CRP Apheresis in STEMI

NCT ID: NCT04939805

Last Updated: 2025-05-09

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

RECRUITING

Clinical Phase

NA

Total Enrollment

202 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-04-01

Study Completion Date

2025-08-31

Brief Summary

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Background: In patients with acute ST-elevation myocardial infarction (STEMI), the amount of infarcted myocardium (infarct size) is known to be a major predictor for adverse remodeling and recurrent adverse cardiovascular events. Effective cardio-protective strategies with the aim of reducing infarct size are therefore of great interest. Local and systemic inflammation influences the fate of ischemic myocardium and thus, adverse remodeling and clinical outcome. C-reactive protein (CRP) also acts as a potential mechanistic mediator that adversely affects the amount of irreversible myocardial tissue damage after acute myocardial infarction.

Objective: The main objectives of the current study are to investigate the efficacy of selective CRP apheresis, using the PentraSorb®-CRP system, as an adjunctive therapy to standard of care for patients with acute STEMI treated with primary PCI.

Design: Investigator-initiated, prospective, randomized, open-label (outcome assessors masked), controlled, multicenter, two group trial with a two-stage adaptive design.

Innovation: Selective CRP apheresis offers potential to decrease infarct size and consequently improve outcome after PCI for STEMI. This is the first randomized trial investigating the impact of selective CRP apheresis on infarct size in post-STEMI patients. In perspective, the study design allows furthermore to collect robust evidence for the design of a definitive outcome study.

Detailed Description

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Conditions

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ST Elevation Myocardial Infarction C-Reactive Protein Apheresis Myocardial Injury

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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Selective CRP apheresis as an adjunct to standard of care

Apheresis using the PentraSorb®-CRP system will be performed at day 1, 2 and 3 after PCI.

Group Type EXPERIMENTAL

Selective CRP apheresis using the PentraSorb®-CRP system

Intervention Type DEVICE

Selective CRP apheresis as an adjunct to standard of care. Apheresis using the PentraSorb®-CRP system will be performed at day 1, 2 and 3 after PCI.

Standard of care according to current guideline recommendations

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Selective CRP apheresis using the PentraSorb®-CRP system

Selective CRP apheresis as an adjunct to standard of care. Apheresis using the PentraSorb®-CRP system will be performed at day 1, 2 and 3 after PCI.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Diagnosis of first acute STEMI in accordance with the European Society of Cardiology (ESC) Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation
2. Symptoms consistent with STEMI with beginning greater than 30 minutes but less than 12 hours prior to primary percutaneous coronary intervention (PCI)
3. CRP elevation of ≥7 mg/l measured between 6 to 16 hours after primary PCI
4. Eligible for primary PCI
5. Age ≥18 years
6. Written informed consent

Exclusion Criteria

1. Prior acute myocardial infarction, coronary artery bypass surgery or PCI.
2. Persistent hemodynamic instability (Killip class \>2 including cardiogenic shock) or resuscitated cardiac arrest not allowing a CMR scan.
3. The patient is febrile (temperature \>38°C) or has experienced an acute infection with fever in the last 14 days.
4. CRP \>15 mg/l at time of hospital admission.
5. Chronic inflammatory disease.
6. Known history of severe hepatic failure
7. Chronic kidney disease with a creatinine clearance \<30ml/min./1.73m²
8. Contraindication to CMR.
9. Pre-STEMI life expectancy of \<1 year
10. Participation in another interventional trial
11. Limited possibility to join the follow-up examinations (e.g. patient lives abroad)
12. Pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University Innsbruck

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sebastian J Reinstadler, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck

Locations

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University Clinic for Cardiology and Nephrology, Medical University of Graz

Graz, , Austria

Site Status RECRUITING

University Clinic of Internal Medicine III, Cardiology and Angiology. University Clinic of Internal Medicine IV, Nephrology and Hypertensiology. University Clinic of Radiology.

Innsbruck, , Austria

Site Status RECRUITING

University Clinic of Internal Medicine II, Paracelsus Medical University Salzburg

Salzburg, , Austria

Site Status NOT_YET_RECRUITING

Medical Clinic II - University Heart Center Lübeck

Lübeck, Schleswig-Holstein, Germany

Site Status NOT_YET_RECRUITING

Leipzig Heart Center

Leipzig, , Germany

Site Status RECRUITING

Countries

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Austria Germany

Central Contacts

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Sebastian J Reinstadler, MD, PhD

Role: CONTACT

+43 (0) 512 504 25665

Ivan Lechner, MD, PhD

Role: CONTACT

+43 (0) 512 504 25665

Facility Contacts

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Heiko Bugger, MD

Role: primary

Sebastian J Reinstadler, MD, PhD

Role: primary

Lukas J Motloch, MD, PhD

Role: primary

Thomas Stiermaier, MD

Role: primary

Hans-Josef Feistritzer, MD, PhD

Role: primary

References

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Reinstadler SJ, Kronbichler A, Reindl M, Tiller C, Holzknecht M, Oberhollenzer F, Kaser A, Gauckler P, Stiermaier T, Feistritzer HJ, Mayr A, Gizewski ER, Rezar R, Bugger H, Eller K, Eitel I, Schneider S, Mayer G, Thiele H, Bauer A, Metzler B, Lechner I; CRP-STEMI Investigators. Selective C-reactive protein apheresis in ST-elevation myocardial infarction: Design and rationale of the randomized CRP-STEMI trial. Am Heart J. 2025 Jul 28;291:1-9. doi: 10.1016/j.ahj.2025.07.067. Online ahead of print.

Reference Type DERIVED
PMID: 40738310 (View on PubMed)

Other Identifiers

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20210121-2475

Identifier Type: -

Identifier Source: org_study_id

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