Trial Outcomes & Findings for Nesiritide Therapy to Preserve Function of the Left Ventricle After Myocardial Infarction (NCT NCT00573144)

NCT ID: NCT00573144

Last Updated: 2014-09-09

Results Overview

Change in Left Ventricular end-systolic volume index as determined by Multiple Gated Acquisition (MUGA) scan from baseline to 30 days. The MUGA scan is a noninvasive tool for assessing the function of the heart. The MUGA scan produces a moving image of the beating heart, and from this image several important features can be determined about the health of the cardiac ventricles (the heart's major pumping chambers). End-systolic volume (ESV) is the volume of blood in a ventricle at the end of contraction, or systole, and the beginning of filling, or diastole. ESV is the lowest volume of blood in the ventricle at any point in the cardiac cycle and can be used clinically as a measurement of the adequacy of cardiac emptying, related to systolic function.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

59 participants

Primary outcome timeframe

baseline, 30 days

Results posted on

2014-09-09

Participant Flow

Subjects were recruited at the Mayo Clinic Cardiac Care Units in Rochester, Minnesota and Jacksonville, Florida.

One subject withdrew consent before randomization.

Participant milestones

Participant milestones
Measure
Placebo
Infusion of 72 hours of saline solution (packaged to match active comparator).
Nesiritide
Infusion of 72 hours of IV nesiritide at 0.006 mcg/kg/min.
Overall Study
STARTED
30
28
Overall Study
COMPLETED
28
25
Overall Study
NOT COMPLETED
2
3

Reasons for withdrawal

Reasons for withdrawal
Measure
Placebo
Infusion of 72 hours of saline solution (packaged to match active comparator).
Nesiritide
Infusion of 72 hours of IV nesiritide at 0.006 mcg/kg/min.
Overall Study
Withdrawal by Subject
2
3

Baseline Characteristics

Nesiritide Therapy to Preserve Function of the Left Ventricle After Myocardial Infarction

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Placebo
n=28 Participants
Infusion of 72 hours of saline solution (packaged to match active comparator).
Nesiritide
n=25 Participants
Infusion of 72 hours of IV nesiritide at 0.006 mcg/kg/min.
Total
n=53 Participants
Total of all reporting groups
Age, Continuous
55.85 years
STANDARD_DEVIATION 11.12 • n=5 Participants
60.4 years
STANDARD_DEVIATION 11.15 • n=7 Participants
58.0 years
STANDARD_DEVIATION 11.26 • n=5 Participants
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
22 Participants
n=5 Participants
17 Participants
n=7 Participants
39 Participants
n=5 Participants
Age, Categorical
>=65 years
6 Participants
n=5 Participants
8 Participants
n=7 Participants
14 Participants
n=5 Participants
Sex: Female, Male
Female
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
Sex: Female, Male
Male
25 Participants
n=5 Participants
22 Participants
n=7 Participants
47 Participants
n=5 Participants
Region of Enrollment
United States
28 participants
n=5 Participants
25 participants
n=7 Participants
53 participants
n=5 Participants

PRIMARY outcome

Timeframe: baseline, 30 days

Change in Left Ventricular end-systolic volume index as determined by Multiple Gated Acquisition (MUGA) scan from baseline to 30 days. The MUGA scan is a noninvasive tool for assessing the function of the heart. The MUGA scan produces a moving image of the beating heart, and from this image several important features can be determined about the health of the cardiac ventricles (the heart's major pumping chambers). End-systolic volume (ESV) is the volume of blood in a ventricle at the end of contraction, or systole, and the beginning of filling, or diastole. ESV is the lowest volume of blood in the ventricle at any point in the cardiac cycle and can be used clinically as a measurement of the adequacy of cardiac emptying, related to systolic function.

Outcome measures

Outcome measures
Measure
Placebo
n=28 Participants
Infusion of 72 hours of saline solution (packaged to match active comparator). Placebo: Infusion of 72 hours of saline solution (packaged to match active comparator)
Nesiritide
n=25 Participants
Infusion of 72 hours of IV nesiritide at 0.006 mcg/kg/min. Nesiritide: Infusion of 72 hours of IV nesiritide at 0.006 mcg/kg/min.
Change in Left Ventricular End-Systolic Volume Index
-2.1 mL of blood/meter^2 body surface area
Standard Deviation 58
-4.6 mL of blood/meter^2 body surface area
Standard Deviation 31

SECONDARY outcome

Timeframe: baseline, 30 days

Change in Left Ventricular end-systolic diastolic volume index determined by Multiple Gated Acquisition (MUGA) scan from baseline to 30 days. The MUGA scan is a noninvasive tool for assessing the function of the heart. The MUGA scan produces a moving image of the beating heart, and from this image several important features can be determined about the health of the cardiac ventricles (the heart's major pumping chambers). End-systolic volume (ESV) is the volume of blood in a ventricle at the end of contraction, or systole, and the beginning of filling, or diastole. ESV is the lowest volume of blood in the ventricle at any point in the cardiac cycle and can be used clinically as a measurement of the adequacy of cardiac emptying, related to systolic function.

