Cardiac MRI-guided Deferiprone Therapy for Acute Myocardial Infarction Patients

NCT ID: NCT05604131

Last Updated: 2025-04-06

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

PHASE2

Total Enrollment

72 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-08

Study Completion Date

2029-08-31

Brief Summary

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The objective of this randomized, controlled pilot study is to determine the efficacy of Deferiprone to reduce the amount of free iron inside the hemorrhagic zone of myocardial infarction among hemorrhagic myocardial infarction patients.

Detailed Description

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Conditions

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Acute Myocardial Infarction Type 1

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Hemorrhagic Myocardial Infarction - Deferiprone

Enrolled patients with CMR confirmed presence of intramyocardial hemorrhage

Group Type ACTIVE_COMPARATOR

Deferiprone Tablets

Intervention Type DRUG

Deferiprone tablets are the active medication for the active arm of the study groups. Randomization will be done by investigational drug services pharmacist and intervention will be double-blinded to investigators and patients.

Non-hemorrhagic Myocardial Infarction - Deferiprone

Enrolled patients with CMR confirmed absence of intramyocardial hemorrhage

Group Type ACTIVE_COMPARATOR

Deferiprone Tablets

Intervention Type DRUG

Deferiprone tablets are the active medication for the active arm of the study groups. Randomization will be done by investigational drug services pharmacist and intervention will be double-blinded to investigators and patients.

Hemorrhagic Myocardial Infarction - Placebo

Enrolled patients with CMR confirmed presence of intramyocardial hemorrhage

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Deferiprone placebo is the non-medicated formulation for a control arm of the study groups.

Non-hemorrhagic Myocardial Infarction - Placebo

Enrolled patients with CMR confirmed absence of intramyocardial hemorrhage

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Deferiprone placebo is the non-medicated formulation for a control arm of the study groups.

Interventions

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Deferiprone Tablets

Deferiprone tablets are the active medication for the active arm of the study groups. Randomization will be done by investigational drug services pharmacist and intervention will be double-blinded to investigators and patients.

Intervention Type DRUG

Placebo

Deferiprone placebo is the non-medicated formulation for a control arm of the study groups.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Age ≥ 18 years
2. Index Anterior wall STEMI
3. Emergency coronary angiogram with primary PCI

Exclusion Criteria

1. Prior history of MI / PCI / coronary artery bypass graft (CABG) within previous 1 year
2. Patients with previous history of left ventricular ejection fraction (LVEF) \< 40%
3. Use of investigational drugs or devices 30 days prior to randomization
4. Known allergy or contra-indication to gadolinium/contrast agents
5. eGFR \< 30 ml/kg/min
6. Any contraindication against cardiac MRI (such as metal implants)
7. Women who are pregnant or breastfeeding. Women of reproductive potential must have a negative pregnancy test prior to randomization
8. Body weight \> 140 kg (or 309 lbs.)
9. Absolute neutrophil count - ANC \< 1.5 k/cumm
10. History of Chronic Liver Disease
11. Elevated hepatic enzymes (BOTH ALT and AST) \> 2 times of upper normal limit
12. Patients with iron storage disease (hemochromatosis, thalassemia) or who are already treated with iron chelators
13. Any clinically significant abnormality identified prior to randomization that in the judgment of the Sponsor-Investigator or Delegate would preclude safe completion of the study or confound the anticipated benefit of deferiprone.
14. Life expectancy of less than 1 year due to non-cardiac pathology
Minimum Eligible Age

18 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rohan Dharmakumar

OTHER

Sponsor Role lead

Responsible Party

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Rohan Dharmakumar

Executive Director, Krannert Cardiovascular Research Center

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Rohan Dharmakumar, PhD

Role: PRINCIPAL_INVESTIGATOR

Krannert Cardiovascular Research Center

Keyur P Vora, MD FACP FACC

Role: PRINCIPAL_INVESTIGATOR

Krannert Cardiovascular Research Center

Locations

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Krannert Cardiovascular Research Center

Indianapolis, Indiana, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Clinical Research Coordinator

Role: CONTACT

(317) 274-0985

References

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Kali A, Kumar A, Cokic I, Tang RL, Tsaftaris SA, Friedrich MG, Dharmakumar R. Chronic manifestation of postreperfusion intramyocardial hemorrhage as regional iron deposition: a cardiovascular magnetic resonance study with ex vivo validation. Circ Cardiovasc Imaging. 2013 Mar 1;6(2):218-28. doi: 10.1161/CIRCIMAGING.112.000133. Epub 2013 Feb 12.

Reference Type BACKGROUND
PMID: 23403335 (View on PubMed)

Kali A, Cokic I, Tang R, Dohnalkova A, Kovarik L, Yang HJ, Kumar A, Prato FS, Wood JC, Underhill D, Marban E, Dharmakumar R. Persistent Microvascular Obstruction After Myocardial Infarction Culminates in the Confluence of Ferric Iron Oxide Crystals, Proinflammatory Burden, and Adverse Remodeling. Circ Cardiovasc Imaging. 2016 Nov;9(11):e004996. doi: 10.1161/CIRCIMAGING.115.004996.

