Effects of Atorvastatin on Myonecrosis
Recruitment status was Not yet recruiting
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Purpose
This study is designed as a prospective, randomized, placebo-controlled, double-blind analysis of atorvastatin 80 mg versus placebo administered on average 4 hours prior to percutaneous coronary intervention [PCI] (at least 2 hours) in patients presenting with unstable angina. Only patients with negative cardiac biomarkers, measured on 2 separate occasions a few hours apart will be eligible for inclusion. Furthermore, patients already on high-dose statin therapy; patients taking any statin within 24 hours prior to the PCI; and patients with contraindications to statins will be excluded from the study. The primary endpoint is a quantitative troponin level at 18-24 hours after PCI. At an enrollment of a total of 150 patients (75 per group), the study is powered to detect a 30% difference in troponin level. Secondary endpoints include elevation of creatine kinase (CK) and CK-MB above the upper limit of normal, change in C-reactive protein (CRP) levels from baseline and thrombolysis in myocardial infarction (TIMI) myocardial perfusion grade. All patients will be started on statin therapy the day after the procedure, as deemed appropriate by their treating physicians.
| Condition | Intervention |
|---|---|
|
Coronary Disease |
Drug: atorvastatin |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double-Blind Primary Purpose: Prevention |
| Official Title: | Effects of Single-Dose Atorvastatin on Peri-Procedural Myonecrosis During Percutaneous Coronary Intervention in Patients With Acute Coronary Syndromes - The NO-MI Study |
- Peri-procedural myonecrosis, as measured by troponin T (TnT), during percutaneous coronary intervention (PCI)
- Other biomarkers of myocyte injury (CK, CK-MB)
- Inflammatory markers (CRP)
- Post PCI growth of tissue level perfusion circumference and tissue level perfusion brightness using digital subtraction angiography
| Estimated Enrollment: | 150 |
| Study Start Date: | July 2006 |
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients must be aged 18 or over.
- Patients must provide written informed consent.
- Patients are presenting with unstable angina (defined as new onset chest pain, accelerating chest pain, chest pain at rest and ST-segment depression on the electrocardiogram [EKG])
- Patients undergoing successful coronary stent implantation of the (presumed) culprit lesion (defined as < 50% residual stenosis).
Exclusion Criteria:
- Any patient who is unable to give written informed consent.
- Any condition which, in the investigator's opinion, would interfere with optimal participation in the study or produce a significant risk to the patient.
- Patients presenting with an ST-elevation myocardial infarction (MI).
- Patients with elevated troponin, CK, or CK-MB (above the upper limit of normal).
- Patients already on high-dose statin therapy (defined as any statin equivalent to atorvastatin ≥ 40 mg).
- Patients who took any statin agent within 24 hours of presentation to the cardiac catheterization laboratory.
- Patients with active hepatic disease or myositis, in whom statin therapy is contraindicated.
- Patients with hypersensitivity to atorvastatin.
- Patients with procedural complications, including unsuccessful percutaneous transluminal coronary angioplasty (PTCA)/stenting, major side-branch occlusion, flow-limiting dissections at the completion of the procedure, emergent coronary artery bypass surgery, peri-procedural thrombus formation with distal embolization, stent thrombosis within the first 24 hours, repeat emergent PCI within 24 hours, and death within 24 hours.
- Cardiogenic shock.
Contacts and Locations| Contact: Allen Jeremias, MD | 617-632-7782 | ajeremias@gmail.com |
| Contact: Joseph Carrozza, Jr, MD | 617-632-7455 | jcarrozz@bidmc.harvard.edu |
| United States, Massachusetts | |
| Beth Israel Deaconess Medical Center | Not yet recruiting |
| Boston, Massachusetts, United States, 02215 | |
| Principal Investigator: Joseph Carrozza, Jr, MD | |
| Principal Investigator: | Joseph Carrozza, Jr, MD | Beth Israel Deaconess Medical Center |
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT00344019 History of Changes |
| Other Study ID Numbers: | 2006-P-000035/1 |
| Study First Received: | June 22, 2006 |
| Last Updated: | March 10, 2008 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Beth Israel Deaconess Medical Center:
|
Acute coronary syndrome Percutaneous coronary intervention Peri-procedure myocardial infarction |
Additional relevant MeSH terms:
|
Coronary Disease Coronary Artery Disease Acute Coronary Syndrome Myocardial Ischemia Heart Diseases Cardiovascular Diseases Vascular Diseases Arteriosclerosis Arterial Occlusive Diseases Angina Pectoris Chest Pain Pain |
Signs and Symptoms Atorvastatin Hydroxymethylglutaryl-CoA Reductase Inhibitors Anticholesteremic Agents Hypolipidemic Agents Antimetabolites Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Enzyme Inhibitors Lipid Regulating Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on June 18, 2013