CARESS in Acute Myocardial Infarction

NCT ID: NCT00220571

Last Updated: 2007-07-03

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

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-05-31

Study Completion Date

2007-03-31

Brief Summary

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The aim of this study conducted in patients with high risk ST-segment elevation AMI admitted to hospitals with no PTCA facilities is to compare the effects on clinical outcome and cost-effectiveness of two reperfusion strategies:

* Fibrinolytic therapy with Abciximab and half-dose Reteplase, with rescue PTCA in case of lack of reperfusion
* Elective referral for "facilitated" PTCA after early administration of Abciximab and half dose of Reteplase

Detailed Description

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All patients with ST-segment elevation AMI admitted within 12 hours from symptoms onset will be screened to enter in this study. Data of patients with ST-segment elevation AMI within 12 hours from symptoms onset who do not meet the inclusion criteria or do not sign the informed consent form are entered into a dedicated registry.

Conditions

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Myocardial Infarction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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Coronary Angioplasty (PTCA)

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

\- ECG with ST-elevation (≥ 1mm in at least 2 ECG limb leads or ≥ 2 mm in 2 contiguous precordial leads) AMI within \<12 hours from symptoms onset fulfilling 1 or more of the following criteria of "high risk":

1. Summation of ST-segment elevation or depression ≥ 15 mm in all 12 electrocardiographic leads or new onset complete left bundle branch block;
2. Previous myocardial infarction (Q- and non Q-wave);
3. Killip Class 2 or 3;
4. LV ejection fraction at transthoracic ultrasound \< 40%.

Exclusion Criteria

1. Inability to provide informed consent;
2. Age \> 75 years
3. CABG or PCI procedure in past history involving the infarct-related artery;
4. Participation in another study with any investigational drug or device within the previous 30 days;
5. Concomitant non-cardiac disease likely to limit long-term prognosis (e.g. cancer);
6. Cardiogenic shock (hypotension with Systolic Blood Pressure (SBP) \< 90 mmHg and tachycardia \> 100 beats / min, not due to hypovolemia and requiring inotropic support or balloon counterpulsation);
7. Need for concomitant major surgery (e.g. valve surgery or resection of aortic or left ventricular aneurysm, carotid endarterectomy, abdominal aortic aneurysm surgery, congenital heart disease etc);
8. Severe hepatic disease;
9. Patients with acute or chronic renal impairment (serum creatinine \> 2.0 mg % or 200 mg/l or creatinine clearance \< 30 ml/min);
10. Transmural MI in different location within the previous week;
11. Previous administration of thrombolytics within 7 days;
12. Intolerance or contraindications to ASA or Clopidogrel;
13. Known leucopenia, defined as a leukocyte count of \< 3.500 White Blood Cells (WBC)/ml
14. Known neutropenia, defined as \< 1000 neutrophils / ml;
15. Known thrombocytopenia (\< 100.000 platelets / ml );
16. Documented active peptic ulcer or upper gastrointestinal bleeding within the previous 6 months;
17. Previous hemorrhagic stroke;
18. Previous ischemic cerebrovascular event within 3 months;
19. Intracranial neoplasm;
20. Recent major surgery at risk of bleeding;
21. Episodes of uncontrolled hypertension (\> 180/110 mmHg despite treatment) in past 2 years;
22. Administration of oral anticoagulants within the previous 7 days unless INR ≤ 1.2;
23. Severe recent trauma;
24. Known or possible pregnancy;
25. Absence of suitable vascular access (diffuse peripheral arterial disease);
26. Basal ECG changes which make identification of ST-segment elevation impossible (i.e.: ventricular activation from artificial pacemaker, etc.).
Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Royal Brompton & Harefield NHS Foundation Trust

OTHER

Sponsor Role collaborator

Eli Lilly and Company

INDUSTRY

Sponsor Role collaborator

Biotronik SE & Co. KG

INDUSTRY

Sponsor Role collaborator

Società Italiana di Cardiologia Invasiva

OTHER

Sponsor Role lead

Principal Investigators

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Leonardo Bolognese, MD, Ph D

