Revascularization in Heart Failure Trial - REHEAT 2

NCT ID: NCT00388245

Last Updated: 2006-10-16

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-01-31

Study Completion Date

2008-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

REHEAT 2 study is designed as a prospective, randomised trial comparing two strategies of myocardial revascularisation (PCI vs CABG) in patients with ischemic cardiomyopathy and low left ventricular ejection fraction.Patients will undergo in random way PCI or CABG procedure. The aim the study is to assess the improvement of left ventricle systolic function and comparing recent (30 days) and late (12 months) results of surgical (CABG) and percutaneous (PCI) revascularization.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Heart failure constitutes one of basic problems of contemporary cardiology. It is most commonly caused by ischaemic heart disease, which as an etiologic factor, has a negative impact on prognosis. On the other hand, decreased left ventricular ejection fraction is the most important prognostic factor in patients with ischaemic heart disease. Annual mortality among patients with ejection fraction below 35% accounts for 17%, and in a group with ejection fraction below 25% reaches 24%. Most of multicenter studies (e.g. ARTS, BARI, ERACI) comparing results of percutaneous and surgical revascularisation in ischemic heart disease pertain to patients with normal or minimally decreased left ventricular ejection fraction, excluding patients with left ventricular ejection fraction lower than 35%. Current medical standards indicate the surgical way as a method of choice in treatment of patients with ischemic cardiomyopathy.

In early nineties the procedures of percutaneous angioplasty in patients with depressed left ventricular function were connected with comparable to CABG risk of death (5-10%).

The intensive progress of percutaneous procedures contributed PCI is competitive method of revasularization to CABG. Our knowledge about the efficacy of above mentioned methods in patients with ischemic heart failure is scarce until now. It was proved, that patients with viable myocardium assessed in dobutamine stress echocardiography or MRI benefit mostly from myocardial revascularization. Repeat revascularization during follow up occurred more frequently in patients after PCI, so that introduction of coronary stents, especially drug eluting stents (DES) could significantly improve the clinical outcome after PCI procedures. The administration of antiplatelet drugs (IIb/IIIa platelet receptor inhibitors) have considerably improved the short and long-term results of PCI so that it is interesting if they could have beneficial effect on clinical outcome of patients with ischemic heart failure. In the field of cardiac surgery the method of left ventricle reconstruction in patients with ischemic cardiomyopathy (STICH Trial) seems to be promising.

Therefore, the comparison of innovative methods of percutaneous and surgical revascularization may influence current medical standards concerning patients with ischemic heart disease.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Left Ventricular Ejection Fraction Myocardial Revascularization Ischemic Heart Disease

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

PCI CABG Ejection Fraction Myocardial Revascularization

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Percutaneous Coronary Intervention

Intervention Type PROCEDURE

Coronary Artery Bypass Grafting

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* symptomatic coronary artery disease (angina CCS class 1)
* left ventricle ejection fraction \<40%
* coronary artery lesions suitable for percutaneous or surgical myocardial revascularisation
* evidence for viability of the myocardium
* written inform consent for the study

Exclusion Criteria

* age \<18 years
* acute myocardial infarct with ST elevation within 30 days
* concomitant congenital heart disease
* mitral regurgitation required surgical intervention
* history of bleeding diathesis, coagulopathy or abnormal bleeding within the previous 30 days.
* major surgery within the previous 6 weeks
* stroke or transient ischemic attack (TIA) within the previous 6 weeks
* history of hemorrhagic stroke
* uncontrolled hypertension
* chronic renal insufficiency with creatinine \>2.0 mg/dl
* platelet count \<100.000/mm3
* hematocrit \<30%
* PT \>1,2 times control
* positive pregnancy test
* any disease that may shorten the life expectancy of the patient
* the patient is currently participating in another research study
Minimum Eligible Age

19 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Ministry of Science and Higher Education, Poland

