Effect of N-acetylcystein in Myocardial Infarction

NCT ID: NCT01741207

Last Updated: 2012-12-04

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

PHASE3

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-01-31

Study Completion Date

2012-12-31

Brief Summary

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We designed this study to evaluate the effect of N-acetylcystein on biomarkers of platelet activation , cardiac necrosis and coronary reperfusion in patients undergoing percutaneous coronary intervention.

Detailed Description

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Percutaneous coronary intervention(PCI) is one of the standard therapies for acute coronary syndrome. Despite major advances in PCI procedure, impaired myocardial perfusion frequently occurred after primary PCI and resulted in a larger infarct size and increased morbidity and mortality.Reperfusion injury process can be resulted in additional death of cardiomyocytes and it is suggested that oxidative stress is a contributing factor to induce reperfusion injury.During PCI,trauma occurs to the arterial endothelium, causes the activation and aggregation of platelets.

It is estimated that approximately 25% of patients undergoing PCI have significant postprocedural creatinine kinase (CK)/creatinine kinase myocardial band (CK-MB) elevations and approximately 50% of patients have significant post-procedural troponin elevations. The most common complication of PCI is a cell damage to cardiomyocyte that can be diagnosed by postprocedure elevation of cardiac markers. N-acetylcystein have several positive effect on platelet and vascular function and infarct size.

This study is a randomized clinical trial (RCT) evaluating the effect of N-acetylcystein on biomarkers of platelet activation and coronary reperfusion in patients undergoing percutaneous coronary intervention. Double blind randomized clinical trial on 100 patients in 2 groups (intervention \& control) is conducted. Patients with confirmed ST-elevation myocardial infarction included in this study. Patients were excluded if they had: emergency for cardiac bypass; cardiogenic shock and rescue percutaneous coronary intervention. Patients in Intervention group were administered 100 mg/kg Iv bolus N-acetylcystein and then 480mg intracoronary and 10mg/kg/h over 12 hours after percutaneous coronary intervention and patients in control group received standard regimens. Primary outcome was platelet activation biomarkers assessment before and 24 hours after percutaneous coronary intervention and secondary outcome was effect of N-acetylcystein on CK-MB and high sensitive Troponin T, 6 and 12 hours after percutaneous coronary intervention.Patients were assessed for coronary blood flow after percutaneous coronary intervention with the use of TIMI flow and myocardial blush grade.

Major adverse cardiac events (MACE) will be evaluated as a secondary endpoint after 30 days.

Conditions

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Acute Myocardial Infarction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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control

control This group is without N-acetylcystein : just receives standard treatment

Group Type NO_INTERVENTION

No interventions assigned to this group

N-acetylcystein

receive N-acetylcystein in addition to standard treatment Ampoule 200 mg/ml

Group Type ACTIVE_COMPARATOR

N-acetylcystein

Intervention Type DRUG

Active Comparator: N-acetylcystein receive N-acetylcystein in addition to standard treatment

Interventions

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N-acetylcystein

Active Comparator: N-acetylcystein receive N-acetylcystein in addition to standard treatment

Intervention Type DRUG

Other Intervention Names

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EXI-NACE,NAC

Eligibility Criteria

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Inclusion Criteria

* Myocardial infarction patients who were candidate of primary PCI

Exclusion Criteria

* Rescue PCI
* Emergency for cardiac bypass
* Cardiogenic shock
* Life expectancy less than 6 months
* Age less than 18 years old
* Uncontrolled hypertension
* Thrombocytopenia
* Malformation or aneurysm
* Sever chronic kidney disease
* Sever liver failure
* Major surgery within 3 months
* Unsatisfactory to enter the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tehran University of Medical Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Azita Hajhossein Talasaz, PharmD,BCPS

Role: PRINCIPAL_INVESTIGATOR

Tehran University of Medical Sciences

Locations

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Teran Heart Center

Tehran, Tehran Province, Iran

Site Status RECRUITING

Countries

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Iran

Facility Contacts

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Azita Hajhossein Talasaz

Role: primary

References

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Nozari Y, Eshraghi A, Talasaz AH, Bahremand M, Salamzadeh J, Salarifar M, Pourhosseini H, Jalali A, Mortazavi SH. Protection from Reperfusion Injury with Intracoronary N-Acetylcysteine in Patients with STEMI Undergoing Primary Percutaneous Coronary Intervention in a Cardiac Tertiary Center. Am J Cardiovasc Drugs. 2018 Jun;18(3):213-221. doi: 10.1007/s40256-017-0258-8.

Reference Type DERIVED
PMID: 29322434 (View on PubMed)

Other Identifiers

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IRCT201210118698N2

Identifier Type: REGISTRY

Identifier Source: secondary_id

524

Identifier Type: -

Identifier Source: org_study_id