Trial Outcomes & Findings for Protection of the Heart With Doxycycline During Coronary Artery Bypass Grafting (NCT NCT00246740)

NCT ID: NCT00246740

Last Updated: 2017-12-15

Results Overview

Measure of global left ventricular function. The formula used for calculation is: LVSWI= SI x MAP x 0.0144 LVSWI = Left Ventricular Stroke Work Index (g\*m/m2) SI = Stroke Index (mL/beat/m2) MAP = Mean Arterial Pressure (mmHg) 0.0144 is a conversion term to equalize units.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

56 participants

Primary outcome timeframe

Before surgery up to 24h of reperfusion

Results posted on

2017-12-15

Participant Flow

Participant milestones

Participant milestones
Measure
Placebo Oral Tablet
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Initial Enrollment
STARTED
28
28
Initial Enrollment
COMPLETED
22
20
Initial Enrollment
NOT COMPLETED
6
8
Experimental Phase
STARTED
22
20
Experimental Phase
COMPLETED
22
20
Experimental Phase
NOT COMPLETED
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Placebo Oral Tablet
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Initial Enrollment
Death
1
0
Initial Enrollment
Additional surgery scheduled
0
2
Initial Enrollment
Surgery schedule change
4
4
Initial Enrollment
Other
1
2

Baseline Characteristics

Protection of the Heart With Doxycycline During Coronary Artery Bypass Grafting

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Placebo Oral Tablet
n=22 Participants
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
n=20 Participants
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Total
n=42 Participants
Total of all reporting groups
Age, Continuous
64.6 years
STANDARD_DEVIATION 1.5 • n=5 Participants
63.1 years
STANDARD_DEVIATION 2 • n=7 Participants
63.9 years
STANDARD_DEVIATION 1.2 • n=5 Participants
Sex: Female, Male
Female
6 Participants
n=5 Participants
3 Participants
n=7 Participants
9 Participants
n=5 Participants
Sex: Female, Male
Male
16 Participants
n=5 Participants
17 Participants
n=7 Participants
33 Participants
n=5 Participants
Region of Enrollment
Canada
22 Participants
n=5 Participants
20 Participants
n=7 Participants
42 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Before surgery up to 24h of reperfusion

Measure of global left ventricular function. The formula used for calculation is: LVSWI= SI x MAP x 0.0144 LVSWI = Left Ventricular Stroke Work Index (g\*m/m2) SI = Stroke Index (mL/beat/m2) MAP = Mean Arterial Pressure (mmHg) 0.0144 is a conversion term to equalize units.

Outcome measures

Outcome measures
Measure
Placebo Oral Tablet
n=22 Participants
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
n=20 Participants
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Left Ventricular Stroke Work Index (LVSWI)
Before surgery
42 g*m/m2
Standard Error 2.6
43 g*m/m2
Standard Error 2.5
Left Ventricular Stroke Work Index (LVSWI)
Post surgery
29 g*m/m2
Standard Error 1.7
28 g*m/m2
Standard Error 1.7
Left Ventricular Stroke Work Index (LVSWI)
1h reperfusion
30 g*m/m2
Standard Error 1.8
29 g*m/m2
Standard Error 1.9
Left Ventricular Stroke Work Index (LVSWI)
3h reperfusion
31 g*m/m2
Standard Error 1.9
29 g*m/m2
Standard Error 2
Left Ventricular Stroke Work Index (LVSWI)
6h reperfusion
28 g*m/m2
Standard Error 1.4
25 g*m/m2
Standard Error 1.4
Left Ventricular Stroke Work Index (LVSWI)
12h reperfusion
30 g*m/m2
Standard Error 1.6
30 g*m/m2
Standard Error 1.7
Left Ventricular Stroke Work Index (LVSWI)
24h reperfusion
32 g*m/m2
Standard Error 1.8
33 g*m/m2
Standard Error 1.9

SECONDARY outcome

Timeframe: Before surgery and 10 minutes reperfusion after surgery

Biochemical activity of MMP-9 activity in right atrial biopsies, measured at 10 minutes of reperfusion after surgery. To determine MMP-9 activity, 20 μg of total protein from both myocardial extracts and plasma were analyzed by gelatin zymography. For detailed methodology consult Cheung PY, Sawicki G, Wozniak M, et al: Matrix metalloproteinase-2 contributes to ischemia-reperfusion injury in the heart. Circulation 2000; 101:1833-1839

Outcome measures

Outcome measures
Measure
Placebo Oral Tablet
n=22 Participants
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
n=20 Participants
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Cardiac Matrix Metalloproteinase-9 Activity in Right Atrial Biopsies at 10 Minutes Reperfusion
Before surgery
.75 Arbitrary units
Standard Error .25
1.56 Arbitrary units
Standard Error .26
Cardiac Matrix Metalloproteinase-9 Activity in Right Atrial Biopsies at 10 Minutes Reperfusion
10 min reperfusion
.44 Arbitrary units
Standard Error .28
1.63 Arbitrary units
Standard Error .29

SECONDARY outcome

Timeframe: Before surgery and 10 minutes reperfusion after surgery

Biochemical activity of MMP-2 activity in right atrial biopsies, measured at 10 minutes of reperfusion after surgery.