OTHER_GOV

Sponsor Role lead

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Pawel E Buszman, Prof

Role: STUDY_DIRECTOR

3-rd Division of Cardiology, University School of Silesia, Poland

Michal Tendera, Prof

Role: STUDY_CHAIR

3-rd Division of Cardiology, University School of Silesia, Poland

Andrzej Bochenek, Prof

Role: PRINCIPAL_INVESTIGATOR

1-st Division of Cardiosurgery, University School of Silesia, Poland

Robert J Gil, Prof

Role: PRINCIPAL_INVESTIGATOR

Invasive Cardiology Department, Central Clinic Hospital, Warsaw, Poland

Piotr Ponikowski, Prof

Role: PRINCIPAL_INVESTIGATOR

Heart Disease Department, Military Clinic Hospital, Wroclaw, Poland

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University School of Silesia, 1-st Department of Cardiosurgery

Katowice, Silesian Voivodeship, Poland

Site Status

University School of Silesia, 3-rd Department of Cardiology, Coronary Care Unit

Katowice, Silesian Voivodeship, Poland

Site Status

Central Clinic Hospital

Warsaw, , Poland

Site Status

Military Clinic Hospital

Wroclaw, , Poland

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Poland

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Pawel E Buszman, Prof

Role: CONTACT

Phone: +48 32 252 72 12

Email: [email protected]

Iwona Szkrobka, MD

Role: CONTACT

Phone: +48 602 457 602

Email: [email protected]

References

Explore related publications, articles, or registry entries linked to this study.

Serruys PW, Ong AT, van Herwerden LA, Sousa JE, Jatene A, Bonnier JJ, Schonberger JP, Buller N, Bonser R, Disco C, Backx B, Hugenholtz PG, Firth BG, Unger F. Five-year outcomes after coronary stenting versus bypass surgery for the treatment of multivessel disease: the final analysis of the Arterial Revascularization Therapies Study (ARTS) randomized trial. J Am Coll Cardiol. 2005 Aug 16;46(4):575-81. doi: 10.1016/j.jacc.2004.12.082.

Reference Type RESULT
PMID: 16098418 (View on PubMed)

Scholz KH, Dubois-Rande JL, Urban P, Morice MC, Loisance D, Smalling RW, Figulla HR. Clinical experience with the percutaneous hemopump during high-risk coronary angioplasty. Am J Cardiol. 1998 Nov 1;82(9):1107-10, A6. doi: 10.1016/s0002-9149(98)00566-9.

Reference Type RESULT
PMID: 9817489 (View on PubMed)

Shawl FA, Quyyumi AA, Bajaj S, Hoff SB, Dougherty KG. Percutaneous cardiopulmonary bypass-supported coronary angioplasty in patients with unstable angina pectoris or myocardial infarction and a left ventricular ejection fraction < or = 25%. Am J Cardiol. 1996 Jan 1;77(1):14-9. doi: 10.1016/s0002-9149(97)89127-8.

Reference Type RESULT
PMID: 8540450 (View on PubMed)

Van Belle E, Blouard P, McFadden EP, Lablanche JM, Bauters C, Bertrand ME. Effects of stenting of recent or chronic coronary occlusions on late vessel patency and left ventricular function. Am J Cardiol. 1997 Nov 1;80(9):1150-4. doi: 10.1016/s0002-9149(97)00631-0.

Reference Type RESULT
PMID: 9359541 (View on PubMed)

Bax JJ, Poldermans D, Elhendy A, Cornel JH, Boersma E, Rambaldi R, Roelandt JR, Fioretti PM. Improvement of left ventricular ejection fraction, heart failure symptoms and prognosis after revascularization in patients with chronic coronary artery disease and viable myocardium detected by dobutamine stress echocardiography. J Am Coll Cardiol. 1999 Jul;34(1):163-9. doi: 10.1016/s0735-1097(99)00157-6.

Reference Type RESULT
PMID: 10400006 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

0213/P01/2006/31

Identifier Type: -

Identifier Source: org_study_id