/or contra-indication(s) to fibrinolytic drugs (streptokinase, tenecteplase, alteplase and reteplase)

General

* Known platelet count \<100,000 cells/microL or history of heparin-induced thrombocytopenia
* Known clinically significant anemia (Hemoglobin \<10 g/dL which is \< 6.2 mmol/L)
* Known renal insufficiency with serum creatinine \>220 mmol/L (2.5 mg/dL) for men and \>175 mmol/L (2.0 mg/dL) for women when assessed prior to baseline examination.
* Advanced neoplastic or other life-threatening disease with a life expectancy of \<12 months
* Pregnancy or parturition within the last 90 days or currently breast feeding
* Women of childbearing potential except if post-menopausal, surgically sterile or using accepted method(s) of birth control or having a negative pregnancy test.
* Treatment with other investigational agents in the last 30 days before study entry or previous enrollment in ExTRACT-TIMI 25
* History of drug or alcohol abuse
* Mental condition rendering the patient unable to understand the nature, scope, and possible consequences of the study
* Any patient unlikely to comply with protocol, e.g., uncooperative attitude, inability to return for follow-up visits, and who are unlikely to complete the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sanofi

INDUSTRY

Sponsor Role lead

Responsible Party

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sanofi-aventis

Principal Investigators

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ICD CSD

Role: STUDY_DIRECTOR

Sanofi

Locations

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Sanofi-Aventis Administrative Office

Bridgewater, New Jersey, United States

Site Status

sanofi-aventis administrative Office

Buenos Aires, , Argentina

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sanofi-aventis Australia & New Zealand administrative office

Macquarie Park, , Australia

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Sanofi-Aventis Administrative Office

Vienna, , Austria

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Sanofi-Aventis Administrative Office

Minsk, , Belarus

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Sanofi-Aventis Administrative Office

Diegem, , Belgium

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Sanofi-Aventis Administrative Office

São Paulo, , Brazil

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Sanofi-Aventis Administrative Office

Sofia, , Bulgaria

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Sanofi-Aventis Administrative Office

Laval, , Canada

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Sanofi-Aventis Administrative Office

Santiago, , Chile

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Sanofi-Aventis Administrative Office

Shangaï, , China

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Sanofi-Aventis Administrative Office

Zagreb, , Croatia

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Sanofi-Aventis Administrative Office

Hørsholm, , Denmark

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Sanofi-Aventis Administrative Office

Tallinn, , Estonia

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Helsinki, , Finland

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Sanofi- Aventis Administrative Office

Paris, , France

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Sanofi-Aventis Administrative Office

Berlin, , Germany

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Athens, , Greece

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Causeway Bay, , Hong Kong

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Budapest, , Hungary

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Sanofi-Aventis Administrative Office

Mumbai, , India

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Dublin, , Ireland

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Sanofi-Aventis Administrative Office

Netanya, , Israel

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Milan, , Italy

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Sanofi-Aventis Administrative Office

Amman, , Jordan

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Riga, , Latvia

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Beirut, , Lebanon

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Sanofi-Aventis Administrative Office

Vilnius, , Lithuania

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Sanofi-Aventis Administrative Office

Kuala Lumpur, , Malaysia

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Sanofi-Aventis Administrative Office

México, , Mexico

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Sanofi-Aventis Administrative Office

Gouda, , Netherlands

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Sanofi-Aventis Administrative Office

Lysaker, , Norway

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Warsaw, , Poland

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Porto Salvo, , Portugal

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Bucharest, , Romania

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Moscow, , Russia

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Singapore, , Singapore

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Sanofi-Aventis Administrative Office

Bratislava, , Slovakia

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Sanofi-Aventis Administrative Office

Midrand, , South Africa

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Sanofi-Aventis Administrative Office

Seoul, , South Korea

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Sanofi-Aventis Administrative Office

Barcelona, , Spain

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Sanofi-Aventis Administrative Office

Bromma, , Sweden

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Sanofi-Aventis Administrative Office

Geneva, , Switzerland

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Sanofi-Aventis Administrative Office

Bangkok, , Thailand

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Sanofi-Aventis Administrative Office

Istanbul, , Turkey (Türkiye)

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Sanofi-Aventis Administrative Office

Kiev, , Ukraine

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Sanofi-aventis adminsitrative office

Guildford Surrey, , United Kingdom

Site Status

Sanofi-Aventis Administrative Office

Montevideo, , Uruguay

Site Status

Countries

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United States Argentina Australia Austria Belarus Belgium Brazil Bulgaria Canada Chile China Croatia Denmark Estonia Finland France Germany Greece Hong Kong Hungary India Ireland Israel Italy Jordan Latvia Lebanon Lithuania Malaysia Mexico Netherlands Norway Poland Portugal Romania Russia Singapore Slovakia South Africa South Korea Spain Sweden Switzerland Thailand Turkey (Türkiye) Ukraine United Kingdom Uruguay

References

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Antman EM, Morrow DA, McCabe CH, Murphy SA, Ruda M, Sadowski Z, Budaj A, Lopez-Sendon JL, Guneri S, Jiang F, White HD, Fox KA, Braunwald E; ExTRACT-TIMI 25 Investigators. Enoxaparin versus unfractionated heparin with fibrinolysis for ST-elevation myocardial infarction. N Engl J Med. 2006 Apr 6;354(14):1477-88. doi: 10.1056/NEJMoa060898. Epub 2006 Mar 14.

Reference Type RESULT
PMID: 16537665 (View on PubMed)

Morrow DA, Antman EM, Fox KA, White HD, Giugliano R, Murphy SA, McCabe CH, Braunwald E; ExTRACT-TIMI 25 Investigators. One-year outcomes after a strategy using enoxaparin vs. unfractionated heparin in patients undergoing fibrinolysis for ST-segment elevation myocardial infarction: 1-year results of the ExTRACT-TIMI 25 trial. Eur Heart J. 2010 Sep;31(17):2097-102. doi: 10.1093/eurheartj/ehq098. Epub 2010 Apr 17.

Reference Type DERIVED
PMID: 20400762 (View on PubMed)

Other Identifiers

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XRP4563B/3001

Identifier Type: -

Identifier Source: secondary_id

EFC6147

Identifier Type: -

Identifier Source: org_study_id

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