Randomized Comparison Angioplasty Outcomes at Hospitals With and Without On-site Cardiac Surgery

NCT ID: NCT00549796

Last Updated: 2014-09-11

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

NA

Total Enrollment

18876 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-04-30

Study Completion Date

2012-02-29

Brief Summary

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Angioplasty is a procedure which opens blocked heart arteries using balloons and/or stents. Most U.S. states and all national heart organizations require that angioplasty be done only at hospitals that can also perform open heart surgery. The reason for this is that there is a risk that angioplasty can cause injury to the heart artery that might require open heart surgery to fix. Open heart surgery is a backup in case it is needed. The risk that open heart surgery will be needed is very small. Nevertheless, without more research, many state Departments of Health and all national heart organizations do not want to change the requirement for having on-site open heart surgery wherever angioplasty is performed. Some States already allow this; and European heart organizations already allow it, as well.

This study is designed to determine whether the safety and benefits of angioplasty are the same at hospitals that perform angioplasty either with or without open heart surgery backup.

Patient who enter the study have a heart catheterization at a hospital without a heart surgery program. If they need angioplasty, then they are randomized to either stay at the hospital without heart surgery for their angioplasty or to be transferred for the procedure to a hospital with heart surgery. For every four patients, three stay at the hospital without heart surgery and one is transferred.

The study is designed to show that there is no detectable difference between the safety and benefits of the procedure at the two types of hospital (with and without heart surgery). The cost of the procedure at the two hospital types is also compared.

Detailed Description

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Conditions

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Coronary Arteriosclerosis Angina Pectoris

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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1

PCI performed at a hospital with co-located (on-site) cardiac surgery

Group Type ACTIVE_COMPARATOR

Percutaneous coronary intervention (PCI)

Intervention Type OTHER

Patients undergo routine, clinically indicated PCI

2

PCI performed at a hospitals without co-located (on-site) cardiac surgery

Group Type OTHER

Percutaneous coronary intervention (PCI)

Intervention Type OTHER

Patients undergo routine, clinically indicated PCI

Interventions

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Percutaneous coronary intervention (PCI)

Patients undergo routine, clinically indicated PCI

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Pre-catheterization:

* Must be undergoing diagnostic cardiac catheterization for suspected CAD
* Be at least 18 years of age
* Must not be pregnant (negative pregnancy test) or must not be of childbearing potential must be able to give informed consent.

Post-catheterization:

* Coronary artery disease judged to be clinically and angiographically significant
* Ability to perform PCI with equipment available at the local site
* Procedure risk judged to be not high (see below)

Exclusion Criteria

Pre-catheterization:

* Inability to give informed consent
* ST-segment elevation myocardial infarction
* Pregnancy

Post-catheterization:

* High likelihood of requiring a device not available at the hospitals without SOS
* No need for PCI
* Need for coronary artery bypass surgery
* High procedural risk (see below)

High procedural risk criteria are:

* PCI of unprotected left main coronary artery
* PCI of left circulation lesion in the presence of critical (\>70%) unprotected left main coronary artery lesion
* Poor left ventricular function (EF\< 20%) and need to perform PCI in a vessel supplying significant myocardium
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Duke University

OTHER

Sponsor Role collaborator

Maryland Medical Research Institute

OTHER

Sponsor Role collaborator

Johns Hopkins University

OTHER

Sponsor Role lead

Responsible Party

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Thomas Aversano

Associate Professor of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Thomas Aversano, MD

