Comparison of Standard Treatment Versus Standard Treatment Plus Extracorporeal Life Support (ECLS) in Myocardial Infarction Complicated With Cardiogenic Shock

NCT ID: NCT00314847

Last Updated: 2010-08-02

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

TERMINATED

Clinical Phase

PHASE4

Total Enrollment

19 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-06-30

Study Completion Date

2009-10-31

Brief Summary

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Cardiogenic shock is currently the main cause of death after myocardial infarction and 50% of deaths occur within the first 48 hours. To limit the extent of the myocardial necrosis is the primary objective of the treatment in this context. The symptomatic treatment of the ventricular failure alone does not allow a reduction of mortality. The immediate prognosis is not significantly improved by the current standard of care, including early revascularisation and intra-aortic balloon counterpulsation.

In order to improve the immediate prognosis, it seems necessary to limit the irreversible myocardial lesions and the systemic inflammatory response induced by an extended myocardial infarction (complement activation, cytokines production, iNOS expression, etc.). These objectives may be reached by a more extended utilization and availability of circulatory assistance methods.

The investigators propose to compare, in a randomised multicenter study, two treatments of the myocardial infarction with cardiogenic shock among 44 patients:

Standard Treatment versus ECLS-Impella +/- standard treatment.

In June 2007, an amendment replaced the device ECMO by the use of Impella intra-thoracic pump.

This amendment has been approved by the Ethic Committee on July 7, 2007. In March 2009, a new amendment has been approved by the EC. This amendment allowed to revise the number of patients to enroll (reduced to 44) and this lead us to modify also the primary endpoint : variation of BNP levels between H0 and H24 (H0 defined as the nearest value of BNP level obtained before the randomization).Showing a more important BNP levels decrease in the experimental group compared to standard treatment group, the investigators obtain an indirect argument to show a superior efficacy of the tested strategy.

Detailed Description

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Conditions

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Myocardial Infarction Shock, Cardiogenic

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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Control

IABP, inotropic drugs, antiplatelet agents according to site habits.

Group Type NO_INTERVENTION

No interventions assigned to this group

Experimental

ECLS +/- IABP, inotropic drugs, antiplatelet agents according to site habits.

Group Type EXPERIMENTAL

Extra-Corporeal Life Support -Impella 2.5

Intervention Type DEVICE

Percutaneous implantation of Impella pump for a duration of 3 days as a minimum and up to 7 days (recommended)

Interventions

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Extra-Corporeal Life Support -Impella 2.5

Percutaneous implantation of Impella pump for a duration of 3 days as a minimum and up to 7 days (recommended)

Intervention Type DEVICE

Other Intervention Names

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IMPELLA LP 2.5

Eligibility Criteria

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Inclusion Criteria

* Acute myocardial infarction complicated with cardiogenic shock
* Patient without contraindication to IABP or ECLS-Impella

Exclusion Criteria

* Patient with refractory cardiogenic shock
* Reperfusion \> 24 hours after the pain begins
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Caen

OTHER

Sponsor Role lead

Responsible Party

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University Hospital of Caen

Principal Investigators

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Massimo Massetti, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Caen

Rémi Sabatier, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Caen

Locations

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Brest University Hospital

Brest, , France

Site Status

Caen University Hospital

Caen, , France

Site Status

Clermont-Ferrand University Hospital

Clermont-Ferrand, , France

Site Status

Hôpital de la Croix Rousse

Lyon, , France

Site Status

Hôpital de la Timone

Marseille, , France

Site Status

Paris Sud Cardiovascular Institute

Massy, , France

Site Status

Mulhouse Hospital

Mulhouse, , France

Site Status

Pitié-Salpétrière Hospital

Paris, , France

Site Status

Cochin Hospital

Paris, , France

Site Status

Hôpital Haut-Lévèque

Pessac, , France

Site Status

Hôpital Charles Nicolle

Rouen, , France

Site Status

Centre Cardiologique du Nord

Saint-Denis, , France

Site Status

Toulouse University Hospital

Toulouse, , France

Site Status

Countries

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France

Other Identifiers

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ECLS

Identifier Type: -

Identifier Source: org_study_id

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