Outcome measures

Outcome measures
Measure
Placebo
n=28 Participants
Infusion of 72 hours of saline solution (packaged to match active comparator). Placebo: Infusion of 72 hours of saline solution (packaged to match active comparator)
Nesiritide
n=25 Participants
Infusion of 72 hours of IV nesiritide at 0.006 mcg/kg/min. Nesiritide: Infusion of 72 hours of IV nesiritide at 0.006 mcg/kg/min.
Change in Left Ventricular End-Systolic Diastolic Volume Index
4.4 mL blood/meter^2 body surface area
Standard Deviation 88
9.7 mL blood/meter^2 body surface area
Standard Deviation 51

SECONDARY outcome

Timeframe: 30 days

Myocardial infarction or acute myocardial infarction (AMI) is the medical term for an event commonly known as a heart attack. Myocardial (heart muscle) infarction is tissue death (also known as necrosis) caused by a local lack of oxygen, due to an obstruction of the tissue's blood supply. The resulting heart tissue lesion is referred to as an infarct. A larger size or area of infarct indicates a greater amount of heart tissue death. Myocardial infarct size was measured using a cardiac Magnetic Resonance Imaging (MRI) scan at 30 days and is the mass of the infarcted tissue divided by the mass of the left ventricle times 100%.

Outcome measures

Outcome measures
Measure
Placebo
n=28 Participants
Infusion of 72 hours of saline solution (packaged to match active comparator). Placebo: Infusion of 72 hours of saline solution (packaged to match active comparator)
Nesiritide
n=25 Participants
Infusion of 72 hours of IV nesiritide at 0.006 mcg/kg/min. Nesiritide: Infusion of 72 hours of IV nesiritide at 0.006 mcg/kg/min.
Myocardial Infarct Size at 30 Days
17 percentage of total cardiac tissue mass
Standard Deviation 14
12 percentage of total cardiac tissue mass
Standard Deviation 9

Adverse Events

Placebo

Serious events: 5 serious events
Other events: 13 other events
Deaths: 0 deaths

Nesiritide

Serious events: 1 serious events
Other events: 13 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Placebo
n=28 participants at risk
Infusion of 72 hours of saline solution (packaged to match active comparator).
Nesiritide
n=25 participants at risk
Infusion of 72 hours of IV nesiritide at 0.006 mcg/kg/min.
Cardiac disorders
Left ventricle aneurysm or thrombus
7.1%
2/28 • Number of events 2
4.0%
1/25 • Number of events 1
Cardiac disorders
Hospital readmission for chest pain
7.1%
2/28 • Number of events 2
0.00%
0/25
General disorders
Hospital readmission for other reasons (not chest pain)
3.6%
1/28 • Number of events 1
0.00%
0/25

Other adverse events

Other adverse events
Measure
Placebo
n=28 participants at risk
Infusion of 72 hours of saline solution (packaged to match active comparator).
Nesiritide
n=25 participants at risk
Infusion of 72 hours of IV nesiritide at 0.006 mcg/kg/min.
Cardiac disorders
Arrhythmia
0.00%
0/28
4.0%
1/25 • Number of events 1
Cardiac disorders
Post coronary angiogram related complications
14.3%
4/28 • Number of events 4
12.0%
3/25 • Number of events 3
Cardiac disorders
Subsequent coronary angiogram with no intervention
7.1%
2/28 • Number of events 2
4.0%
1/25 • Number of events 1
Cardiac disorders
Subsequent coronary angiogram with intervention other than LAD
10.7%
3/28 • Number of events 3
4.0%
1/25 • Number of events 1
Cardiac disorders
Persistent ECG ST changes
0.00%
0/28
4.0%
1/25 • Number of events 1
Cardiac disorders
Recurrent chest pain
3.6%
1/28 • Number of events 1
4.0%
1/25 • Number of events 1
Cardiac disorders
Vasovagal spell
3.6%
1/28 • Number of events 1
0.00%
0/25
General disorders
MRI dye allergy
3.6%
1/28 • Number of events 1
0.00%
0/25
Respiratory, thoracic and mediastinal disorders
Asthma flare
0.00%
0/28
4.0%
1/25 • Number of events 1
Infections and infestations
Fever
7.1%
2/28 • Number of events 2
0.00%
0/25
Cardiac disorders
First episode of hypotension (asymptomatic)
46.4%
13/28 • Number of events 13
52.0%
13/25 • Number of events 13
Cardiac disorders
First episode of hypotension (symptomatic)
0.00%
0/28
8.0%
2/25 • Number of events 2
Cardiac disorders
Second episode of hypotension (asymptomatic)
25.0%
7/28 • Number of events 7
40.0%
10/25 • Number of events 10
Cardiac disorders
Second episode of hypotension (symptomatic)
0.00%
0/28
4.0%
1/25 • Number of events 1

Additional Information

Dr. Horng H. Chen

Mayo Clinic

Phone: 507-284-1644

Results disclosure agreements

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