POSTconditioning During Coronary Angioplasty in Acute Myocardial Infarction Study

NCT ID: NCT01004289

Last Updated: 2010-10-15

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

PHASE2

Total Enrollment

78 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-04-30

Study Completion Date

2010-04-30

Brief Summary

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The POST-conditioning during coronary angioplasty in Acute Myocardial Infarction (POST-AMI) trial will evaluate the usefulness of postconditioning in limiting infarct size and microvascular damage during the early and late phases after AMI.

Detailed Description

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POST-AMI is a single-center, prospective, randomized trial, with a planned inclusion of 78 patients with ST-elevation Acute Myocardial Infarction (AMI). Patients will be randomly assigned to postconditioning arm (primary angioplasty (PA) and stenting followed by brief episodes of ischemia-reperfusion performed during the first minutes of reperfusion) or non-postconditioning arm (PA and stenting without additional intervention). All patients will be treated medically according to current international guidelines, including glycoprotein IIb/IIIa inhibitors before PCI. The primary end point is to evaluate whether postconditioning, compared to PA without additional intervention, reduces infarct size estimated by magnetic resonance at 30±10 days after the AMI. Secondary end points are microvascular obstruction observed at magnetic resonance, ST-segment elevation resolution, persistent ST-segment elevation, angiographic myocardial blush grade \<2 and non sustained/sustained ventricular tachycardia in the 48 hours following PA. Further secondary end points are enzymatic infarct size, left ventricular remodeling and left ventricular function at magnetic resonance performed at 6±1 months, and the reduction of major adverse cardiac events at 30 days and 6 months.

Conditions

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Myocardial Reperfusion Injury

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

Primary angioplasty and stenting without additional intervention.

Group Type ACTIVE_COMPARATOR

Primary angioplasty and stenting without additional intervention

Intervention Type PROCEDURE

Primary angioplasty and stenting without additional intervention.

Postconditioning

Primary angioplasty and stenting followed by brief episodes of ischemia-reperfusion performed during the first minutes of reperfusion.

Group Type EXPERIMENTAL

Postconditioning

Intervention Type PROCEDURE

Primary angioplasty and stenting followed by brief episodes of ischemia-reperfusion performed during the first minutes of reperfusion

Interventions

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Postconditioning

Primary angioplasty and stenting followed by brief episodes of ischemia-reperfusion performed during the first minutes of reperfusion

Intervention Type PROCEDURE

Primary angioplasty and stenting without additional intervention

Primary angioplasty and stenting without additional intervention.

Intervention Type PROCEDURE

Other Intervention Names

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Staccato Reperfusion

Eligibility Criteria

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Inclusion Criteria

* clinical evidence of myocardial infarction defined by the presence of ischemic chest pain lasting more than 30 minutes, with a time interval from the onset of symptoms less than 6 hours before hospital admission, associated with typical ST-segment elevation on the 12-lead ECG
* angiographic-detected culprit lesion with stenosis diameter \>70% and TIMI flow grade \<=1

Exclusion Criteria

* previous acute myocardial infarction
* previous myocardial revascularization (angioplasty or coronary bypass)
* previous heart valve replacement
* previous heart transplant
* clinical instability precluding the suitability of the study
* cardiogenic shock or persistent hypotension (systolic blood pressure \<100 mmHg)
* rescue angioplasty after thrombolytic therapy
* evidence of coronary collaterals (Rentrop grade\>0) in the risk area
* advanced atrioventricular block
* significant bradycardia
* absence of sinus rhythm
* inability to lay flat (due to severe cardiac heart failure/respiratory insufficiency)
* history or clinical evidence of bronchospastic lung disease
* pregnancy
* known existence of a life-threatening disease with a life expectancy \<6 months
* inability to give informed consent
* any contraindication to undergo cardiac-MRI, such as implanted metallic objects (cardiac pacemakers and/or implantable cardioverter defibrillator, implanted insulin pumps or any other type of electronic devices, cerebral clips, aneurysm clips) or any other contraindication to cardiac-MRI (such as claustrophobia)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Padova

OTHER

Sponsor Role lead

Responsible Party

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Department of Cardiac, Thoracic and Vascular Sciences. University of Padua

Principal Investigators

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Giuseppe Tarantini, MD, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Department of Cardiac, Thoracic and Vascular Sciences, University of Padua

Locations

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Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy

Padua, , Italy

Site Status

Countries

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Italy

References

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Tarantini G, Favaretto E, Marra MP, Frigo AC, Napodano M, Cacciavillani L, Giovagnoni A, Renda P, De Biasio V, Plebani M, Mion M, Zaninotto M, Isabella G, Bilato C, Iliceto S. Postconditioning during coronary angioplasty in acute myocardial infarction: the POST-AMI trial. Int J Cardiol. 2012 Dec 15;162(1):33-8. doi: 10.1016/j.ijcard.2012.03.136. Epub 2012 Apr 9.

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Reference Type DERIVED
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Other Identifiers

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1328P

Identifier Type: -

Identifier Source: org_study_id