Treatment of Reperfusion Event by Vitamin C Infusion

NCT ID: NCT01090895

Last Updated: 2016-03-09

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-03-31

Study Completion Date

2018-12-31

Brief Summary

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Primary Hypothesis: Prophylactic Vitamin C Intravenous Infusion at the time of percutaneous coronary intervention (PCI) would limit the size of the infarct, assessed by measurements of cardiac biomarkers, during acute myocardial infarction.

Secondary Hypotheses: Prophylactic Vitamin C Intravenous Infusion at the time of percutaneous coronary intervention (PCI) would limit the size of the infarct, as measured by the area of delayed hyperenhancement that was seen on cardiac magnetic resonance imaging (MRI), assessed on day 5 after infarction, during acute myocardial infarction.

Detailed Description

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This is a multicenter, prospective, controlled, randomized study that will be conducted at up to 5 centers in Italy. All patients who meet the eligibility criteria will be randomized to receive during surgical procedure an intravenous infusion of Vitamin C or Placebo.

Patients will have repeat clinical follow-up to 5 days, 3 and 6 months and 1 year.

The new angiography evaluation will be done if necessary. The study population will consist of at least 100 patients who presented within 12 hours after the onset of chest pain, who had ST-segment elevation of more than 0.1 mV in two contiguous leads, and for whom the clinical decision was made to treat with percutaneous coronary intervention (PCI). Following confirmation of eligibility criteria, patients will be randomized in a 1:1 ratio to receive prophylactic infusion of Vitamin C or Placebo. The coronary angiograms will be assessed at a core laboratory with Quantitative Coronary Angiography.

The incidence of clinical events, including death, myocardial infarction, target vessel revascularization, stent thrombosis, will be evaluated at 1, 3, 6 and, 12 months.

Conditions

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Angina Pectoris

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Vitamin C

Vitamin C infusion

Group Type ACTIVE_COMPARATOR

Vitamin C

Intervention Type DRUG

Intravenous infusion of vitamin C (1 g) 10 minutes before percutaneous coronary intervention.

Placebo

Saline solution

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Intravenous infusion of placebo(saline solution) 10 minutes before percutaneous coronary intervention.

Interventions

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Vitamin C

Intravenous infusion of vitamin C (1 g) 10 minutes before percutaneous coronary intervention.

Intervention Type DRUG

Placebo

Intravenous infusion of placebo(saline solution) 10 minutes before percutaneous coronary intervention.

Intervention Type DRUG

Other Intervention Names

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Ascorbic Acid Saline solution

Eligibility Criteria

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Inclusion Criteria

* Subjects who presented within 12 hours after the onset of chest pain, who had ST-segment elevation of more than 0.1 mV in two contiguous leads, and for whom the clinical decision was made to treat with percutaneous coronary intervention (PCI)
* Patients will be eligible for the study whether they were undergoing primary PCI.
* Signed written informed consent

Exclusion Criteria

* Patients with cardiac arrest, ventricular fibrillation, cardiogenic shock, stent thrombosis, previous acute myocardial infarction, or angina within 48 hours before infarction were not included in the study
* Patients with evidence of coronary collaterals (2-3 Rentrop) to the region at risk on initial coronary angiography (at the time of admission) will be excluded
* The patient has impaired renal function (creatinine \> 3.0 mg/dl)
* The patient has known allergies to aspirin, clopidogrel bisulfate and ticlopidine, heparin, contrast media or stainless steel that cannot be managed medically
* The patient needs therapy with warfarin
* The patient has a life expectancy less than 12 months
* Recipient of heart transplant
* The patient is currently participating in an investigational drug or another device study
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Roma La Sapienza

OTHER

Sponsor Role lead

Responsible Party

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Francesco Violi

Full professor of internal medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Francesco Violi, Full Prof

Role: STUDY_CHAIR

Divisione di Prima Clinica Medica - Sapienza University of Rome

Locations

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Sapienza Università di Roma

Rome, Italy, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Francesco Violi, Full Prof

Role: CONTACT

+39-06-4461933

Stefania Basili, Ass Prof

Role: CONTACT

+39-06-49974678

Facility Contacts

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Francesco Violi, Full Prof

Role: primary

+39-06-4461933

Stefania Basili, Ass Prof

Role: backup

+39-06-49974678

References

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Pignatelli P, Sanguigni V, Paola SG, Lo Coco E, Lenti L, Violi F. Vitamin C inhibits platelet expression of CD40 ligand. Free Radic Biol Med. 2005 Jun 15;38(12):1662-6. doi: 10.1016/j.freeradbiomed.2005.02.032. Epub 2005 Mar 23.