Role: PRINCIPAL_INVESTIGATOR

Ospedale San Donato - Arezzo Italy

Gabriel P. Steg, MD. Ph D

Role: PRINCIPAL_INVESTIGATOR

Hopital Bichat - Paris France

Darius Dudek, MD, Ph D

Role: PRINCIPAL_INVESTIGATOR

Jagellonian University Krakow Poland

Carlo Di Mario, MD

Role: STUDY_CHAIR

Royal Brompton and Harefield Hospital - London UK

Locations

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Cardiologie Hop. Duffaut

Avignon, , France

Site Status

SAMU - Hop. Duffaut

Avignon, , France

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Cardiologie - Hop. Louis Pradel

Bron, , France

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Cardiologie - CH

Caen, , France

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Urgences - CH

Carpentras, , France

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Cardiologie - CH

Cherbourg, , France

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SAMU - Hop. Beaujon

Clichy, , France

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Service de Cardiologie - Hopital St. Joseph

Colmar, , France

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Cardiologie - CHU

Grenoble, , France

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Samu - Chu

Grenoble, , France

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SAMU 69 - Hop. E. Herriot

Lyon, , France

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Cardiologie - Hop. Bichat

Paris, , France

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Centre Cardiologique du Nord

Saint-Denis, , France

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SMUR Delafontaine

Saint-Denis, , France

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SAMU - Reanimation - CH

Sélestat, , France

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Ospedale San Donato

Arezzo, , Italy

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Presidio Ospedaliero del Casentino

Bibbiena, , Italy

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Spedali Civili

Brescia, , Italy

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Az. Ospedaliera di Circolo

Busto Arsizio, , Italy

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P.O. di Camposampiero

Camposampiero, , Italy

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Ospedale Ramazzini

Carpi, , Italy

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Ospedale Bufalini

Cesena, , Italy

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P.O. Cittadella

Cittadella, , Italy

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P.O. di Codogno

Codogno, , Italy

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Ospedale di Conegliano

Conegliano, , Italy

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Ospedale S. Giuseppe da Copertino

Copertino, , Italy

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Ospedale S. Sebastiano

Correggio, , Italy

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P.O. di Cortona

Cortona, , Italy

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Ospedale Santa Croce e Carle

Cuneo, , Italy

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Ospedale di Desio

Desio, , Italy

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Ospedale Santa Maria del Prato

Feltre, , Italy

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Ospedale S. Sebastiano Martire

Frascati, , Italy

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Ospedale Santa Caterina Novella

Galatina, , Italy

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Ospedale La Memoria

Gavardo, , Italy

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Ospedale San Giuliano

Giugliano in Campania, , Italy

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Ospedale di Guastalla

Guastalla, , Italy

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Az. Osp.Vito Fazzi

Lecce, , Italy

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Ospedale Civile di Legnano

Legnano, , Italy

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Az. Ospedaliera Desenzano sul Garda

Manerbio, , Italy

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Fondazione Centro San Raffaele del Monte Tabor IRCCS

Milan, , Italy

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Hesperia Hospital

Modena, , Italy

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Nuovo Ospedale S. Agostino Estense - Baggiovara

Modena, , Italy

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Ospedale Civile

Mondovì, , Italy

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P.O. di Montebelluna

Montebelluna, , Italy

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Ospedale Franchini

Montecchio, , Italy

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Azienda Universitaria Federico II

Napoli, , Italy

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Ospedale Santa Maria delle Grazie

Pozzuoli, , Italy

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Arcispedale Santa Maria Nuova

Reggio Emilia, , Italy

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Ospedale Civile

Riccione, , Italy

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Ospedale degli Infermi

Rimini, , Italy

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Ospedale S. Eugenio

Roma, , Italy

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A.O. San Camillo

Roma, , Italy

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Istituto Clinico Humanitas

Rozzano, , Italy

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P.O. U.O. Struttura Complessa

San Giovanni Valdarno, , Italy

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Ospedale della Valtiberina

Sansepolcro, , Italy

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Ospedale Provinciale di Saronno

Saronno, , Italy

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Nuovo Ospedale Civile di Sassuolo

