Effects of Pressure-controlled Intermittent Coronary Sinus Occlusion (PiCSO) Therapy on miRNAs Expression and Absolute Microvascular Resistance by Continuous Thermodilution in ST-segment Elevation Myocardial Infarction (STEMI) Patients: PiCSO-STEMI TRIAL

NCT ID: NCT05644925

Last Updated: 2025-08-14

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

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-14

Study Completion Date

2024-06-21

Brief Summary

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In this study we pretend to determine the molecular (miRNAs expression, angiogenic and inflammatory biomarkers) and microcirculatory (assessed by the innovative continuous intracoronary thermodilution technique) effects of PiCSO compared to a standard PCI control group in patients with high-risk anterior STEMI. Then, we aim to assess the efficacy of these molecular biomarkers as prognostic tools. Also, we will evaluate the impact of PiCSO on the coronary microcirculation beyond the acute phase in the follow-up six months after STEMI. Finally, we will assess PiCSO influence on Heart Failure (HF) clinical variables and patients' quality of life including a cost-effectiveness assessment in the mid-term follow-up one year after the STEMI event.

Detailed Description

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Conditions

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Anterior Myocardial Infarction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients will be randomized (1:1) to PiCSO group or standard PCI control group. Once randomized, PiCSO group patients will receive PiCSO therapy inside the catheterization laboratory.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The subjects as well as the investigator performing the procedure will not be blind to the study treatment. An independent experienced cardiologist, who will be blinded to all clinical data; will analyze anonymized Cardiac Magnetic Resonance (CMR) images for unbiased endpoints assessment.

Study Groups

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PICSO+PCI

Group Type EXPERIMENTAL

PiCSO Impulse System

Intervention Type DEVICE

The PiCSO Impulse System is intended to reduce infarct size by intermittently occluding the coronary sinus outflow in patients undergoing a percutaneous coronary interventional procedure for myocardial infarction and presenting with Thrombolysis in myocardial infarction (TIMI) flow of 0 or 1.

Percutaneous Coronary Intervention (PCI)

Intervention Type PROCEDURE

Minimally invasive procedures used to open clogged coronary arteries

Standard PCI

Group Type ACTIVE_COMPARATOR

Percutaneous Coronary Intervention (PCI)

Intervention Type PROCEDURE

Minimally invasive procedures used to open clogged coronary arteries

Interventions

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PiCSO Impulse System

The PiCSO Impulse System is intended to reduce infarct size by intermittently occluding the coronary sinus outflow in patients undergoing a percutaneous coronary interventional procedure for myocardial infarction and presenting with Thrombolysis in myocardial infarction (TIMI) flow of 0 or 1.

Intervention Type DEVICE

Percutaneous Coronary Intervention (PCI)

Minimally invasive procedures used to open clogged coronary arteries

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Age ≥ 18 years old.
2. Anterior STEMI (ECG with persistent elevation ≥ 2 mm (0.2 mV) in 2 or more contiguous anterior precordial leads (V2, V3, V4) in men or ≥ 1.5 mm (0.15 mV) in women.
3. Culprit lesion in proximal or mid Left Anterior Descending Artery (LAD).
4. Pre-PCI TIMI flow 0-1.
5. Symptoms consistent with myocardial ischemia (persistent chest pain, dyspnea, nauseas/vomiting, fatigue, palpitations or syncope) present for ≤ 12 hours.
6. The patient is eligible for primary PCI.
7. Informed consent received and signed for study enrollment.

Exclusion Criteria

1. Contraindication to coronary angiogram or PCI.
2. Implants or foreign bodies in the coronary sinus.
3. Known allergies to polyurethanes, Polyethylene Terephthalate (PET) or stainless steel.
4. Known pregnancy or breastfeeding.
5. Known coagulopathy.
6. Known severe kidney disease (eGFR \<=30 mL/min/1.73) and/or hemodialysis.
7. Known large pericardial effusion or cardiac tamponade.
8. Central hemodynamically relevant left-right shunt.
9. Previous MI or Coronary Artery Bypass Graft (CABG).
10. Previous history of stroke, transient ischemic attack (TIA) or reversible ischemic neurological deficit within last 6 months.
11. Cardiopulmonary resuscitated (CPR) cardiac arrest ≥ 5 minutes whom baseline neurologic status is not present.
12. Unconscious at presentation.
13. Need for circulatory support.
14. Need for invasive mechanical ventilation.
15. Need for temporal intravenous pacemaker.
16. Patient not suitable for femoral access.
17. Known contraindication for adenosine administration (severe asthma, complicated Atrioventricular (AV) block, critical aortic stenosis, severe cardiac arrhythmias, severe valve diseases).
18. Known epicardial stenosis greater than 50% distal to the culprit LAD lesion.
19. Active participation in another drug or device investigational trial.
20. Medical, social or psychological condition that limits the ability of patient to participate in the study.
21. Patients with definite or probable coronavirus disease 19 diagnosis within 2 weeks prior to STEMI.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Miracor Medical SA

INDUSTRY

Sponsor Role collaborator

Fundacio Privada Mon Clinic Barcelona

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Other Identifiers

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PiCSO-STEMI

Identifier Type: -

Identifier Source: org_study_id

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