Trial Outcomes & Findings for Renin-Angiotensin Aldosterone System and Fibrinolysis Interaction in Humans-Specific Aim 3 (NCT NCT00685945)

NCT ID: NCT00685945

Last Updated: 2013-02-25

Results Overview

Individual net t-PA release at each time point were calculated by the following formula: net release = (Cv-CA) x {FBF x \[101-hematocrit/100\]}, where Cv and CA represent the concentration of t-PA in the brachial vein and artery, respectively.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

24 participants

Primary outcome timeframe

During and after each study drug administration

Results posted on

2013-02-25

Participant Flow

Subjects were recruited from a volunteer registry at Vanderbilt University. Subjects who participated in prior studies and requested to be contacted for future studies were included in the recruitment process. Recruitment began on 12/07 and stopped on 1/09.

Subjects with renal, endocrine, hematological or cardiovascular disease (including hypertension defined as an untreated systolic/diastolic blood pressure greater than 140/90 mmHg were excluded. Subjects with a fasting cholesterol greater than 5.7 mmol/L (220 mg/dl) and smokers were excluded. No washout period was required for the study.

Participant milestones

Participant milestones
Measure
All Participants
24 subjects received a bradykinin infusion and then a bradykinin + L-NMMA infusion. Subjects were then randomized to receive either isosorbide (N=12) or sildenafil (N=12). The infusion of bradykinin + L-NMMA was then repeated.
Control (Bradykinin Infusion)
STARTED
24
Control (Bradykinin Infusion)
COMPLETED
24
Control (Bradykinin Infusion)
NOT COMPLETED
0
L-NMMA + Bradykinin
STARTED
24
L-NMMA + Bradykinin
COMPLETED
23
L-NMMA + Bradykinin
NOT COMPLETED
1
Isosorbide + L-NMMA + Bradykinin
STARTED
11
Isosorbide + L-NMMA + Bradykinin
COMPLETED
11
Isosorbide + L-NMMA + Bradykinin
NOT COMPLETED
0
Sildenafil + L-NMMA + Bradykinin
STARTED
12
Sildenafil + L-NMMA + Bradykinin
COMPLETED
12
Sildenafil + L-NMMA + Bradykinin
NOT COMPLETED
0

Reasons for withdrawal

Reasons for withdrawal
Measure
All Participants
24 subjects received a bradykinin infusion and then a bradykinin + L-NMMA infusion. Subjects were then randomized to receive either isosorbide (N=12) or sildenafil (N=12). The infusion of bradykinin + L-NMMA was then repeated.
L-NMMA + Bradykinin
Physician Decision
1

Baseline Characteristics

Renin-Angiotensin Aldosterone System and Fibrinolysis Interaction in Humans-Specific Aim 3

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
All Participants
n=24 Participants
Subjects characteristics for all 24 participants
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
24 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
Age Continuous
31.71 years
STANDARD_DEVIATION 6.51 • n=5 Participants
Sex: Female, Male
Female
12 Participants
n=5 Participants
Sex: Female, Male
Male
12 Participants
n=5 Participants
Region of Enrollment
United States
24 participants
n=5 Participants

PRIMARY outcome

Timeframe: During and after each study drug administration

Population: Twenty four subjects were studied. One subject was excluded because of erroneous drug administration. Analysis was per protocol. Twenty-three subjects receive bradykinin then L-NMMA plus bradykinin infusions. Subjects were then randomized to either isosorbide or sildenafil. Twelve subjects received sildenafil and 11 subjects received isosorbide.

Individual net t-PA release at each time point were calculated by the following formula: net release = (Cv-CA) x {FBF x \[101-hematocrit/100\]}, where Cv and CA represent the concentration of t-PA in the brachial vein and artery, respectively.

Outcome measures

Outcome measures
Measure
Control
n=24 Participants
Subjects received bradykinin at 50, 100 and 200ng/min
L-NMMA + Control
n=23 Participants
After the intial bradykinin infusion subjects then received a continuous infusion of L-NMMA plus bradykinin at 50, 100 and 200ng/min
Isosorbide + L-NMMA + Control
n=11 Participants
Eleven of the twenty-four subjects were randomized to isosorbide after completing the bradykinin and bradykinin plus L-NMMA infusions. The bradykinin plus L-NMMA infusions were then repeated.
Sildenafil + L-NMMA + Control
n=12 Participants
Twelve of the twenty-four subjects were randomized to sildenafil after completing the bradykinin and bradykinin plus L-NMMA infusions. After 1 hour, bradykinin plus L-NMMA infusions were repeated.
Net Tissue-type Plasminogen Activator (t-PA) Release
Net t-PA release (bradykinin 0ng/min)
0.24 ng/min/100ml
Standard Error 0.39
0.59 ng/min/100ml
Standard Error 0.23
-0.38 ng/min/100ml
Standard Error 0.51
0.29 ng/min/100ml
Standard Error 0.67
Net Tissue-type Plasminogen Activator (t-PA) Release
Net t-PA release (bradykinin 50ng/min)
1.02 ng/min/100ml
Standard Error 1.06
3.65 ng/min/100ml
Standard Error 0.79
3.14 ng/min/100ml
Standard Error 1.13
2.46 ng/min/100ml
Standard Error 2.07
Net Tissue-type Plasminogen Activator (t-PA) Release
Net t-PA release (bradykinin 100ng/min)
11.81 ng/min/100ml
Standard Error 2.12
22.10 ng/min/100ml
Standard Error 5.51
15.90 ng/min/100ml
Standard Error 3.13
18.48 ng/min/100ml
Standard Error 9.11
Net Tissue-type Plasminogen Activator (t-PA) Release
Net t-PA release (bradykinin 200ng/min)
30.03 ng/min/100ml
Standard Error 4.24
39.90 ng/min/100ml
Standard Error 6.98
45.32 ng/min/100ml
Standard Error 9.45
37.39 ng/min/100ml
Standard Error 11.79

