Remote Ischaemic Postconditioning in the Clinical Setting of NSTEACS and Urgent PCI

NCT ID: NCT03726164

Last Updated: 2020-12-01

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

626 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-06-30

Study Completion Date

2014-12-31

Brief Summary

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This study investigates the cardioprotective effect of remote ischaemic pre-/postconditioning in patients presenting with a NSTEMI/Unstable angina undergoing PCI.

Detailed Description

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Patients presenting with Non ST elevation acute coronary syndromes (NSTEACS) - NSTEMI and Unstable angina patients are enrolled in this study.

Eligible patients are approached, with patient information sheets and are consented for involvement into the study. Patients are randomised to intervention or control. Patients randomised to intervention will receive 3 x 5 minutes of forearm ischaemia (with the cuff inflated to 200 mmHg) separated by 5 minutes of reperfusion between each cuff inflation, prior coronary angiography.

This protocol of episodic forearm ischaemia/reperfusion has been demonstrated to confer remote ischaemic preconditioning-induced protection.

Prior to the intervention, a blood sample will be taken to measure serum troponin T and CK-MB (baseline level). Following PCI patients will be reviewed on the wards and their ongoing recovery will be assessed and reviewed prior to discharge from the study. Troponin T and CK-MB levels will be measured for the 24 hours after PCI, at various time points (6 hour, 12 hour, 24 hour) as a measure of the degree of myocardial damage, and levels compared between the different treatment groups.

Primary end point

Myocardial injury (Peri-procedural Myocardial Infarction and Injury) measured by cTnT and CK-MB release over 24 hours after primary PCI.

Conditions

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Post Procedural Myocardial Infarction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Remote Conditioning group

Patients will receive a standard remote ischaemia preconditioning protocol comprising a blood pressure cuff placed on arm and inflated to 200mmHg for 5 minutes and then deflated for 5 minutes, a cycle repeated three times, prior to the PCI procedure.

Group Type ACTIVE_COMPARATOR

Remote Conditioning

Intervention Type DEVICE

A Blood pressure cuff will be placed on the arm and inflated to 200mm hg for 5 minutes, and then deflated for 5 minutes, a cycle repeated 3 times.

Control Group

Patients will receive a standard sham remote ischaemia preconditioning protocol with an un-inflated cuff be placed on the arm in this group of patients for 30 minutes. This is the sham intervention for this group.

Group Type PLACEBO_COMPARATOR

Sham protocol

Intervention Type DEVICE

An un-inflated blood pressure cuff will be placed on the arm for 20 minutes.

Interventions

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Remote Conditioning

A Blood pressure cuff will be placed on the arm and inflated to 200mm hg for 5 minutes, and then deflated for 5 minutes, a cycle repeated 3 times.

Intervention Type DEVICE

Sham protocol

An un-inflated blood pressure cuff will be placed on the arm for 20 minutes.

Intervention Type DEVICE

Other Intervention Names

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RIC Control

Eligibility Criteria

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Inclusion Criteria

* Patients admitted with NSTEMI/ Unstable angina undergoing percutaneous intervention

Exclusion Criteria

* Known renal failure
* Known liver disease
* Peripheral vascular disease involving upper limbs
* Inability to consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University College London Hospitals

OTHER

Sponsor Role collaborator

Surrey and Sussex Healthcare NHS Trust

OTHER

Sponsor Role collaborator

University College, London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Derek M Yellon, PhD, FACC

Role: STUDY_DIRECTOR

University College, London

Other Identifiers

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05/0138

Identifier Type: -

Identifier Source: org_study_id