ImmeDiate Versus EArLy Invasive Approach in Non-ST-Elevation Myocardial Infarction (IDEAL NSTEMI)
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Purpose
Of estimated 140,000 cases of acute myocardial infarction admitted to hospitals in Germany per year, approximately 50% present with Non-ST-elevation myocardial infarction (NSTEMI). The currently available evidence led to current guideline recommendations that a systematic approach of immediate angiography in NSTEMI patients stabilized with contemporary antiplatelet treatment is not mandatory. However, this immediate invasive approach is appealing because it allows treating the underlying cause (the plaque rupture) as early as possible with subsequent reduction of death and recurrent myocardial infarction. In the IDEAL NSTEMI trial we test an immediate invasive approach (<2 h) with an approach 12-72 h according top guidelines with respect to 6 months death and mortality.
| Condition | Intervention | Phase |
|---|---|---|
|
Non-ST-Elevation Myocardial Infarction |
Procedure: immediate angiography and revascularization Procedure: early invasive angiography |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | ImmeDiate Versus EArLy Invasive Approach in Non-ST-Elevation Myocardial Infarction (IDEAL NSTEMI) |
- Death and non-fatal recurrent infarction [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
- Composite of death, recurrent non-fatal myocardial infarction, refractory ischemia or target vessel re-vascularization [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 2100 |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: immediate angiography
Immediate invasive angiography < 2 h after randomization
|
Procedure: immediate angiography and revascularization
immediate angiography < 2 hours after randomization
|
|
Active Comparator: early invasive angiography
early invasive angiography 12-72 h after randomization
|
Procedure: early invasive angiography
early invasive angiography 12-72 h after randomization
|
Eligibility| Ages Eligible for Study: | 18 Years to 90 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
NSTEMI with
- ischemic symptoms >10 minutes within 24 h
- elevated troponin or creatine kinase above the upper limit of normal
- ST-segment depression or transient ST-segment elevation, T-wave inversion
- informed consent.
Exclusion Criteria:
- Age < 18 years
- Age > 90 years
- persistent angina
- hemodynamic instability
- overt congestive heart failure
- life-threatening arrhythmias
- STEMI
- limited life-expectancy < 6 months
- chronic oral anticoagulation
- fibrinolysis < 48 hours
- PCI < 14 days
- contraindication for treatment with glycoprotein IIb/IIIa inhibitors, heparin, aspirin and clopidogrel
- recent major trauma or surgery
Contacts and Locations| Germany | |
| University of Leipzig - Heart Center | |
| Leipzig, Germany, 04289 | |
| Study Chair: | Holger Thiele, MD | University of Leipzig |
| Study Director: | Uwe Zeymer, MD | Institut für Herzinfarktforschung |
More Information
No publications provided
| Responsible Party: | Holger Thiele, University of Leipzig - Heart Center |
| ClinicalTrials.gov Identifier: | NCT00954668 History of Changes |
| Other Study ID Numbers: | IDEAL NSTEMI 1, DFG application no. 29 |
| Study First Received: | August 6, 2009 |
| Last Updated: | June 24, 2010 |
| Health Authority: | Germany: Federal Institute for Drugs and Medical Devices |
Keywords provided by University of Leipzig:
|
Non-ST-elevation myocardial infarction angiography percutaneous coronary intervention timing |
Additional relevant MeSH terms:
|
Infarction Myocardial Infarction Ischemia Pathologic Processes Necrosis |
Myocardial Ischemia Heart Diseases Cardiovascular Diseases Vascular Diseases |
ClinicalTrials.gov processed this record on May 22, 2013