GLP-1 Agonist Exenatide for Improved Glucose Control and Cardiac Function in Diabetic Patients With Aortocoronary Bypass (Executive)
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Purpose
GLP-1 has not only beneficial effects on glucose metabolism but also direct positive effects on cardiac function and metabolism in both experimental models and in patients with type 2 diabetes mellitus. Clinical data on the effects of GLP-1 agonists on cardiac function and glucose control in diabetic patients undergoing cardiac surgery are not known. Based on the results of experimental studies there is a potential for exenatide to positively influence both cardiac function and glucose metabolism in cardiac surgery patients with type 2 diabetes mellitus. The primary endpoint of this study is to examine whether pre- and peri-operative administration of exenatide affects perioperative hemodynamics, echocardiographic parameters, necessity of antiarrhythmic and inotropic treatment and glucose control in type 2 diabetics with coronary atherosclerosis and left ventricular dysfunction elective undergoing coronary artery bypass grafting operation (CABG). In addition, safety and tolerability of peri-operative administration of exenatide in these patients will be examined as a secondary study objective.
| Condition | Intervention | Phase |
|---|---|---|
|
Coronary Artery Disease Left Ventricular Dysfunction Type 2 Diabetes Mellitus |
Drug: Exenatide |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | EXEnatide in Diabetic Patients Undergoing Coronary Artery Bypass Grafting for Improved glUcose conTrol and hemodynamIc ValuEs |
- Cardiac function - echocardiographic parameters [ Time Frame: 90 days after administration of exenatide ] [ Designated as safety issue: No ]
- cardiac chamber dimensions
- left ventricular systolic function
- left ventricular diastolic function
- right ventricular systolic function
- Number of participants with adverse effects [ Time Frame: 90 days after administration of exenatide ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 38 |
| Study Start Date: | June 2011 |
| Estimated Study Completion Date: | February 2013 |
| Estimated Primary Completion Date: | August 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Exenatide
Patients with left ventricular dysfunction undergoing elective coronary artery by-pass grafting receiving perioperatively i.v. exenatide on top of standard treatment
|
Drug: Exenatide
Perioperative continuous i.v. administration of exenatide lasting for 72 hours - 40 ng/min for initial 30 min, 20 ng/min for remaining 71.5 hours
|
|
No Intervention: Control
Patients with left ventricular dysfunction undergoing elective coronary artery by-pass grafting receiving standard treatment
|
Eligibility| Ages Eligible for Study: | 18 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- established diagnosis of type 2 diabetes mellitus treated by oral antidiabetic agents
- elective coronary artery bypass grafting operation (CABG)
- LV systolic dysfunction (EF LV ≤ 40%)
- Age 18 to 85
Exclusion Criteria:
- allergy to exenatide
- allergy to insulin
- mental incapacity or language barrier
- use of incretin-based therapies <3 months before inclusion in the study
- diabetic ketoacidosis
- established autonomic neuropathy
- history of acute pancreatitis or severe disease of digestive tract
- renal failure (preoperative creatinine ≥ 180 umol/l)
- liver failure (coagulation times more than 1.5 times higher without use of anticoagulants)
- chronic intensified insulin regimen treatment (more than two insulin injections/day)
- cardiac surgical procedure on valve, thoracic aorta or MAZE procedure
- pregnancy and lactation
Contacts and Locations| Contact: Martin Haluzik, D.Sc. | +420 224 96 29 08 | mhalu@lf1.cuni.cz |
| Contact: Milos Mraz, M.D. | +420 224 96 28 84 | milos_mraz@yahoo.co.uk |
| Czech Republic | |
| General University Hospital | Recruiting |
| Prague, Czech Republic, 128 08 | |
| Contact: Milos Mraz, M.D. +420 224 96 28 84 milos_mraz@yahoo.co.uk | |
| Principal Investigator: | Martin Haluzik, D.Sc. | General University Hospital, Charles University, Prague |
More Information
No publications provided
| Responsible Party: | Prof. Martin Haluzik, M.D., D.Sc., General University Hospital, Charles University Prague |
| ClinicalTrials.gov Identifier: | NCT01373216 History of Changes |
| Other Study ID Numbers: | H8O-CY-O027 |
| Study First Received: | June 10, 2011 |
| Last Updated: | June 13, 2011 |
| Health Authority: | Czech Republic: State Institute for Drug Control |
Additional relevant MeSH terms:
|
Coronary Artery Disease Myocardial Ischemia Coronary Disease Diabetes Mellitus Diabetes Mellitus, Type 2 Ventricular Dysfunction, Left Ventricular Dysfunction Heart Diseases Cardiovascular Diseases Arteriosclerosis |
Arterial Occlusive Diseases Vascular Diseases Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Exenatide Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013