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Using Left Atrium Appendage Closure in NVAF Patients With High Risk of Ischemic Stroke (SAFE-PROTECT)

Primary Purpose

Atrial Fibrillation, Stroke

Status
Active
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Left atrial appendage closure procedure
Sponsored by
Shanghai MicroPort Medical (Group) Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Atrial Fibrillation focused on measuring LAAC, NVAF, ischemic stroke

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Non valvular atrial fibrillation subjects aged ≥18 and ≤80;
  • High risk of ischemic stroke: CHA2DS2VASc score ≥ 2 ( ≥ 3 for female) together with any of the following circumstances:

    1. With a recorded history (happened earlier than 6 months from now) of bleeding (including gingival/nasal/oral bleeding, skin &soft tissue bleeding, gastrointestinal bleeding, urinary tract bleeding, cerebral haemorrhage, etc.) or bleeding tendency;
    2. Intolerance or rejection of long-term anti-coagulation therapy;
    3. Suffering stroke or embolism despite routine anti-coagulation therapy;
    4. With a predicting HAS-BLED score ≥3.
  • Subjects (or his/her legal representatives) are able to understand the study objectives, willing to cooperate with procedure and follow-up. Subjects who voluntarily participate in this trial and have signed the written informed consent form.

Exclusion Criteria:

  • Subjects with atrial fibrillation (AF) caused by rheumatic valvular disease, moderate to severe mitral stenosis, severe mitral regurgitation, severe aortic valve disease or severe left ventricular outflow tract obstruction with pressure difference greater than 40mmHg;
  • Suffering with other disease(s) requiring long-term oral anticoagulation treatment;
  • Initial untreated AF, or secondary AF with clear cause (such as hyperthyroid heart disease);
  • Intracardiac thrombus (including left and/or right atrium) found or persisted;
  • Suffered with myocardial infarction within 3 months;
  • History of previous atrial septum repair operation or Atrial Septal Occluder implantation;
  • History of previous heart valve (mechanical valve) replacement operation;
  • Subjects undergoing heart transplant operation;
  • Subjects with symptomatic carotid artery disease (such as carotid stenosis > 50%) or subjects with vulnerable carotid artery plaque.
  • Suffered with ischemic stroke or TIA recently (within 30 days);
  • Known complex active atherosclerotic plaque(s) in the descending aorta or aortic arch;
  • Severe heart failure (NYHA Grade Ⅳ);
  • The investigator assessed that there were abnormal result(s) with clinical significance in the routine blood test of subjects;
  • Severe renal abnormal: serum creatinine >250μmol/l; or on dialysis;
  • Allergic or contraindicated to aspirin, clopidogrel, heparin, contrast agent, and nitinol alloy;
  • Subjects who are scheduled to receive operation within 1 year after procedure, and need to stop anti-thrombotic therapy;
  • Pregnant or breast-feeding subjects, or subjects who plan to have a child within 1 year after procedure;
  • Subjects with a life expectancy less than 12 months;
  • Subjects who are participating in another investigational drug or device clinical trial in which the primary endpoint is still not reached before enrolment;
  • Subjects have other reasons that cannot maintain 2 months anticoagulation or 6 months dual antiplatelet therapy;
  • Subjects with poor compliance (judged by investigator) or cannot complete the study according to the protocol due to other reasons;
  • Subjects who are unsuitable to receive LAA occlusion treatment (judged by investigator).

Sites / Locations

  • Shanghai Chest Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Microport CardioAdvance LAAC system

Watchman LAAC system

Arm Description

Subject implant Microport CardioAdvance LAAC system to occlude LAA through percutaneous intervention.

Subject implant Watchman LAAC system to occlude LAA through percutaneous intervention.

Outcomes

Primary Outcome Measures

Clinical success
Freedom from ischemic stroke, hemorrhagic stroke, systemic embolism, cardiovascular death and unexplained death

Secondary Outcome Measures

LAA occlusion success
TEE examination showing that the residual shunt < 5mm jet width or complete occlusion of LAA

Full Information

First Posted
July 16, 2020
Last Updated
October 18, 2023
Sponsor
Shanghai MicroPort Medical (Group) Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04479722
Brief Title
Using Left Atrium Appendage Closure in NVAF Patients With High Risk of Ischemic Stroke
Acronym
SAFE-PROTECT
Official Title
Safety And EFficacy of Using LEft Atrium APpendage Closure in Nonvalvular AtRial FibrillatiOn PatienTs With High Risk of ischEmiC sTroke -- A Prospective Multicenter Randomized Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 3, 2021 (Actual)
Primary Completion Date
September 27, 2022 (Actual)
Study Completion Date
September 30, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai MicroPort Medical (Group) Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
To evaluate the safety and efficacy of using Microport CardioAdvance Left Atrium Appendage Closure for preventing stroke in Non-valvular atrial fibrillation (NVAF) patients who have contraindications for long-term anti-coagulation. And to support registration approval from National Medical Products Administration (NMPA).
Detailed Description
SAFE-PROTECT trial is composed of Roll-in group, small-size group and RCT group. This trial is planned to conduct in about 20 sites from China. Roll-in group plans to enroll at most 3 subjects each site to implant experimental device for exploration and observation. RCT group plans to enroll no less than 210 subjects who meet the inclusion/exclusion criteria, and 1:1 randomly allocated to experimental arm or comparator arm.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Atrial Fibrillation, Stroke
Keywords
LAAC, NVAF, ischemic stroke