Outcome measures

Outcome measures
Measure
Placebo Oral Tablet
n=22 Participants
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
n=20 Participants
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Cardiac Matrix Metalloproteinase-2 Activity in Right Atrial Biopsies at 10 Minutes Reperfusion
Before surgery
.36 Arbitrary units
Standard Error .04
.24 Arbitrary units
Standard Error .04
Cardiac Matrix Metalloproteinase-2 Activity in Right Atrial Biopsies at 10 Minutes Reperfusion
10 min reperfusion
.42 Arbitrary units
Standard Error .04
.25 Arbitrary units
Standard Error .04

SECONDARY outcome

Timeframe: Before surgery and up to 72 h reperfusion after surgery

Biochemical activity of MMP-9 activity in venous plasma, measured before surgery and up to 72h of reperfusion after surgery.

Outcome measures

Outcome measures
Measure
Placebo Oral Tablet
n=22 Participants
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
n=20 Participants
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Venous Plasma Cardiac Matrix Metalloproteinase-9 Activity Before and After Reperfusion
Before anesthesia
.07 Arbitrary units
Standard Error .04
.11 Arbitrary units
Standard Error .04
Venous Plasma Cardiac Matrix Metalloproteinase-9 Activity Before and After Reperfusion
After anesthesia
.06 Arbitrary units
Standard Error .04
.12 Arbitrary units
Standard Error .04
Venous Plasma Cardiac Matrix Metalloproteinase-9 Activity Before and After Reperfusion
10 min reperfusion
1.22 Arbitrary units
Standard Error .08
1.37 Arbitrary units
Standard Error .08
Venous Plasma Cardiac Matrix Metalloproteinase-9 Activity Before and After Reperfusion
20 min reperfusion
1.14 Arbitrary units
Standard Error .09
1.3 Arbitrary units
Standard Error .09
Venous Plasma Cardiac Matrix Metalloproteinase-9 Activity Before and After Reperfusion
3 h reperfusion
.52 Arbitrary units
Standard Error .08
.53 Arbitrary units
Standard Error .08
Venous Plasma Cardiac Matrix Metalloproteinase-9 Activity Before and After Reperfusion
6 h reperfusion
.21 Arbitrary units
Standard Error .04
.22 Arbitrary units
Standard Error .04
Venous Plasma Cardiac Matrix Metalloproteinase-9 Activity Before and After Reperfusion
24 h reperfusion
.05 Arbitrary units
Standard Error .03
.09 Arbitrary units
Standard Error .01
Venous Plasma Cardiac Matrix Metalloproteinase-9 Activity Before and After Reperfusion
72 h reperfusion
.03 Arbitrary units
Standard Error .01
.03 Arbitrary units
Standard Error .01

SECONDARY outcome

Timeframe: Before surgery and up to 72 h reperfusion after surgery

Biochemical activity of MMP-2 activity in venous plasma, measured before surgery and up to 72h of reperfusion after surgery.

Outcome measures

Outcome measures
Measure
Placebo Oral Tablet
n=22 Participants
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
n=20 Participants
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Venous Plasma Cardiac Matrix Metalloproteinase-2 Activity Before and After Reperfusion
3 h reperfusion
.99 Arbitrary units
Standard Error .05
1.06 Arbitrary units
Standard Error .05
Venous Plasma Cardiac Matrix Metalloproteinase-2 Activity Before and After Reperfusion
Before anesthesia
.99 Arbitrary units
Standard Error .05
1.06 Arbitrary units
Standard Error .05
Venous Plasma Cardiac Matrix Metalloproteinase-2 Activity Before and After Reperfusion
After anesthesia
.93 Arbitrary units
Standard Error .04
.96 Arbitrary units
Standard Error .04
Venous Plasma Cardiac Matrix Metalloproteinase-2 Activity Before and After Reperfusion
10 min reperfusion
1.01 Arbitrary units
Standard Error .06
1.05 Arbitrary units
Standard Error .06
Venous Plasma Cardiac Matrix Metalloproteinase-2 Activity Before and After Reperfusion
20 min reperfusion
.87 Arbitrary units
Standard Error .04
1 Arbitrary units
Standard Error .04
Venous Plasma Cardiac Matrix Metalloproteinase-2 Activity Before and After Reperfusion
6 h reperfusion
.92 Arbitrary units
Standard Error .07
1.07 Arbitrary units
Standard Error .07
Venous Plasma Cardiac Matrix Metalloproteinase-2 Activity Before and After Reperfusion
24 h reperfusion
.78 Arbitrary units
Standard Error .05
.9 Arbitrary units
Standard Error .05
Venous Plasma Cardiac Matrix Metalloproteinase-2 Activity Before and After Reperfusion
72 h reperfusion
.78 Arbitrary units
Standard Error .04
.9 Arbitrary units
Standard Error .04

