Multivessel Disease Diagnosed at the Time of PPCI for STEMI: Complete Revascularization Versus Conservative Strategy.

NCT ID: NCT01332591

Last Updated: 2015-01-01

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

213 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-09-30

Study Completion Date

2014-12-31

Brief Summary

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The aim of the study is to find the optimal management of patients with acute myocardial infarction with ST elevations treated by primary PCI who have at least one significant stenosis of non-culprit coronary artery. The primary endpoint of the study will be incidence of combined endpoint of all cause mortality, nonfatal myocardial infarction and stroke during the follow up of 24 months in group of patients treated with staged revascularization (PCI or CABG) in comparison with patients treated conservatively.

Detailed Description

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Introduction:

Primary percutaneous coronary intervention (PPCI) of the occlussion or significant stenosis of infarct artery is a method of choice in treatment of acute myocardial infarction with ST segment elevation (STEMI). It is not clear, what is the optimal management of patients with acute myocardial infarction with ST elevations (STEMI) treated by primary percutaneous coronary intervention (PPCI) who have at least one significant stenosis of non-culprit coronary artery. Numerous cardiology centers perform staged PCI on significant stenoses involving the "non-infarct" coronary artery (arteries) 3-40 days after PPCI, but the benefit of this staged PCI for such patients has not yet been clearly demonstrated.

Aim of study:

The aim is to find the optimal management of patients with acute myocardial infarction with ST elevations (STEMI) treated by PPCI who have at least one significant stenosis of non-culprit coronary artery. The primary endpoint of the study will be incidence of combined endpoint of all cause mortality, nonfatal myocardial infarction and stroke during the follow up of 24 months in group of patients treated with staged revascularization (PCI or CABG) in comparison with patients treated conservatively.

Hypothesis:

Our hypothesis is that complete staged revascularization of significant stenoses of the coronary arteries will improve the long-term prognosis in patients after PPCI as compared to conservative management.

Conditions

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Coronary Artery Stenosis

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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Complete revascularization

Percutaneous coronary intervention of "non-infarct" coronary arteries

Group Type ACTIVE_COMPARATOR

Percutaneous coronary intervention

Intervention Type PROCEDURE

PCI of significant stenoses of "non-infarct" coronary arteries

Conservative management

standard guideline-based medical therapy

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Percutaneous coronary intervention

PCI of significant stenoses of "non-infarct" coronary arteries

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patient with acute myocardial infarction with ST segment elevation (STEMI)
* Angiographically successful primary PCI of infarct-related stenosis (TIMI flow grades II-III)
* One or more other stenoses (≥70%) of "non-infarct" coronary artery (arteries) found by coronary angiography, (diameter of artery ≥ 2,5mm)
* Enrollment ≥48 hours following onset of symptoms

Exclusion Criteria

* Stenosis of the left main of left coronary artery ≥ 50%
* Hemodynamically significant valvular disease
* Patients in cardiogenic shock during STEMI
* Hemodynamic instability
* Angina pectoris \> grade 2 CCS lasting 1 month prior to STEMI
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bulgarian Cardiac Institute

NETWORK

Sponsor Role collaborator

Tomas Bata Hospital, Czech Republic

OTHER

Sponsor Role collaborator

St. Anne's University Hospital Brno, Czech Republic

OTHER

Sponsor Role lead

Responsible Party

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Ota Hlinomaz, MD, PhD

Ota Hlinomaz, MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ota Hlinomaz, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

+420604273627

Locations

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Department of Cardioangiology, St. Anne University Hospital

Brno, , Czechia

Site Status

Countries

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Czechia

Other Identifiers

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NT11412

Identifier Type: -

Identifier Source: org_study_id

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