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
210 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Microport CardioAdvance LAAC system
Arm Type
Experimental
Arm Description
Subject implant Microport CardioAdvance LAAC system to occlude LAA through percutaneous intervention.
Arm Title
Watchman LAAC system
Arm Type
Active Comparator
Arm Description
Subject implant Watchman LAAC system to occlude LAA through percutaneous intervention.
Intervention Type
Device
Intervention Name(s)
Left atrial appendage closure procedure
Intervention Description
Implant LAAC system in LAA through percutaneous intervention
Primary Outcome Measure Information:
Title
Clinical success
Description
Freedom from ischemic stroke, hemorrhagic stroke, systemic embolism, cardiovascular death and unexplained death
Time Frame
12-month
Secondary Outcome Measure Information:
Title
LAA occlusion success
Description
TEE examination showing that the residual shunt < 5mm jet width or complete occlusion of LAA
Time Frame
12-month

10. Eligibility

Sex
All
Gender Based
Yes
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Non valvular atrial fibrillation subjects aged ≥18 and ≤80; High risk of ischemic stroke: CHA2DS2VASc score ≥ 2 ( ≥ 3 for female) together with any of the following circumstances: With a recorded history (happened earlier than 6 months from now) of bleeding (including gingival/nasal/oral bleeding, skin &soft tissue bleeding, gastrointestinal bleeding, urinary tract bleeding, cerebral haemorrhage, etc.) or bleeding tendency; Intolerance or rejection of long-term anti-coagulation therapy; Suffering stroke or embolism despite routine anti-coagulation therapy; With a predicting HAS-BLED score ≥3. Subjects (or his/her legal representatives) are able to understand the study objectives, willing to cooperate with procedure and follow-up. Subjects who voluntarily participate in this trial and have signed the written informed consent form. Exclusion Criteria: Subjects with atrial fibrillation (AF) caused by rheumatic valvular disease, moderate to severe mitral stenosis, severe mitral regurgitation, severe aortic valve disease or severe left ventricular outflow tract obstruction with pressure difference greater than 40mmHg; Suffering with other disease(s) requiring long-term oral anticoagulation treatment; Initial untreated AF, or secondary AF with clear cause (such as hyperthyroid heart disease); Intracardiac thrombus (including left and/or right atrium) found or persisted; Suffered with myocardial infarction within 3 months; History of previous atrial septum repair operation or Atrial Septal Occluder implantation; History of previous heart valve (mechanical valve) replacement operation; Subjects undergoing heart transplant operation; Subjects with symptomatic carotid artery disease (such as carotid stenosis > 50%) or subjects with vulnerable carotid artery plaque. Suffered with ischemic stroke or TIA recently (within 30 days); Known complex active atherosclerotic plaque(s) in the descending aorta or aortic arch; Severe heart failure (NYHA Grade Ⅳ); The investigator assessed that there were abnormal result(s) with clinical significance in the routine blood test of subjects; Severe renal abnormal: serum creatinine >250μmol/l; or on dialysis; Allergic or contraindicated to aspirin, clopidogrel, heparin, contrast agent, and nitinol alloy; Subjects who are scheduled to receive operation within 1 year after procedure, and need to stop anti-thrombotic therapy; Pregnant or breast-feeding subjects, or subjects who plan to have a child within 1 year after procedure; Subjects with a life expectancy less than 12 months; Subjects who are participating in another investigational drug or device clinical trial in which the primary endpoint is still not reached before enrolment; Subjects have other reasons that cannot maintain 2 months anticoagulation or 6 months dual antiplatelet therapy; Subjects with poor compliance (judged by investigator) or cannot complete the study according to the protocol due to other reasons; Subjects who are unsuitable to receive LAA occlusion treatment (judged by investigator).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ming Zheng, Prof.
Organizational Affiliation
MicroPort Orthopedics Inc.
Official's Role
Study Chair
Facility Information:
Facility Name
Shanghai Chest Hospital
City
Shanghai
State/Province
Shanghai
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Individual participant data that underlie the results reported in the article, after deidentification (text, tables, figures, and appendices) will be shared. Additionally, study protocol will be available. The data will become available for the beginning 3 months and ending 5 years following article publication. If the data sharing plan changes after registration, this should be reflected in the statement submitted and published with the manuscript, and updated in the registry record.
IPD Sharing Time Frame
For the beginning 3 months and ending 5 years following article publication
IPD Sharing Access Criteria
(with) Researchers who provide a methodologically sound proposal. (For the analysis) To achieve aims in the approved proposal. (Requisite mechanism) Proposals should be directed to mzheng@microport.com. To gain access, data requestors will need to sign a data access agreement. Data are available for 5 years at a third party website (Link to be included).

Learn more about this trial

Using Left Atrium Appendage Closure in NVAF Patients With High Risk of Ischemic Stroke

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