SECONDARY outcome

Timeframe: Before surgery and 10 minutes reperfusion after surgery

Measurement of levels of TnI (troponin-I), a marker of cardiac cell damage

Outcome measures

Outcome measures
Measure
Placebo Oral Tablet
n=22 Participants
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
n=20 Participants
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Venous Plasma Concentration of Troponin-I
Before surgery
1.23 pg/ml
Standard Error .33
1.07 pg/ml
Standard Error .34
Venous Plasma Concentration of Troponin-I
Post surgery
1.39 pg/ml
Standard Error .46
1.78 pg/ml
Standard Error .47

SECONDARY outcome

Timeframe: Before surgery and 10 minutes reperfusion after surgery

Measurement of the ratios of cleaved TnI (troponin-I) versus GAPDH in biopsies collected from right atria. Measure is the ratio TnI/GAPDH

Outcome measures

Outcome measures
Measure
Placebo Oral Tablet
n=22 Participants
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
n=20 Participants
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Cleaved TroponinI/GAPDH Ratios in Right Atrial Biopsy
Before surgery
1.1318 Arbitrary units-Cleaved TnI/GAPDH
Standard Error .3852
2.3454 Arbitrary units-Cleaved TnI/GAPDH
Standard Error .3978
Cleaved TroponinI/GAPDH Ratios in Right Atrial Biopsy
Post surgery
1.5195 Arbitrary units-Cleaved TnI/GAPDH
Standard Error .3745
2.1893 Arbitrary units-Cleaved TnI/GAPDH
Standard Error .3868

SECONDARY outcome

Timeframe: Before surgery and up to 72 h reperfusion after surgery

Measurement of inflammation marker C-reactive protein in plasma

Outcome measures

Outcome measures
Measure
Placebo Oral Tablet
n=22 Participants
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
n=20 Participants
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Venous Plasma Concentration of C-reactive Protein
Before anesthesia
5.7 ng/ml
Standard Error 2
10 ng/ml
Standard Error 2
Venous Plasma Concentration of C-reactive Protein
After anesthesia
5.7 ng/ml
Standard Error 1.8
9.9 ng/ml
Standard Error 2
Venous Plasma Concentration of C-reactive Protein
10 min reperfusion
4 ng/ml
Standard Error 1.3
7.5 ng/ml
Standard Error 1.5
Venous Plasma Concentration of C-reactive Protein
20 min reperfusion
4 ng/ml
Standard Error 1.5
7.2 ng/ml
Standard Error 1.3
Venous Plasma Concentration of C-reactive Protein
3 h reperfusion
5.2 ng/ml
Standard Error 1.7
9.4 ng/ml
Standard Error 1.8
Venous Plasma Concentration of C-reactive Protein
6 h reperfusion
12.9 ng/ml
Standard Error 2
16.3 ng/ml
Standard Error 2.1
Venous Plasma Concentration of C-reactive Protein
24 h reperfusion
51 ng/ml
Standard Error 1.9
48.8 ng/ml
Standard Error 1.9
Venous Plasma Concentration of C-reactive Protein
72 h reperfusion
51.1 ng/ml
Standard Error 1.2
51.2 ng/ml
Standard Error 1.2

SECONDARY outcome

Timeframe: Before surgery and up to 72 h reperfusion after surgery

Measurement of inflammation marker interleukin-6 in plasma

Outcome measures

Outcome measures
Measure
Placebo Oral Tablet
n=22 Participants
Patients received oral administration of matching placebo pills, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Placebo Oral Tablet: In addition to standard care, patients received oral administration of placebo twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Periostat
n=20 Participants
Patients received oral administration of 20 mg of doxycycline, twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days (via a nasogastric tube or orally when patients tolerated it). Periostat: In addition to standard care, patients received oral administration of 20 mg of doxycycline twice a day at least 2 days prior to surgery, on the day of surgery, and on postoperative days 1, 2, and 3.
Venous Plasma Concentration of IL-6
Before anesthesia
5.7 pg/ml
Standard Error 2
1.9 pg/ml
Standard Error 2
Venous Plasma Concentration of IL-6
After anesthesia
5.6 pg/ml
Standard Error 1.9
2.8 pg/ml
Standard Error 1.9
Venous Plasma Concentration of IL-6
10 min reperfusion
15.4 pg/ml
Standard Error 2.7
7.3 pg/ml
Standard Error 2.7
Venous Plasma Concentration of IL-6
20 min reperfusion
24.4 pg/ml
Standard Error 3.3
15.1 pg/ml
Standard Error 3.4
Venous Plasma Concentration of IL-6
3 h reperfusion
72.9 pg/ml
Standard Error 6.6
76.1 pg/ml
Standard Error 6.7
Venous Plasma Concentration of IL-6
6 h reperfusion
75.6 pg/ml
Standard Error 5.9
83.4 pg/ml
Standard Error 6
Venous Plasma Concentration of IL-6
24 h reperfusion
66.4 pg/ml
Standard Error 6.4
71.8 pg/ml
Standard Error 6.5
Venous Plasma Concentration of IL-6
72 h reperfusion
39 pg/ml
Standard Error 5.7
28.1 pg/ml
Standard Error 5.8

Adverse Events

Placebo Oral Tablet

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Periostat

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr Richard Schulz

Departments of Pediatrics and Pharmacology, University of Alberta

Phone: 780-492-6581

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place