Ticagrelor Removal Study Using CytoSorb® 300 mL Device During CPB in Patients Undergoing Emergent Cardiothoracic Surgery (CyTation)
Primary Purpose
Acute Coronary Syndrome
Status
Terminated
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Blood sampling and analysis
Sponsored by
About this trial
This is an interventional treatment trial for Acute Coronary Syndrome focused on measuring Cardiopulmonary bypass, CPB, Ticagrelor removal, CytoSorb, Platelet reactivity, MEA platform test, Intensive care medicine, Hemadsorbtion, Extracorporeal blood purification, Coronary Artery Bypass Grafting, CABG, Cardiac Surgery, Aortic valve replacement, Mitral valve replacement
Eligibility Criteria
Inclusion Criteria:
- Signed informed consent
- Males and females aged ≥18 years
- Patients treated with ticagrelor
- Emergency Coronary Artery Bypass Graft (CABG) surgery
- Cardiothoracic surgery requiring CPB ≤24 hours following the last dose of ticagrelor
Exclusion Criteria:
- Any cardiothoracic surgery >24 hours after last dose of ticagrelor
- Resuscitation
- Any pre-operative coagulopathy unrelated to ticagrelor or standard of care (SoC) to undergo surgery with CPB
- Sepsis (according to Sepsis 3.0 definition)
- Malignant tumor
- Left ventricular ejection fraction (LVEF) < 20%
- History or presence of significant pulmonary, hepatic, renal, hematologic, gastrointestinal, endocrine, immunologic, neurologic, or psychiatric disease which, in the opinion of the Investigator, increases risk to the patient or could confound the results of the study
- Presence of end-stage renal disease or currently receiving renal replacement therapy
- Patients with a history of major organ transplantation
- Patients in acute sickle cell crisis
- Patients concurrently requiring immunosuppressive therapy, with the exception of corticosteroids, or who are profoundly immune suppressed (e.g. CD4 < 200 or neutropenia with ANC < 1000/μL)
- Women of childbearing potential with a positive pregnancy test performed during the current admission or who are lactating. Women are considered not of child bearing potential if they have been sterilized at least 6 months prior to the study or if they are post-menopausal, defined as amenorrhea for at least 12 months
Sites / Locations
- University Hospital Essen
- Asklepios Hospital St. Georg Hamburg
- University Hospital Jena
- Institut National de Chirurgie Cardiaque et de Cardiologie Interventionnelle
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
patients on ticagrelor undergoing emergent cardiothoracic surgery requiring CPB
Arm Description
Outcomes
Primary Outcome Measures
Platelet reactivity
Proportion of patients with post-operative platelet reactivity to ADP above the level associated with increased bleeding risk (≥ 22 ADP-induced platelet aggregation units (AUC in units)) measured on the MEA platform immediately after CPB compared to immediately before CPB.