Sassuolo, , Italy

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Ospedale SS.Annunziata

Savigliano, , Italy

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Ospedale M. Scarlato

Scafati, , Italy

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Ospedale Magati

Scandiano, , Italy

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Az. Ospedaliera Galmarini

Tradate, , Italy

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Ospedale Cà Foncello

Treviso, , Italy

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Specjalista Chorob Wewnetryznich

Będzin, , Poland

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Oddzial Chorob Wewnetrznych

Brzesku, , Poland

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Szpital Powiatowy w Chrzanowie

Chrzanów, , Poland

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Oddzialu Kardiologicznego

Dąbrowa Górnicza, , Poland

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Oddzialu Chorob Wewnetrznych

Dąbrowa Tarnowska, , Poland

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II Oddzial Kardiologiczno - Wewnetrezny Szpital Miejski w Jawozznie

Jaworzno, , Poland

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Oddzial Wewneztrnj Okregowy Szpital Kolciowy

Katowice, , Poland

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First Dept. Cardiology - Gornoslaskiego Centrum Medycznego

Katowice, , Poland

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Zaklad Hemodynamiki i Angiokardiografii Pracownia 1

Krakow, , Poland

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Zaklad Hemodynamiki i Angiokardiografii - Pracownia 2

Krakow, , Poland

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Oddzial Wewnetrzny - Szpital Mijski w Krynicy

Krynica, , Poland

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Oddzial Wewnetrzny - Szpital Powiatowy w Limanowej

Limanowa, , Poland

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Oddzial Internistyczno- kardiologiczny

Nowy Sącz, , Poland

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Oddzial Kardiologiczny

Nowy Targ, , Poland

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Szpital Powiatowy im. Sw. Maksimiliana w Oswiecimiu

Oświęcim, , Poland

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Oddzial Intensywnej Opieki Kardiologicznej i Kardiologii Olgonej

Sosnowiec, , Poland

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Zaklad Opieki Zdrowotnej

Sucha Beskidzka, , Poland

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Oddzial Wewnetrzny Szpital w Szczyrzu

Szczyrzyc, , Poland

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Oddzial Kardiologii Inwazijnej - Szpital im. E. Szczeklika

Tarnów, , Poland

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Oddzialu Kardiologii z OIOK

Tarnów, , Poland

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Oddzial Kardiologii - Szpital Miejski w Tychach

Tychy, , Poland

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Szpital Powiatowy im. Jana Pawla II w Wadowicach

Wadowice, , Poland

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Oddzial Kardiologii - Szpital Powiatowy w Zakopane

Zakopane, , Poland

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Countries

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France Italy Poland

References

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Di Mario C, Bolognese L, Maillard L, Dudek D, Gambarati G, Manari A, Guiducci V, Patrizi G, Rusconi LC, Piovaccari G, Hibon AR, Belpomme V, Indolfi C, Olivari Z, Steffenino G, Zmudka K, Airoldi F, Panzarasa R, Flather M, Steg PG. Combined Abciximab REteplase Stent Study in acute myocardial infarction (CARESS in AMI). Am Heart J. 2004 Sep;148(3):378-85. doi: 10.1016/j.ahj.2004.03.038.

Reference Type BACKGROUND
PMID: 15389222 (View on PubMed)

Di Mario C, Dudek D, Piscione F, Mielecki W, Savonitto S, Murena E, Dimopoulos K, Manari A, Gaspardone A, Ochala A, Zmudka K, Bolognese L, Steg PG, Flather M; CARESS-in-AMI (Combined Abciximab RE-teplase Stent Study in Acute Myocardial Infarction) Investigators. Immediate angioplasty versus standard therapy with rescue angioplasty after thrombolysis in the Combined Abciximab REteplase Stent Study in Acute Myocardial Infarction (CARESS-in-AMI): an open, prospective, randomised, multicentre trial. Lancet. 2008 Feb 16;371(9612):559-68. doi: 10.1016/S0140-6736(08)60268-8.

Reference Type DERIVED
PMID: 18280326 (View on PubMed)

Other Identifiers

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2003OE001B

Identifier Type: -

Identifier Source: secondary_id

IIT(IT) H4S-IT-O038

Identifier Type: -

Identifier Source: org_study_id