NCT03074214

Brief Summary

ST-elevation myocardial infarction (STEMI) has a serious health threaten to population. PCI, which can timely restore the blood flow to the ischemic myocardium, is a well-proved measure in STEMI management. However, the process of the restoration can induce injury. The phenomenon is defined as ischemia/reperfusion (I/R) injury. The studies indicate that I/R injury accounts for up to 50% of the final myocardial infarct size. However, previous attempts to target known mediators of myocardial I/R injury in patients have been disappointing, leading to calls for a reevaluation of factors affecting myocardial I/R injury \[1\]. Arginine vasopressin (AVP), that response to acute illness, is unstable and cleared rapidly from the circulation. However, copeptin, the C-terminal portion of provasopressin, is released in equimolar amounts to AVP and is easy to determine. So, copeptin can be a surrogate marker for AVP secretion. Recently, copeptin was found to serve as a potential prognostic biomarker in heart failure and acute myocardial infarction (AMI). AMI can activate the AVP axis, which have a causative role in the evolution of heart failure. Increasing copeptin was shown to correlate with myocardial remodeling, mortality and morbidity. In patients with STEMI, myocardial infarct size is a stronger outcome predictor than LV function, and is related to LV remodeling, which often indicates a significant worse prognosis after AMI. As the gold standard for characterisation of cardiac structure and function, cardiac magnetic resonance (CMR) parameters can serve as surrogate end points in clinical trials of STEMI. We hypothesised that plasma copeptin values, tested before and after PCI, are related to myocardial infarct size, myocardial function both and outcomes at baseline and 6 months follow-up as assessed by CMR in patients with STEMI.

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
275

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Mar 2017

Typical duration for all trials

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

First Submitted

Initial submission to the registry

February 28, 2017

Completed
6 days until next milestone

Study Start

First participant enrolled

March 6, 2017

Completed
2 days until next milestone

First Posted

Study publicly available on registry

March 8, 2017

Completed
2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 28, 2019

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2019

Completed
Last Updated

March 10, 2017

Status Verified

March 1, 2017

Enrollment Period

2 years

First QC Date

February 28, 2017

Last Update Submit

March 9, 2017

Conditions

Keywords

copeptinmyocardial infarct sizeprognosisST-elevation myocardial infarctionpercutaneous coronary intervention

Outcome Measures

Primary Outcomes (1)

  • Major adverse cardiovascular events (MACE)

    Composite of MACE including cardiac death, non-fatal myocardial reinfarction, unplanned repeat revascularization, congestive heart failure or angina requiring rehospitalization or an emergency room visit, ventricular fibrillation or ventricular tachycardia with hemodynamic instability

    6 months

Secondary Outcomes (17)

  • All-cause death

    6 months

  • Cardiac death

    6 months

  • unplanned repeat revascularization

    6 months

  • congestive heart failure requiring rehospitalization or an emergency room visit

    6 months

  • angina requiring rehospitalization or an emergency room visit

    6 months

  • +12 more secondary outcomes

Study Arms (1)

STEMI patients receiving PCI

patients with STEMI receiving percutaneous coronary intervention

Procedure: percutaneous coronary intervention

Interventions

All STEMI patients enrolled will at first receive "Device"(such as: stent or balloon) treatment for their coronary artery.

STEMI patients receiving PCI

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

275 patients with STEMI receiving PPCI in department of Cardiology, Shengjing Hospital of China Medical University from March 1, 2017 to February 28, 2019

You may qualify if:

  • chest pain present less than 12 hours from onset of pain to time of catheterization;
  • significant ST-segment elevation (at least 0.1 mV in two or more standard leads or at least 0.2 mV in two or more contiguous precordial leads) or a new left bundle branch block;
  • receiving primary PCI.

You may not qualify if:

  • Patients with conditions other than STEMI that could cause increased copeptin levels, such as renal dysfunction (eGFR\<30 ml/min), liver failure, respiratory tract infection, stroke, sepsis, hyponatremia (Serum sodium concentration\<135mmol/L), central diabetes insipidus or malignancy;
  • Patients with contraindications to perform cardiac magnetic resonance;
  • Patients with cardiogenic shock (Killip class IV);
  • Patients in whom reperfusion therapy failed;
  • Patients who were referred for emergency coronary artery bypass grafting (CABG) in view of unfavourable coronary anatomy.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Shengjing Hospital of China Medical University

Shenyang, Liaoning, 8611004, China

RECRUITING

Related Publications (2)

  • Ellis SG, Tendera M, de Belder MA, van Boven AJ, Widimsky P, Janssens L, Andersen HR, Betriu A, Savonitto S, Adamus J, Peruga JZ, Kosmider M, Katz O, Neunteufl T, Jorgova J, Dorobantu M, Grinfeld L, Armstrong P, Brodie BR, Herrmann HC, Montalescot G, Neumann FJ, Effron MB, Barnathan ES, Topol EJ; FINESSE Investigators. Facilitated PCI in patients with ST-elevation myocardial infarction. N Engl J Med. 2008 May 22;358(21):2205-17. doi: 10.1056/NEJMoa0706816.

    PMID: 18499565BACKGROUND
  • O'Malley RG, Bonaca MP, Scirica BM, Murphy SA, Jarolim P, Sabatine MS, Braunwald E, Morrow DA. Prognostic performance of multiple biomarkers in patients with non-ST-segment elevation acute coronary syndrome: analysis from the MERLIN-TIMI 36 trial (Metabolic Efficiency With Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndromes-Thrombolysis In Myocardial Infarction 36). J Am Coll Cardiol. 2014 Apr 29;63(16):1644-53. doi: 10.1016/j.jacc.2013.12.034. Epub 2014 Feb 13.

    PMID: 24530676BACKGROUND

Biospecimen

Retention: SAMPLES WITHOUT DNA

A venous blood sample will be collected at before, immediately after, and 3 days after PPCI and 6-month visit for biomarker analysis and storage for future studies.

MeSH Terms

Conditions

ST Elevation Myocardial InfarctionDiabetes Insipidus

Interventions

Percutaneous Coronary Intervention

Condition Hierarchy (Ancestors)

Myocardial InfarctionMyocardial IschemiaHeart DiseasesCardiovascular DiseasesVascular DiseasesInfarctionIschemiaPathologic ProcessesPathological Conditions, Signs and SymptomsNecrosisKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital DiseasesPituitary DiseasesEndocrine System Diseases

Intervention Hierarchy (Ancestors)

Endovascular ProceduresVascular Surgical ProceduresCardiovascular Surgical ProceduresSurgical Procedures, OperativeMinimally Invasive Surgical Procedures

Study Officials

  • Zhaoqing Su, Doctor

    Shengjing Hospital

    STUDY CHAIR

Central Study Contacts

Tongtong Yu, Doctor

CONTACT

Zhijun Su, Doctor

CONTACT

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

February 28, 2017

First Posted

March 8, 2017

Study Start

March 6, 2017

Primary Completion

February 28, 2019

Study Completion

August 31, 2019

Last Updated

March 10, 2017

Record last verified: 2017-03

Data Sharing

IPD Sharing
Will not share

We will not share IPD to protect our data very well.

Locations