Role: STUDY_DIRECTOR

Johns Hopkins University

Locations

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Crestwood Medical Center

Huntsville, Alabama, United States

Site Status

Wellstar Cobb Hospital

Austell, Georgia, United States

Site Status

Southeast Georgia Health System

Brunswick, Georgia, United States

Site Status

Tanner Medical Center

Carrollton, Georgia, United States

Site Status

Hamilton Medical Center

Dalton, Georgia, United States

Site Status

Fairview Park Hospital

Dublin, Georgia, United States

Site Status

Spalding Regional Medical Center

Griffin, Georgia, United States

Site Status

West Georgia Health

La Grange, Georgia, United States

Site Status

Southern Regional Medical Center

Riverdale, Georgia, United States

Site Status

Archbold Memorial Hospital

Thomasville, Georgia, United States

Site Status

Tift Regional Medical Center

Tifton, Georgia, United States

Site Status

Little Company of Mary Hospital

Evergreen Park, Illinois, United States

Site Status

Advocate South Suburban Hospital

Hazel Crest, Illinois, United States

Site Status

Anne Arundel Medical Center

Annapolis, Maryland, United States

Site Status

Johns Hopkins Bayview Medical Center

Baltimore, Maryland, United States

Site Status

St. Agnes Hospital

Baltimore, Maryland, United States

Site Status

Southern Maryland Hospital Center

Clinton, Maryland, United States

Site Status

Frederick Memorial Hospital

Frederick, Maryland, United States

Site Status

Baltimore Washington Medical Center

Glen Burnie, Maryland, United States

Site Status

Meritus Medical Center

Hagerstown, Maryland, United States

Site Status

Shady Grove Adventist Hospital

Rockville, Maryland, United States

Site Status

Holy Cross Hospital

Silver Spring, Maryland, United States

Site Status

Bayonne Medical Center

Bayonne, New Jersey, United States

Site Status

Clara Maas Medical Center

Belleville, New Jersey, United States

Site Status

JFK Medical Center

Edison, New Jersey, United States

Site Status

Trinitas Hospital

Elizabeth, New Jersey, United States

Site Status

Robert Wood Johnson Medical Center

Hamilton, New Jersey, United States

Site Status

Monmouth Medical Center

Long Branch, New Jersey, United States

Site Status

Virtua-West Jersey Hospital Marlton

Marlton, New Jersey, United States

Site Status

Raritan Bay Medical Center

Perth Amboy, New Jersey, United States

Site Status

Riverview Medical Center

Red Bank, New Jersey, United States

Site Status

Somerset Medical Center

Somerville, New Jersey, United States

Site Status

Muhlenberg Regional Medical Center

South Plainfield, New Jersey, United States

Site Status

Overlook Medical Center

Summit, New Jersey, United States

Site Status

Holy Name Hospital

Teaneck, New Jersey, United States

Site Status

Community Medical Center

Toms River, New Jersey, United States

Site Status

Duke Health Raleigh Hospital

Raleigh, North Carolina, United States

Site Status

Rowan Regional Medical Center

Salisbury, North Carolina, United States

Site Status

Community Health and Wellness Center

Bryan, Ohio, United States

Site Status

University Hospitals Case Medical Center / Geauga Medical Center

Chardon, Ohio, United States

Site Status

University Hospital East Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

Southview Medical Center

Dayton, Ohio, United States

Site Status

Fort Hamilton Hospital

Hamilton, Ohio, United States

Site Status

Marietta Memorial Hospital

Marietta, Ohio, United States

Site Status

Knox Community Hospital

Mount Vernon, Ohio, United States

Site Status

Licking Memorial Hospital

Newark, Ohio, United States

Site Status

Southern Ohio Medical Center

Portsmouth, Ohio, United States

Site Status

Mt. Carmel St. Ann's Hospital

Westerville, Ohio, United States

Site Status

Legacy Meridian Park Hospital

Portland, Oregon, United States

Site Status

Sacred Heart Hospital

Allentown, Pennsylvania, United States

Site Status

Chambersburg Hospital

Chambersburg, Pennsylvania, United States

Site Status

Armstrong County Memorial Hospital

Kittanning, Pennsylvania, United States

Site Status

Evangelical Community Hospital

Lewisburg, Pennsylvania, United States

Site Status

UPMC McKeesport

McKeesport, Pennsylvania, United States

Site Status

Meadville Medical Center

Meadville, Pennsylvania, United States

Site Status

Monongahela Valley Hospital

Monongahela, Pennsylvania, United States

Site Status

West Chester Hospital

West Chester, Pennsylvania, United States

Site Status

Memorial Hospital

York, Pennsylvania, United States

Site Status

Kingwood Medical Center

Kingwood, Texas, United States

Site Status

Mainland Medical Center

Texas City, Texas, United States

Site Status

Countries

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United States

References

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Hiremath PG, Aversano T, Spertus JA, Lemmon CC, Naiman DQ, Czarny MJ. Sex Differences in Health Status and Clinical Outcomes After Nonprimary Percutaneous Coronary Intervention. Circ Cardiovasc Interv. 2022 Feb;15(2):e011308. doi: 10.1161/CIRCINTERVENTIONS.121.011308. Epub 2022 Jan 23.

Reference Type DERIVED
PMID: 35067071 (View on PubMed)

Aversano T, Lemmon CC, Liu L; Atlantic CPORT Investigators. Outcomes of PCI at hospitals with or without on-site cardiac surgery. N Engl J Med. 2012 May 10;366(19):1792-802. doi: 10.1056/NEJMoa1114540. Epub 2012 Mar 25.

Reference Type DERIVED
PMID: 22443460 (View on PubMed)

Other Identifiers

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C-PORT E Trial

Identifier Type: -

Identifier Source: secondary_id

NA_000230

Identifier Type: -

Identifier Source: org_study_id

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