SECONDARY outcome

Timeframe: During and after each study drug administration

Forearm blood flow was measured by strain gauge plethysmography

Outcome measures

Outcome measures
Measure
Control
n=24 Participants
Subjects received bradykinin at 50, 100 and 200ng/min
L-NMMA + Control
n=23 Participants
After the intial bradykinin infusion subjects then received a continuous infusion of L-NMMA plus bradykinin at 50, 100 and 200ng/min
Isosorbide + L-NMMA + Control
n=11 Participants
Eleven of the twenty-four subjects were randomized to isosorbide after completing the bradykinin and bradykinin plus L-NMMA infusions. The bradykinin plus L-NMMA infusions were then repeated.
Sildenafil + L-NMMA + Control
n=12 Participants
Twelve of the twenty-four subjects were randomized to sildenafil after completing the bradykinin and bradykinin plus L-NMMA infusions. After 1 hour, bradykinin plus L-NMMA infusions were repeated.
Forearm Blood Flow (FBF)
FBF (bradykinin 200 ng/min)
17.74 ml/min/100ml
Standard Error 1.43
11.21 ml/min/100ml
Standard Error 1.12
9.91 ml/min/100ml
Standard Error 1.72
12.92 ml/min/100ml
Standard Error 1.30
Forearm Blood Flow (FBF)
FBF (bradykinin 0 ng/min)
4.03 ml/min/100ml
Standard Error 0.25
2.36 ml/min/100ml
Standard Error 0.18
2.18 ml/min/100ml
Standard Error 0.33
2.80 ml/min/100ml
Standard Error 0.37
Forearm Blood Flow (FBF)
FBF (bradykinin 50ng/min)
7.02 ml/min/100ml
Standard Error 0.57
5.16 ml/min/100ml
Standard Error 0.37
4.73 ml/min/100ml
Standard Error 0.70
5.87 ml/min/100ml
Standard Error 0.79
Forearm Blood Flow (FBF)
FBF (bradykinin 100ng/min)
13.17 ml/min/100ml
Standard Error 1.04
8.67 ml/min/100ml
Standard Error 0.81
6.83 ml/min/100ml
Standard Error 1.13
9.13 ml/min/100ml
Standard Error 0.76

OTHER_PRE_SPECIFIED outcome

Timeframe: At baseline and after maximum dose of bradykinin

Individual net reuptake rates at each time point were calculated by the following formula: net uptake = (Cv-CA) x {FBF x \[101-hematocrit/100\]}, where Cv and CA represent the concentration of glucose in the brachial vein and artery, respectively.

Outcome measures

Outcome measures
Measure
Control
n=24 Participants
Subjects received bradykinin at 50, 100 and 200ng/min
L-NMMA + Control
n=23 Participants
After the intial bradykinin infusion subjects then received a continuous infusion of L-NMMA plus bradykinin at 50, 100 and 200ng/min
Isosorbide + L-NMMA + Control
n=11 Participants
Eleven of the twenty-four subjects were randomized to isosorbide after completing the bradykinin and bradykinin plus L-NMMA infusions. The bradykinin plus L-NMMA infusions were then repeated.
Sildenafil + L-NMMA + Control
n=12 Participants
Twelve of the twenty-four subjects were randomized to sildenafil after completing the bradykinin and bradykinin plus L-NMMA infusions. After 1 hour, bradykinin plus L-NMMA infusions were repeated.
Net Glucose Uptake
Net glucose uptake (bradykinin 0 ng/min)
-79.95 microgram/min/100ml
Standard Error 22.894
-74.36 microgram/min/100ml
Standard Error 7.125
-71.4 microgram/min/100ml
Standard Error 27.74
-67.3 microgram/min/100ml
Standard Error 13.17
Net Glucose Uptake
Net glucose uptake (bradykinin 200 ng/min)
-319.85 microgram/min/100ml
Standard Error 97.109
-142.86 microgram/min/100ml
Standard Error 49.935
-163.233 microgram/min/100ml
Standard Error 36.504
-125.32 microgram/min/100ml
Standard Error 45.705

Adverse Events

All Participants

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
All Participants
n=24 participants at risk
Subjects characteristics for all 24 participants
Nervous system disorders
Headache
8.3%
2/24 • Number of events 2
Nervous system disorders
fainted
4.2%
1/24 • Number of events 1
Vascular disorders
unexpected drug response
4.2%
1/24 • Number of events 1

Additional Information

Dr. Mias Pretorius

Vanderbilt University

Phone: 615-343-0665

Results disclosure agreements

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