Alpha-1 Anti-Trypsin (AAT) Treatment in Acute Myocardial Infarction (VCU-Alpha1RT)
Primary Purpose
Acute Myocardial Infarction
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Alpha 1-Antitrypsin
Sponsored by
About this trial
This is an interventional treatment trial for Acute Myocardial Infarction focused on measuring Acute myocardial infarction, Heart Failure, Inflammation
Eligibility Criteria
Inclusion Criteria:
- Acute STEMI defined as chest pain (or equivalent) with an onset within 12 hours and ECG evidence of ST segment elevation (>1 mm) in 2 or more anatomically contiguous leads that is new or presumably new
- Planned or completed coronary angiogram for potential intervention
- Age>21
Exclusion Criteria:
- Inability to give informed consent
- Hemodynamic instability as defined as need for inotropic or vasoactive agents, or need for mechanical support devices (including intra-aortic balloon pump)
- Pregnancy
- Preexisting congestive heart failure (American Heart Association/American College of Cardiology class C-D, New York Heart Association III-IV)
- Preexisting severe left ventricular dysfunction (EF<20%)
- Preexisting severe valvular heart disease
- Known active infections (acute or chronic)
- Recent (<14 days) or active use of anti-inflammatory drugs (not including NSAIDs or corticosteroids used for IV dye allergy only)
- Known chronic inflammatory disease (including but not limited to rheumatoid arthritis, systemic lupus erythematosus)
- Known active malignancy of any type, or prior diagnosis in the past 10 years
- Anticipated need for cardiac or major surgery
- Known active cancer (or prior diagnosis of cancer within the past 10 years)
- Known Immunoglobulin A (IgA) deficiency
Sites / Locations
- Virginia Commonwealth University
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Alpha-1 anti-trypsin (AAT)
Arm Description
We will use plasma derived AAT 60 mg/Kg, single infusion, within 12 hours of hospital admission for ST-segment elevation myocardial infarction (STEMI)
Outcomes
Primary Outcome Measures
C Reactive Protein (Area Under the Curve)
A single area under the curve (AUC) calculation based upon C-reactive protein (CRP) values drawn at baseline, 3 days, and 14 days.
Secondary Outcome Measures
Left Ventricular End-systolic Volume Change
We will calculate the interval change between admission and 3 months in left ventricular end-systolic volume, using echocardiography
Full Information
NCT ID
NCT01936896
First Posted
August 30, 2013
Last Updated
January 15, 2016
Sponsor
Virginia Commonwealth University
1. Study Identification
Unique Protocol Identification Number
NCT01936896
Brief Title
Alpha-1 Anti-Trypsin (AAT) Treatment in Acute Myocardial Infarction
Acronym
VCU-Alpha1RT
Official Title
Alpha-1 Anti-Trypsin (AAT) to Quench the Acute Inflammatory Response in ST-segment Elevation Acute Myocardial Infarction
Study Type
Interventional
2. Study Status
Record Verification Date
January 2016
Overall Recruitment Status
Completed
Study Start Date
December 2013 (undefined)
Primary Completion Date
June 2014 (Actual)
Study Completion Date
July 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Virginia Commonwealth University
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Acute myocardial infarction is characterized by an intense inflammatory response.
The degree of the response influences clinical outcome, with 'more' inflammation promoting heart failure. In this study we plan to determine whether treatment with plasma derived alpha-1 antitrypsin will quench the inflammatory response in patients with acute ST-segment elevation myocardial infarction (STEMI).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myocardial Infarction
Keywords
Acute myocardial infarction, Heart Failure, Inflammation
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Alpha-1 anti-trypsin (AAT)
Arm Type
Experimental
Arm Description
We will use plasma derived AAT 60 mg/Kg, single infusion, within 12 hours of hospital admission for ST-segment elevation myocardial infarction (STEMI)
Intervention Type
Drug
Intervention Name(s)
Alpha 1-Antitrypsin
Other Intervention Name(s)
Prolastin C, Aralast NP
Primary Outcome Measure Information:
Title
C Reactive Protein (Area Under the Curve)
Description
A single area under the curve (AUC) calculation based upon C-reactive protein (CRP) values drawn at baseline, 3 days, and 14 days.
Time Frame
14 days
Secondary Outcome Measure Information:
Title
Left Ventricular End-systolic Volume Change
Description
We will calculate the interval change between admission and 3 months in left ventricular end-systolic volume, using echocardiography
Time Frame
3 months
Other Pre-specified Outcome Measures:
Title
Safety
Description
We will record the number of participants with all adverse events (cardiac and non-cardiac) over the 3 months, including infusion reactions and drug-related issues.
Time Frame
3 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Acute STEMI defined as chest pain (or equivalent) with an onset within 12 hours and ECG evidence of ST segment elevation (>1 mm) in 2 or more anatomically contiguous leads that is new or presumably new
Planned or completed coronary angiogram for potential intervention
Age>21
Exclusion Criteria:
Inability to give informed consent
Hemodynamic instability as defined as need for inotropic or vasoactive agents, or need for mechanical support devices (including intra-aortic balloon pump)
Pregnancy
Preexisting congestive heart failure (American Heart Association/American College of Cardiology class C-D, New York Heart Association III-IV)
Preexisting severe left ventricular dysfunction (EF<20%)
Preexisting severe valvular heart disease
Known active infections (acute or chronic)
Recent (<14 days) or active use of anti-inflammatory drugs (not including NSAIDs or corticosteroids used for IV dye allergy only)
Known chronic inflammatory disease (including but not limited to rheumatoid arthritis, systemic lupus erythematosus)
Known active malignancy of any type, or prior diagnosis in the past 10 years
Anticipated need for cardiac or major surgery
Known active cancer (or prior diagnosis of cancer within the past 10 years)
Known Immunoglobulin A (IgA) deficiency
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Antonio Abbate, MD, PhD
Organizational Affiliation
Virginia Commonwealth University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Benjamin Van Tassell, PharmD
Organizational Affiliation
Virginia Commonwealth University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Virginia Commonwealth University
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
29634656
Citation
Abouzaki NA, Christopher S, Trankle C, Van Tassell BW, Carbone S, Mauro AG, Buckley L, Toldo S, Abbate A. Inhibiting the Inflammatory Injury After Myocardial Ischemia Reperfusion With Plasma-Derived Alpha-1 Antitrypsin: A Post Hoc Analysis of the VCU-alpha1RT Study. J Cardiovasc Pharmacol. 2018 Jun;71(6):375-379. doi: 10.1097/FJC.0000000000000583.
Results Reference
derived
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Alpha-1 Anti-Trypsin (AAT) Treatment in Acute Myocardial Infarction
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