Pretreatment With Unfractionated Heparin for ST Elevation Myocardial Infarction (UFH-STEMI)
Primary Purpose
STEMI - ST Elevation Myocardial Infarction
Status
Not yet recruiting
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Unfractionated heparin
Sponsored by
About this trial
This is an interventional treatment trial for STEMI - ST Elevation Myocardial Infarction focused on measuring Myocardial Reperfusion, Unfractionated heparin, pre-treatment
Eligibility Criteria
Inclusion Criteria:
- Adult patients with STEMI referred for primary PCI
- Duration of symptoms less than 6 hours before presentation
Exclusion Criteria:
- Pregnancy
- Cardiogenic shock at presentation (hemodynamic instability)
- Cardiac arrest before randomization
- Duration of symptoms for more than 6 hours before presentation
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
Early unfractionated heparin
Control - Unfractionated heparin for coronary intervention only
Arm Description
Administration of UFH at a dose of 100 IU/kg body weight at first medical contact. Addition of UFH before coronary intervention according to ACT measurement after coronary angiography before coronary intervention.
Control arm with administration of UFH at a dose of 100 IU/kg body weight after coronary angiography before coronary intervention.
Outcomes
Primary Outcome Measures
TIMI flow
TIMI flow in culprit coronary artery at first coronary angiography
Secondary Outcome Measures
Bleeding
Bleeding assessed by Bleeding Academic Research Consortium (BARC) score. BARC incorporates 5 bleeding types, ranging from BARC 0 - no bleeding to BARC 5 - fatal bleeding.
Cardiogenic shock
Presence of cardiogenic shock at any time after randomization
30 day mortality after STEMI
30-day mortality after STEMI
Troponin I concentration 24 h after primary PCI
Troponin I concentration 24 h after primary PCI
Full Information
NCT ID
NCT05247424
First Posted
January 30, 2022
Last Updated
February 9, 2022
Sponsor
University Medical Centre Ljubljana
1. Study Identification
Unique Protocol Identification Number
NCT05247424
Brief Title
Pretreatment With Unfractionated Heparin for ST Elevation Myocardial Infarction
Acronym
UFH-STEMI
Official Title
Pretreatment With Unfractionated Heparin for ST Elevation Myocardial Infarction
Study Type
Interventional
2. Study Status
Record Verification Date
February 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
February 15, 2022 (Anticipated)
Primary Completion Date
May 30, 2023 (Anticipated)
Study Completion Date
September 30, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University Medical Centre Ljubljana
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Rupture of a coronary artery plaque leads to thrombotic occlusion of the coronary artery and would present as ST segment elevation myocardial infarction. Early treatment with aspirin and early primary percutaneous coronary intervention are indicated. Anticoagulation therapy, usually with unfractionated heparin, is required during percutaneous coronary intervention.
Investigators hypothesis is that pretreatment with unfractionated heparin in addition to aspirin at first medical contact may facilitate spontaneous reperfusion of culprit artery and procedural thrombotic complication in patients with ST elevation myocardial infarction without significant risk of bleeding complications.
Detailed Description
Randomization of patients with STEMI at first medical contact in a 1:1 ratio into an intervention group receiving 100 IU of unfractionated heparin (UFH) per kilogram of body weight IV and later additionally UFH after diagnostic coronary angiography according to the activated clotting time (ACT) and a control group receiving only UFH after diagnostic coronary angiography at the dose of 100 IU per kilogram of body weight.
The primary end point of the study is TIMI flow at coronary angiography. Secondary endpoints are: Bleeding complications (defined by BARC score), occurrence of cardiogenic shock, and 30-day mortality.
Investigators plan to randomize 600 patients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
STEMI - ST Elevation Myocardial Infarction
Keywords
Myocardial Reperfusion, Unfractionated heparin, pre-treatment
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Model Description
randomization in 1:1 ratio
Masking
Outcomes Assessor
Masking Description
Interventional cardiologists evaluating coronary angiography will be blinded to assigned group
Allocation
Randomized
Enrollment
600 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Early unfractionated heparin
Arm Type
Experimental
Arm Description
Administration of UFH at a dose of 100 IU/kg body weight at first medical contact. Addition of UFH before coronary intervention according to ACT measurement after coronary angiography before coronary intervention.
Arm Title
Control - Unfractionated heparin for coronary intervention only
Arm Type
No Intervention
Arm Description
Control arm with administration of UFH at a dose of 100 IU/kg body weight after coronary angiography before coronary intervention.
Intervention Type
Drug
Intervention Name(s)
Unfractionated heparin
Intervention Description
Unfractionated heparin at dose of 100 IU /kg body weight
Primary Outcome Measure Information:
Title
TIMI flow
Description
TIMI flow in culprit coronary artery at first coronary angiography
Time Frame
Day 0
Secondary Outcome Measure Information:
Title
Bleeding
Description
Bleeding assessed by Bleeding Academic Research Consortium (BARC) score. BARC incorporates 5 bleeding types, ranging from BARC 0 - no bleeding to BARC 5 - fatal bleeding.
Time Frame
Day 0
Title
Cardiogenic shock
Description
Presence of cardiogenic shock at any time after randomization
Time Frame
Day 0 to 10
Title
30 day mortality after STEMI
Description
30-day mortality after STEMI
Time Frame
30 days
Title
Troponin I concentration 24 h after primary PCI
Description
Troponin I concentration 24 h after primary PCI
Time Frame
24 h
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Adult patients with STEMI referred for primary PCI
Duration of symptoms less than 6 hours before presentation
Exclusion Criteria:
Pregnancy
Cardiogenic shock at presentation (hemodynamic instability)
Cardiac arrest before randomization
Duration of symptoms for more than 6 hours before presentation
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Miša Fister, MD, PhD
Phone
+38615229825
Email
misa.fister@gmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Tomaz Goslar, MD, PhD
Phone
+38615229825
Email
tomaz.goslar@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Miša Fister, MD, PhD
Organizational Affiliation
UMC Ljubljana
Official's Role
Study Chair
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Learn more about this trial
Pretreatment With Unfractionated Heparin for ST Elevation Myocardial Infarction
We'll reach out to this number within 24 hrs