Reference Type BACKGROUND
PMID: 27903536 (View on PubMed)

Wang G, Yang HJ, Kali A, Cokic I, Tang R, Xie G, Yang Q, Francis J, Li S, Dharmakumar R. Influence of Myocardial Hemorrhage on Staging of Reperfused Myocardial Infarctions With T2 Cardiac Magnetic Resonance Imaging: Insights Into the Dependence on Infarction Type With Ex Vivo Validation. JACC Cardiovasc Imaging. 2019 Apr;12(4):693-703. doi: 10.1016/j.jcmg.2018.01.018. Epub 2018 Apr 18.

Reference Type BACKGROUND
PMID: 29680356 (View on PubMed)

Liu T, Howarth AG, Chen Y, Nair AR, Yang HJ, Ren D, Tang R, Sykes J, Kovacs MS, Dey D, Slomka P, Wood JC, Finney R, Zeng M, Prato FS, Francis J, Berman DS, Shah PK, Kumar A, Dharmakumar R. Intramyocardial Hemorrhage and the "Wave Front" of Reperfusion Injury Compromising Myocardial Salvage. J Am Coll Cardiol. 2022 Jan 4;79(1):35-48. doi: 10.1016/j.jacc.2021.10.034.

Reference Type BACKGROUND
PMID: 34991787 (View on PubMed)

Dharmakumar R. "Rusty Hearts": Is It Time to Rethink Iron Chelation Therapies in Post-Myocardial-Infarction Setting? Circ Cardiovasc Imaging. 2016 Oct;9(10):e005541. doi: 10.1161/CIRCIMAGING.116.005541. No abstract available.

Reference Type BACKGROUND
PMID: 27894072 (View on PubMed)

Dharmakumar R. Colors of Myocardial Infarction: Can They Predict the Future? Circ Cardiovasc Imaging. 2017 Dec;10(12):e007291. doi: 10.1161/CIRCIMAGING.117.007291. No abstract available.

Reference Type BACKGROUND
PMID: 29242241 (View on PubMed)

Dharmakumar R, Nair AR, Kumar A, Francis J. Myocardial Infarction and the Fine Balance of Iron. JACC Basic Transl Sci. 2021 Jul 26;6(7):581-583. doi: 10.1016/j.jacbts.2021.06.004. eCollection 2021 Jul.

Reference Type BACKGROUND
PMID: 34368506 (View on PubMed)

Guan X, Chen Y, Yang HJ, Zhang X, Ren D, Sykes J, Butler J, Han H, Zeng M, Prato FS, Dharmakumar R. Assessment of intramyocardial hemorrhage with dark-blood T2*-weighted cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2021 Jul 15;23(1):88. doi: 10.1186/s12968-021-00787-4.

Reference Type BACKGROUND
PMID: 34261494 (View on PubMed)

Chen Y, Ren D, Guan X, Yang HJ, Liu T, Tang R, Ho H, Jin H, Zeng M, Dharmakumar R. Quantification of myocardial hemorrhage using T2* cardiovascular magnetic resonance at 1.5T with ex-vivo validation. J Cardiovasc Magn Reson. 2021 Sep 30;23(1):104. doi: 10.1186/s12968-021-00779-4.

Reference Type BACKGROUND
PMID: 34587984 (View on PubMed)

Kali A, Tang RL, Kumar A, Min JK, Dharmakumar R. Detection of acute reperfusion myocardial hemorrhage with cardiac MR imaging: T2 versus T2. Radiology. 2013 Nov;269(2):387-95. doi: 10.1148/radiology.13122397. Epub 2013 Jul 11.

Reference Type BACKGROUND
PMID: 23847253 (View on PubMed)

Cokic I, Kali A, Yang HJ, Yee R, Tang R, Tighiouart M, Wang X, Jackman WS, Chugh SS, White JA, Dharmakumar R. Iron-Sensitive Cardiac Magnetic Resonance Imaging for Prediction of Ventricular Arrhythmia Risk in Patients With Chronic Myocardial Infarction: Early Evidence. Circ Cardiovasc Imaging. 2015 Aug;8(8):10.1161/CIRCIMAGING.115.003642 e003642. doi: 10.1161/CIRCIMAGING.115.003642.

Reference Type BACKGROUND
PMID: 26259581 (View on PubMed)

Cokic I, Kali A, Wang X, Yang HJ, Tang RL, Thajudeen A, Shehata M, Amorn AM, Liu E, Stewart B, Bennett N, Harlev D, Tsaftaris SA, Jackman WM, Chugh SS, Dharmakumar R. Iron deposition following chronic myocardial infarction as a substrate for cardiac electrical anomalies: initial findings in a canine model. PLoS One. 2013 Sep 16;8(9):e73193. doi: 10.1371/journal.pone.0073193. eCollection 2013.

Reference Type BACKGROUND
PMID: 24066038 (View on PubMed)

Nair AR, Johnson EA, Yang HJ, Cokic I, Francis J, Dharmakumar R. Reperfused hemorrhagic myocardial infarction in rats. PLoS One. 2020 Dec 2;15(12):e0243207. doi: 10.1371/journal.pone.0243207. eCollection 2020.

Reference Type BACKGROUND
PMID: 33264359 (View on PubMed)

Related Links

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https://www.cardio-theranostics.com/

CARDIO-THERANOSTICS is developing diagnostics and therapeutics for hemorrhagic myocardial infarction

Other Identifiers

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13487

Identifier Type: -

Identifier Source: org_study_id

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