Intracoronary Tirofiban on No-Reflow Phenomena

NCT ID: NCT02054000

Last Updated: 2014-02-04

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

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

162 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-01-31

Study Completion Date

2013-12-31

Brief Summary

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The goal of this study was to evaluate the acute effect of intracoronary administration of tirofiban on no-reflow phenomenon in patients with STEMI and occurrence of no-reflow phenomenon undergoing primary percutaneous coronary intervention (PCI).

Detailed Description

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The no-reflow phenomenon is one of the most common causes of adverse cardiovascular events in patients with ST-elevated myocardial infarction (STEMI). Re-canalization of infarct related arterial (IRA) flow related to better ventricular performance and lower mortality rate in patients with STEMI. In addition, no-reflow phenomena may limit the benefits of re-canalization of the IRA.

In recent years, many mechanical or pharmacological treatment strategies including adjunctive administration of glycoprotein IIb/IIIa inhibitors (GPI) have been proposed in patients with STEMI. Although current guidelines recommend that small molecule GPI should be administered as an upstream bolus followed by a continuous infusion in patients with STEMI, changes in clinical practice may obviate the need for GPI dosage or routes in current practice. Previous studies have shown that intravenous and intracoronary administration of GPI improve the prognosis and significantly reduce mortality in patients with STEMI. Recently, the Ongoing Tirofiban in Myocardial infarction Evaluation-2 (ON-TIME 2) trial found that the use of tirofiban started during the pre-hospital phase as upstream therapy for primary percutaneous coronary intervention (PCI) and continued for up to 18 hours infusion after the procedure showed an improvement in the markers of reperfusion. Additionally, a reduction was demonstrated in the death in recurrent myocardial infarction in urgent target vessel revascularization and thrombotic bailout. However, in the current literature there are insufficient data regarding the role of intracoronary administration of GPI inhibitors in patients with STEMI who developed the no-reflow phenomenon. The goal of this study was to evaluate the acute effect of intracoronary administration of tirofiban on no-reflow phenomenon in patients with STEMI and occurrence of no-reflow phenomenon undergoing primary PCI.

Conditions

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No-Reflow Phenomenon

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Tirofiban group

If thrombolysis in myocardial infarction flow \<3 in spite of performed treatments, patients were considered as no-reflow and randomized to tirofiban or placebo group. Intracoronary tirofiban (25 µgr/kg) was administered via the guiding catheter to the infarct related artery

Group Type ACTIVE_COMPARATOR

Tirofiban

Intervention Type DRUG

Intracoronary administering of Tirofiban

Placebo group

If thrombolysis in myocardial infarction flow \<3 in spite of performed treatments, patients were considered as no-reflow and randomized to tirofiban or placebo group. Intracoronary serum physiologic as placebo was administered via the guiding catheter to the infarct related artery

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Intracoronary serum physiologic

Interventions

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Tirofiban

Intracoronary administering of Tirofiban

Intervention Type DRUG

Placebo

Intracoronary serum physiologic

Intervention Type OTHER

Other Intervention Names

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Glycoprotein IIb/IIIa inhibitor

Eligibility Criteria

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Inclusion Criteria

\- Patients with ST-elevated myocardial infarction who developed no-reflow phenomena

Exclusion Criteria

* Treatment with thrombolytic drugs in the previous 24 hours
* Known malignancy
* Pain to balloon time \>6 hours
* Uncontrolled hypertension (\>180/110 mmHg)
* Bleeding diathesis
* Thrombocytopenia
* End-stage liver disease
* Cardiogenic shock
* Renal failure
* Life expectancy of less than 1 year
* Contraindication for the use of tirofiban.
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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TC Erciyes University

OTHER

Sponsor Role lead

Responsible Party

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Mahmut Akpek

Medical doctor of Cardiology department

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Erciyes University School of Medicine

Kayseri, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Other Identifiers

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Makpek-2

Identifier Type: -

Identifier Source: org_study_id

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