Effect of Low-dose Intracoronary Reteplase on Myocardial Infarct Size During Primary Percutaneous Coronary Intervention

NCT ID: NCT04571580

Last Updated: 2023-09-14

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

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-01

Study Completion Date

2023-01-31

Brief Summary

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OBJECTIVE: To determine whether a therapeutic strategy involving low-dose intracoronary fibrinolytic therapy with reteplase infused after coronary reperfusion will reduce the myocardial infarction size.

DESIGN, SETTING, AND PARTICIPANTS: 306 patients presenting at 15 hospitals in China within 12 hours of acute ST-segment elevation myocardial infarction (STEMI) due to a proximal-mid-vessel occlusion of left anterior descending (LAD) coronary artery occlusion will be randomized in a 1:1:1 dose-ranging trial design. Patients will be followed up to 1 month.

INTERVENTIONS: Participants will be randomly assigned to treatment with placebo (n = 102), reteplase 9mg (n = 102), or reteplase 18mg (n = 102) by manual infusion over 2 minutes after reperfusion of the infarct-related coronary artery and before stent implant.

MAIN OUTCOMES AND MEASURES The primary outcomewas the myocardial infarct size (% left ventricular mass) demonstrated by contrast-enhanced cardiac magnetic resonance imaging (MRI) conducted from days 2 through 7 after enrollment.

Detailed Description

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Conditions

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Acute ST-segment Elevation Myocardial Infarction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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placebo

intracoronary infusion with saline

Group Type PLACEBO_COMPARATOR

Normal Saline

Intervention Type DRUG

intracoronary infusion with normal saline

reteplase 9mg

intracoronary infusion with reteplase 9mg

Group Type EXPERIMENTAL

Reteplase Injection 9mg

Intervention Type DRUG

low-dose intracoronary fibrinolytic therapy with reteplase 9mg

reteplase 18mg

intracoronary infusion with reteplase 18mg

Group Type EXPERIMENTAL

Reteplase Injection 18mg

Intervention Type DRUG

low-dose intracoronary fibrinolytic therapy with reteplase 18mg

Interventions

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Reteplase Injection 18mg

low-dose intracoronary fibrinolytic therapy with reteplase 18mg

Intervention Type DRUG

Normal Saline

intracoronary infusion with normal saline

Intervention Type DRUG

Reteplase Injection 9mg

low-dose intracoronary fibrinolytic therapy with reteplase 9mg

Intervention Type DRUG

Other Intervention Names

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intracoronary normal saline intracoronary reteplase 9mg intracoronary reteplase 18mg

Eligibility Criteria

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Inclusion Criteria

1. Acute STEMI with persistent ST-segment elevation or recent left bundle-branch block with a symptom onset to reperfusion time of 12 hours or less.
2. Angiographic criteria included a proximal-mid coronary artery occlusion (TIMI coronary flow grade 0 or 1) or, impaired coronary flow (TIMI flow grade 2, slow but complete filling) in the presence of definite angiographic evidence of large thrombus (TIMI grade ≥2) in left anterior descending (LAD) coronary artery.

Exclusion Criteria

1. Rescue PCI after thrombolytic therapy.
2. Need for emergency coronary artery bypass grafting.
3. Presence of cardiogenic shock.
4. Life expectancy of \< 6 months.
5. Inability to provide informed consent.
6. Contraindications for the use of thrombolysis, including active internal bleeding, history of intracranial haemorrhage or ischaemic stroke within 6 months, recent major surgery or trauma, severe uncontrolled hypertension, thrombocytopenia and severe liver or kidney failure.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ge Junbo

OTHER

Sponsor Role lead

Responsible Party

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Ge Junbo

Director, Dept. of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Junbo Ge

Role: PRINCIPAL_INVESTIGATOR

Department of Cardiology, Zhongshan Hospital

Locations

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Department of Cardiology, Zhongshan Hospital, Fudan University

Shanghai, Shanghai Municipality, China

Site Status

Countries

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China

References

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Huang D, Ma Y, Wu H, Zhong X, Gao W, Zhou J, Qian J, Ge J. Impact of intracoronary reteplase during primary percutaneous coronary intervention on infarct size in large anterior myocardial infarction: rationale and design of the RECOVER II trial. Cardiovasc Diagn Ther. 2022 Jun;12(3):352-359. doi: 10.21037/cdt-21-756.

Reference Type RESULT
PMID: 35800360 (View on PubMed)

Other Identifiers

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RECOVERII

Identifier Type: -

Identifier Source: org_study_id

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