Effectiveness of Intracoronary Injection of Eptifibatide in Primary Coronary Intervention in STEMI Patients (ICE)
Recruitment status was Not yet recruiting
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Purpose
The achievement of high local concentration of Eptifibatide, a GP 2b3a inhibitor,via direct intracoronary injection, promotes (in vitro) clot disaggregation. It remains unclear if it is of superior benefit than the routine intravenous administration of these agents.
In patients presenting with acute myocardial infarction, and undergoing primary coronary intervention, intracoronary administration of Eptifibatide may increase local drug concentration by several orders of magnitude and promote clot disaggregation with a minimal increase in systemic drug concentration, and in that way enhancing myocardial perfusion and survival.
| Condition | Intervention | Phase |
|---|---|---|
|
Acute Myocardial Infarction |
Drug: Eptifibatide |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Treatment |
| Official Title: | Effectiveness of Intracoronary Injection of Eptifibatide as Adjunctive Antiplatelet Therapy in Primary Coronary Intervention in Patients With ST Segment Elevation Acute Myocardial Infarction. |
- Coronary angiography [ Time Frame: At the time of the procedure ] [ Designated as safety issue: No ]
- Electrocardiogram [ Time Frame: 90 min after the procedure ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 50 |
| Study Start Date: | August 2009 |
| Estimated Study Completion Date: | February 2010 |
| Estimated Primary Completion Date: | February 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Eptifibatide (intracoronary) |
Drug: Eptifibatide
Intracoronary injection of Eptifibatide injected in two consecutive bolus of 180 mcg/kg each, followed immediately by continuous infusion of 2 mcg/kg/min for 12 hs.
|
| Active Comparator: Eptifibatide (intravenous) |
Drug: Eptifibatide
Intravenous injection of Eptifibatide in two consecutive boluses of 180 mcg/kg followed by continuous intravenous injection dosing 2 mcg/kg/min for 12 hours
|
Detailed Description:
Patients will be randomized, prospectively, single blinded into one of two arms:1)intravenous administration of Eptifibatide and 2) intracoronary administration. The primary end-point will be the angiographic achievement of TIMI 3 flow at the infarct related artery and TIMI myocardial perfusion grade (blush) and the electrocardiographic surrogate of myocardial perfusion the ST segment resolution.
The secondary end-points will be the occurrence of bleeding or hemorrhagic complication according to TIMI classification and the LVEF at one month compared with baseline
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Acute myocardial infarction candidate for primary coronary angioplasty, presenting within 12 hours of onset of pain and ability to clearly identified only one infarct related artery.
Exclusion Criteria:
- Contraindications for antiplatelet therapy such as bleeding disorders,
- Thrombocytopenia,
- Severe uncontrolled hypertension,
- Recent stroke (<6 months),
- Intracranial hemorrhage at any time
- Patients after recent major surgery (<30 days),
- Previous myocardial infarction
- Previous revascularization either by CABG or PCI and 9)patients presented with cardiogenic shock.
Contacts and Locations| Contact: Alberto Hendler, MD | +972526467757 | ahendler@asaf.health.gov.il |
| Contact: Alex Blatt, MD | +97257345906 | alexb@asaf.health.gov.il |
| Israel | |
| Assaf Harofeh Medical Center | Not yet recruiting |
| Beer Yakov, Israel, 70300 | |
| Contact: Alberto Hendler, MD +9726467757 ahendler@asaf.health.gov.il | |
| Principal Investigator: Alberto Hendler, MD | |
More Information
No publications provided
| Responsible Party: | Alberto Hendler MD, Assaf harofeh Medical Center |
| ClinicalTrials.gov Identifier: | NCT00945308 History of Changes |
| Other Study ID Numbers: | 97/09 |
| Study First Received: | July 8, 2009 |
| Last Updated: | July 23, 2009 |
| Health Authority: | Israel: Ministry of Health |
Keywords provided by Assaf-Harofeh Medical Center:
|
Primary PCI Acute myocardial infarction Myocardial blush Primary coronary intervention in acute myocardial infarction |
focusing on the effect of the study drug on the immediate TIMI flow at the infarct related artery and on the myocardial perfusion evaluated by the TIMI myocardial perfusion grade or blush |
Additional relevant MeSH terms:
|
Infarction Myocardial Infarction Ischemia Pathologic Processes Necrosis Myocardial Ischemia Heart Diseases |
Cardiovascular Diseases Vascular Diseases Eptifibatide Platelet Aggregation Inhibitors Hematologic Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 17, 2013