NCT00989508

Brief Summary

Open-heart surgery causes injury of the heart muscle. Although this is usually mild, temporary and reversible, if it is severe it can endanger life and require additional high cost care. During surgery, techniques are used to protect the heart from injury, but these remain imperfect. Patients with a thickened wall of the heart (left ventricular hypertrophy) may be at greater risk. This study assesses the effect of facilitating sugar metabolism (a more efficient fuel) by the heart muscle using the drug Perhexiline given before the operation. This treatment has a sound experimental basis for improving outcome. If this improvement is confirmed surgical results could be improved. The investigators will be studying heart function, heart muscle energy stores and chemicals which quantify the amount of heart muscle injury. The investigators' hypothesis is that Perhexiline will improve the protection of the heart by decreasing damage that may occur during heart surgery.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
220

participants targeted

Target at P75+ for phase_2

Timeline
Completed

Started Oct 2009

Typical duration for phase_2

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 1, 2009

Completed
1 day until next milestone

First Submitted

Initial submission to the registry

October 2, 2009

Completed
3 days until next milestone

First Posted

Study publicly available on registry

October 5, 2009

Completed
2.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2012

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2012

Completed
Last Updated

August 11, 2011

Status Verified

April 1, 2011

Enrollment Period

2.9 years

First QC Date

October 2, 2009

Last Update Submit

August 10, 2011

Conditions

Keywords

PerhexilineAortic Valve StenosisHypertrophy, Left VentricularMyocardial Reperfusion InjuryCardiac Output, LowTroponin

Outcome Measures

Primary Outcomes (1)

  • Absolute difference in Cardiac Index (>0.3 l/min/m2)

    6 hours post-removal of aortic X-clamp

Secondary Outcomes (3)

  • Incidence of Low Cardiac Output Syndrome

    6 hours post-removal of aortic X-clamp

  • Incidence of inotrope use according to protocol

    6 and 12 hours post-removal of aortic X-clamp

  • Peak and total release of Troponin

    12 and 24 hours post-release of aortic X-clamp

Study Arms (2)

Perhexiline

EXPERIMENTAL

Pre-operative administration of Perhexiline tablets according to dosing schedule

Drug: Perhexiline

Placebo marked PEXSIG

PLACEBO COMPARATOR

Pre-operative administration of placebo tablets according to dosing schedule

Drug: Placebo marked PEXSIG

Interventions

Tablets. Dose: 200mg BD for 3 days, then 100mg BD until surgery. Duration of therapy: 5-31 days.

Also known as: PEXSIG
Perhexiline

Tablets. Dose: 200mg BD for 3 days, then 100mg BD until surgery. Duration of therapy: 5-31 days.

Placebo marked PEXSIG

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adult
  • First-time
  • Aortic valve surgery for aortic stenosis +/- coronary artery bypass

You may not qualify if:

  • Diabetes Mellitus
  • Renal impairment with Creatinine greater than or equal to 200micromol/L
  • Atrial fibrillation
  • Amiodarone therapy, recent (in last month) or current
  • Hepatic impairment, significant preoperative
  • Peripheral neuropathy
  • Pregnancy or breast-feeding
  • Emergency surgery or required on clinical grounds within 5 days of referral

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University Hospital Birmingham

Birmingham, West Midlands, B15 2TH, United Kingdom

RECRUITING

Related Publications (3)

  • Quinn DW, Pagano D, Bonser RS, Rooney SJ, Graham TR, Wilson IC, Keogh BE, Townend JN, Lewis ME, Nightingale P; Study Investigators. Improved myocardial protection during coronary artery surgery with glucose-insulin-potassium: a randomized controlled trial. J Thorac Cardiovasc Surg. 2006 Jan;131(1):34-42. doi: 10.1016/j.jtcvs.2005.05.057.

    PMID: 16399292BACKGROUND
  • Ranasinghe AM, Quinn DW, Pagano D, Edwards N, Faroqui M, Graham TR, Keogh BE, Mascaro J, Riddington DW, Rooney SJ, Townend JN, Wilson IC, Bonser RS. Glucose-insulin-potassium and tri-iodothyronine individually improve hemodynamic performance and are associated with reduced troponin I release after on-pump coronary artery bypass grafting. Circulation. 2006 Jul 4;114(1 Suppl):I245-50. doi: 10.1161/CIRCULATIONAHA.105.000786.

    PMID: 16820580BACKGROUND
  • Ashrafian H, Horowitz JD, Frenneaux MP. Perhexiline. Cardiovasc Drug Rev. 2007 Spring;25(1):76-97. doi: 10.1111/j.1527-3466.2007.00006.x.

    PMID: 17445089BACKGROUND

MeSH Terms

Conditions

Myocardial Reperfusion InjuryCardiac Output, LowHypertrophy, Left VentricularAortic Valve Stenosis

Interventions

Perhexiline

Condition Hierarchy (Ancestors)

CardiomyopathiesHeart DiseasesCardiovascular DiseasesMyocardial IschemiaVascular DiseasesReperfusion InjuryPostoperative ComplicationsPathologic ProcessesPathological Conditions, Signs and SymptomsSigns and SymptomsCardiomegalyHypertrophyPathological Conditions, AnatomicalAortic Valve DiseaseHeart Valve DiseasesVentricular Outflow Obstruction

Intervention Hierarchy (Ancestors)

PiperidinesHeterocyclic Compounds, 1-RingHeterocyclic Compounds

Study Officials

  • Domeinco Pagano, MD FRCS

    University Hospital Birmingham

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Eshan Senanayake, MBBS MRCS

CONTACT

Nigel E Drury, BM MRCS

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER

Study Record Dates

First Submitted

October 2, 2009

First Posted

October 5, 2009

Study Start

October 1, 2009

Primary Completion

September 1, 2012

Study Completion

December 1, 2012

Last Updated

August 11, 2011

Record last verified: 2011-04

Locations