Secondary Outcome Measures
Full Information
NCT ID
NCT04625764
First Posted
November 6, 2020
Last Updated
January 21, 2022
Sponsor
CytoSorbents Europe GmbH
1. Study Identification
Unique Protocol Identification Number
NCT04625764
Brief Title
Ticagrelor Removal Study Using CytoSorb® 300 mL Device During CPB in Patients Undergoing Emergent Cardiothoracic Surgery
Acronym
CyTation
Official Title
A Prospective, Open, Multi-center, Single-arm Study to Demonstrate the Feasibility of the CytoSorb® 300 mL Device to Remove Ticagrelor During Cardiopulmonary Bypass in Patients on Ticagrelor Undergoing Emergent Cardiothoracic Surgery
Study Type
Interventional
2. Study Status
Record Verification Date
January 2022
Overall Recruitment Status
Terminated
Why Stopped
Due to Corona pandemic, planned ammount of enrolled patient could not be reached, protocol section "Early termination of the study" - criterion "Difficulties in recruiting patients" is fully met->recruitment period will not be extended
Study Start Date
February 23, 2021 (Actual)
Primary Completion Date
October 14, 2021 (Actual)
Study Completion Date
December 14, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CytoSorbents Europe GmbH
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The aim of CyTation is to demonstrate intra-operative removal of ticagrelor by CytoSorb® hemadsorption in patients on ticagrelor undergoing emergent cardiothoracic surgery requiring CPB, using platelet reactivity to adenosine diphosphate (ADP) as a pharmacodynamics surrogate measure of ticagrelor levels in blood.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Coronary Syndrome
Keywords
Cardiopulmonary bypass, CPB, Ticagrelor removal, CytoSorb, Platelet reactivity, MEA platform test, Intensive care medicine, Hemadsorbtion, Extracorporeal blood purification, Coronary Artery Bypass Grafting, CABG, Cardiac Surgery, Aortic valve replacement, Mitral valve replacement
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)
8. Arms, Groups, and Interventions
Arm Title
patients on ticagrelor undergoing emergent cardiothoracic surgery requiring CPB
Arm Type
Experimental
Intervention Type
Procedure
Intervention Name(s)
Blood sampling and analysis
Intervention Description
Blood sampling for pharmacokinetics (Plasma ticagrelor concentrations and its metabolite) and MEA platform testing (ADPtest, TRAPtest)
Primary Outcome Measure Information:
Title
Platelet reactivity
Description
Proportion of patients with post-operative platelet reactivity to ADP above the level associated with increased bleeding risk (≥ 22 ADP-induced platelet aggregation units (AUC in units)) measured on the MEA platform immediately after CPB compared to immediately before CPB.
Time Frame
8 hours
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed informed consent
Males and females aged ≥18 years
Patients treated with ticagrelor
Emergency Coronary Artery Bypass Graft (CABG) surgery
Cardiothoracic surgery requiring CPB ≤24 hours following the last dose of ticagrelor
Exclusion Criteria:
Any cardiothoracic surgery >24 hours after last dose of ticagrelor
Resuscitation
Any pre-operative coagulopathy unrelated to ticagrelor or standard of care (SoC) to undergo surgery with CPB
Sepsis (according to Sepsis 3.0 definition)
Malignant tumor
Left ventricular ejection fraction (LVEF) < 20%
History or presence of significant pulmonary, hepatic, renal, hematologic, gastrointestinal, endocrine, immunologic, neurologic, or psychiatric disease which, in the opinion of the Investigator, increases risk to the patient or could confound the results of the study
Presence of end-stage renal disease or currently receiving renal replacement therapy
Patients with a history of major organ transplantation
Patients in acute sickle cell crisis
Patients concurrently requiring immunosuppressive therapy, with the exception of corticosteroids, or who are profoundly immune suppressed (e.g. CD4 < 200 or neutropenia with ANC < 1000/μL)
Women of childbearing potential with a positive pregnancy test performed during the current admission or who are lactating. Women are considered not of child bearing potential if they have been sterilized at least 6 months prior to the study or if they are post-menopausal, defined as amenorrhea for at least 12 months
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kambiz Hassan, M.D.
Organizational Affiliation
Asklepios Kliniken Hamburg gGmbH, Asklepios Klinik St. Georg, Abteilung für Herzchirurgie/ Chefarzt Prof. Michael Schmoeckel, Lohmühlenstr. 5, 20099 Hamburg/Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital Essen
City
Essen
ZIP/Postal Code
45147
Country
Germany
Facility Name
Asklepios Hospital St. Georg Hamburg
City
Hamburg
ZIP/Postal Code
20099
Country
Germany
Facility Name
University Hospital Jena
City
Jena
ZIP/Postal Code
07747
Country
Germany
Facility Name
Institut National de Chirurgie Cardiaque et de Cardiologie Interventionnelle
City
Luxembourg
ZIP/Postal Code
1210
Country
Luxembourg
12. IPD Sharing Statement
Learn more about this trial
Ticagrelor Removal Study Using CytoSorb® 300 mL Device During CPB in Patients Undergoing Emergent Cardiothoracic Surgery
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