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Effects Contrast on Platelet Activity, Thrombosis and Fibrinolysis in Patients Undergoing Coronary Angiography

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ClinicalTrials.gov Identifier: NCT01848899
Recruitment Status : Completed
First Posted : May 8, 2013
Results First Posted : April 6, 2016
Last Update Posted : April 6, 2016
Sponsor:
Collaborator:
Guerbet
Information provided by (Responsible Party):
NYU Langone Health

Study Description
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Brief Summary:
The aim of this study is to determine how two different types of iodinated contrast media (CM) agents, low-osmolar ionic ioxaglate and iso-osmolar non-ionic iodixanol, affect specific markers of thrombogenesis and platelet function in patients undergoing coronary angiography, and if the use of bivalirudin, a direct thrombin inhibitor used during percutaneous coronary intervention (PCI), affects any contrast-related changes in thrombogenesis and platelet function.

Condition or disease Intervention/treatment Phase
Coronary Artery Disease Drug: Iodixanol Drug: Ioxaglate Drug: Bivalirudin Phase 4

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 100 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Official Title: The Assesment of Thrombotic Markers Utilizing Ionic Versus Non-Ionic Contrast During Coronary Angiography and Intervention (AToMIC) Trial
Study Start Date : February 2013
Actual Primary Completion Date : November 2013
Actual Study Completion Date : November 2014

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Arms and Interventions
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Arm Intervention/treatment
Experimental: Ioxaglate Arm Drug: Ioxaglate
contrast media used during coronary angiography
Other Name: Hexabrix

Drug: Bivalirudin
A direct thrombin inhibitor
Other Names:
  • Angiomax
  • Angiox
Experimental: Iodixanol arm Drug: Iodixanol
contrast media used during coronary angiography
Other Name: Visipaque

Drug: Bivalirudin
A direct thrombin inhibitor
Other Names:
  • Angiomax
  • Angiox


Outcome Measures
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Primary Outcome Measures :
  1. Thrombin Generation Test: Baseline [ Time Frame: baseline ]
    The thrombin generation test uses recombinant tissue factor as a stimulus to initiate thrombin generation in plasma samples. The outcome from this assay is reported as area under the curve and represents the amount of thrombin in each sample. The curve is created by measuring the generated thrombin every 20 seconds from 0 to 95 minutes post stimulus.

  2. Thrombin Generation Test: After Coronary Angiography [ Time Frame: 1 hour ]
    The thrombin generation test uses recombinant tissue factor as a stimulus to initiate thrombin generation in plasma samples. The outcome from this assay is reported as area under the curve and represents the amount of thrombin in each sample. The curve is created by measuring the generated thrombin every 20 seconds from 0 to 95 minutes post stimulus.


Secondary Outcome Measures :
  1. Percent Change in Maximal Platelet Aggregation: Epinephrine [ Time Frame: Baseline to 1 hour ]
    Percent change in maximal platelet aggregation from pre- to post-contrast in response to 10 μM epinephrine

  2. Percent Change in Maximal Platelet Aggregation: Arachidonic Acid [ Time Frame: 1 hour ]
    Percent change in maximal platelet aggregation from pre- to post-contrast in response to 1600 μM arachidonic acid

  3. Percent Change in Maximal Platelet Aggregation: ADP [ Time Frame: 1 hour ]
    Percent change in maximal platelet aggregation from pre- to post-contrast in response to 20 μM of ADP


Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must be more than 18 years of age
  • referred for coronary angiography and on dual anti-platelet therapy (aspirin and clopidogrel).

Exclusion Criteria:

  • on warfarin
  • on low molecular weight heparin within 12 hours of coronary angiography or unfractionated heparin with activated clotting time >150 at time of procedure -on cilostazol
  • on persantine
  • on non- steroidal anti-inflammatory medications (ibuprofen/motrin/advil, naproxen/aleve, indomethacin, sulindac, etodolac, diclofenac, celecoxib) within 72 hours of procedure
  • on prasugrel (not an exclusion criteria for ST-segment elevation myocardial infarction registry
  • undergoing coronary angiography via radial access
  • undergoing planned diagnostic coronary angiography only
  • unable to tolerate dual anti-platelet therapy
  • with known allergy to CM
  • received CM within 24 hours of coronary angiography
  • on dialysis
  • do not consent or are unable to give consent
  • are participating in another competing study.
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01848899


Locations
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United States, New York
New York University School of Medicine
New York, New York, United States, 10016
Sponsors and Collaborators
NYU Langone Health
Guerbet
Investigators
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Principal Investigator: Fred Feit, MD NYU Langone Health
Principal Investigator: Binita Shah, MD, MS NYU Langone Health
More Information
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Responsible Party: NYU Langone Health
ClinicalTrials.gov Identifier: NCT01848899    
Other Study ID Numbers: 12-02409
First Posted: May 8, 2013    Key Record Dates
Results First Posted: April 6, 2016
Last Update Posted: April 6, 2016
Last Verified: March 2016
Keywords provided by NYU Langone Health:
Coronary angiography
Percutaneous coronary intervention
Contrast media
 Platelet activity
Thrombin generation
Fibrinolysis
Additional relevant MeSH terms:
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Coronary Artery Disease
Coronary Disease
Myocardial Ischemia
Heart Diseases
Cardiovascular Diseases
Arteriosclerosis
Arterial Occlusive Diseases
Vascular Diseases
 Bivalirudin
Antithrombins
Serine Proteinase Inhibitors
Protease Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Anticoagulants