Reference Type BACKGROUND
PMID: 15917194 (View on PubMed)

Cordova C, Musca A, Violi F, Perrone A, Alessandri C. Influence of ascorbic acid on platelet aggregation in vitro and in vivo. Atherosclerosis. 1982 Jan;41(1):15-9. doi: 10.1016/0021-9150(82)90064-8.

Reference Type BACKGROUND
PMID: 7073791 (View on PubMed)

Basili S, Tanzilli G, Mangieri E, Raparelli V, Di Santo S, Pignatelli P, Violi F. Intravenous ascorbic acid infusion improves myocardial perfusion grade during elective percutaneous coronary intervention: relationship with oxidative stress markers. JACC Cardiovasc Interv. 2010 Feb;3(2):221-9. doi: 10.1016/j.jcin.2009.10.025.

Reference Type BACKGROUND
PMID: 20170881 (View on PubMed)

Violi F, Cangemi R. Antioxidant supplements and cardiovascular disease in men. JAMA. 2009 Apr 1;301(13):1335; author reply 1336-7. doi: 10.1001/jama.2009.314. No abstract available.

Reference Type BACKGROUND
PMID: 19336704 (View on PubMed)

Cangemi R, Angelico F, Loffredo L, Del Ben M, Pignatelli P, Martini A, Violi F. Oxidative stress-mediated arterial dysfunction in patients with metabolic syndrome: Effect of ascorbic acid. Free Radic Biol Med. 2007 Sep 1;43(5):853-9. doi: 10.1016/j.freeradbiomed.2007.06.002. Epub 2007 Jun 13.

Reference Type BACKGROUND
PMID: 17664149 (View on PubMed)

Basili S, Pignatelli P, Tanzilli G, Mangieri E, Carnevale R, Nocella C, Di Santo S, Pastori D, Ferroni P, Violi F. Anoxia-reoxygenation enhances platelet thromboxane A2 production via reactive oxygen species-generated NOX2: effect in patients undergoing elective percutaneous coronary intervention. Arterioscler Thromb Vasc Biol. 2011 Aug;31(8):1766-71. doi: 10.1161/ATVBAHA.111.227959. Epub 2011 Jun 2.

Reference Type BACKGROUND
PMID: 21636808 (View on PubMed)

Basili S, Tanzilli G, Raparelli V, Calvieri C, Pignatelli P, Carnevale R, Dominici M, Placanica A, Arrivi A, Farcomeni A, Barilla F, Mangieri E, Violi F. Aspirin reload before elective percutaneous coronary intervention: impact on serum thromboxane b2 and myocardial reperfusion indexes. Circ Cardiovasc Interv. 2014 Aug;7(4):577-84. doi: 10.1161/CIRCINTERVENTIONS.113.001197. Epub 2014 Jul 29.

Reference Type BACKGROUND
PMID: 25074252 (View on PubMed)

Pignatelli P, Tanzilli G, Carnevale R, Di Santo S, Loffredo L, Celestini A, Proietti M, Tovaglia P, Mangieri E, Basili S, Violi F. Ascorbic acid infusion blunts CD40L upregulation in patients undergoing coronary stent. Cardiovasc Ther. 2011 Dec;29(6):385-94. doi: 10.1111/j.1755-5922.2010.00168.x. Epub 2010 Jul 12.

Reference Type RESULT
PMID: 20629665 (View on PubMed)

Other Identifiers

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Violi012009

Identifier Type: -

Identifier Source: org_study_id

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