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Full-dose Atorvastatin After Acute Coronary Syndrome (ACS) in Non-revascularisable Coronary Artery Disease (APRIRE)

Primary Purpose

Acute Coronary Syndrome, Coronary Artery Disease

Status
Terminated
Phase
Phase 3
Locations
Italy
Study Type
Interventional
Intervention
Atorvastatin
Sponsored by
San Filippo Neri General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Coronary Syndrome focused on measuring Atorvastatin, Acute coronary syndrome, Advanced coronary artery disease

Eligibility Criteria

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

Inclusion Criteria:

  • non-ST-segment elevation acute myocardial infarction.
  • coronary angiography within 48 hours from admission.
  • angiographic evidence of severe and diffuse coronary artery disease,not amenable to conventional direct revascularisation techniques by coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI).

Exclusion Criteria:

  • ST-segment elevation acute myocardial infarction,
  • clinical history of heart failure
  • left ventricular ejection fraction <35%,
  • any form of severe valvular dysfunction,
  • previous implantation or indication to implant a cardioverter-defibrillator during the index admission,
  • any increase in liver enzymes,
  • history of any liver or muscle disease,
  • renal failure with serum creatinine >2.5 mg/dL (221 mmol/L),
  • need for continued use of intravenous medications to relieve anginal symptoms,
  • presence of any major comorbidity with life expectancy <24 months.

Sites / Locations

  • San Filippo Neri General Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Full-dose atorovastatin (80 mg/d)

Conventional medical treatment

Arm Description

For patients randomised to this arm, atorvastatin in the fixed dose of 80 mg/ day was started immediately after randomisation.

For patients randomised to this arm, adherence to the National Cholesterol Education Program, Adult Treatment Panel III guidelines was required. In particular, in these patients,atorvastatin was started at the initial dosage of 20 mg/day immediately after randomisation. Subsequently, atorvastatin dosage was titrated in order to attain low-density lipoprotein cholesterol (LDL-C) levels <100 mg/dL (2.5 mmol/L).

Outcomes

Primary Outcome Measures

Major adverse cardiovascular events
The primary end point of the study was prospectively defined as the combination of cardiovascular death, non-fatal acute myocardial re-infarction (re-AMI) and disabling non-fatal stroke.

Secondary Outcome Measures

Cardiovascular mortality
Non-fatal acute myocardial re-infarction (re-AMI)
Disabling non-fatal stroke
New-onset heart failure
Atrial fibrillation

Full Information

First Posted
August 24, 2010
Last Updated
August 24, 2010
Sponsor
San Filippo Neri General Hospital
Collaborators
Associazione Nazionale Medici Cardiologi Ospedalieri
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1. Study Identification

Unique Protocol Identification Number
NCT01187992
Brief Title
Full-dose Atorvastatin After Acute Coronary Syndrome (ACS) in Non-revascularisable Coronary Artery Disease
Acronym
APRIRE
Official Title
Full-dose Atorvastatin Versus Conventional Medical Therapy After Non-ST-elevation Acute Myocardial Infarction in Patients With Advanced Non-revascularisable Coronary Artery Disease
Study Type
Interventional

2. Study Status

Record Verification Date
May 2010
Overall Recruitment Status
Terminated
Why Stopped
Interim analysis showed significant effect in favour of full-dose atorvastatin.
Study Start Date
September 2003 (undefined)
Primary Completion Date
March 2007 (Actual)
Study Completion Date
April 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
San Filippo Neri General Hospital
Collaborators
Associazione Nazionale Medici Cardiologi Ospedalieri

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study was designed to test the hypothesis that the addition of full-dose atorvastatin (80 mg/day) to conventional medical treatment could reduce ischaemic recurrences after non-ST-elevation acute myocardial infarction (NSTE-AMI) in patients with severe and diffuse coronary artery disease (CAD) not amenable to any form of mechanical revascularisation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Coronary Syndrome, Coronary Artery Disease
Keywords
Atorvastatin, Acute coronary syndrome, Advanced coronary artery disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
290 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Full-dose atorovastatin (80 mg/d)
Arm Type
Experimental
Arm Description
For patients randomised to this arm, atorvastatin in the fixed dose of 80 mg/ day was started immediately after randomisation.
Arm Title
Conventional medical treatment
Arm Type
No Intervention
Arm Description
For patients randomised to this arm, adherence to the National Cholesterol Education Program, Adult Treatment Panel III guidelines was required. In particular, in these patients,atorvastatin was started at the initial dosage of 20 mg/day immediately after randomisation. Subsequently, atorvastatin dosage was titrated in order to attain low-density lipoprotein cholesterol (LDL-C) levels <100 mg/dL (2.5 mmol/L).
Intervention Type
Drug
Intervention Name(s)
Atorvastatin
Intervention Description
80 mg/day
Primary Outcome Measure Information:
Title
Major adverse cardiovascular events
Description
The primary end point of the study was prospectively defined as the combination of cardiovascular death, non-fatal acute myocardial re-infarction (re-AMI) and disabling non-fatal stroke.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Cardiovascular mortality
Time Frame
12 months
Title
Non-fatal acute myocardial re-infarction (re-AMI)
Time Frame
12 months
Title
Disabling non-fatal stroke
Time Frame
12 months
Title
New-onset heart failure
Time Frame
12 months
Title
Atrial fibrillation
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: non-ST-segment elevation acute myocardial infarction. coronary angiography within 48 hours from admission. angiographic evidence of severe and diffuse coronary artery disease,not amenable to conventional direct revascularisation techniques by coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI). Exclusion Criteria: ST-segment elevation acute myocardial infarction, clinical history of heart failure left ventricular ejection fraction <35%, any form of severe valvular dysfunction, previous implantation or indication to implant a cardioverter-defibrillator during the index admission, any increase in liver enzymes, history of any liver or muscle disease, renal failure with serum creatinine >2.5 mg/dL (221 mmol/L), need for continued use of intravenous medications to relieve anginal symptoms, presence of any major comorbidity with life expectancy <24 months.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Furio Colivicchi, MD
Organizational Affiliation
Clinical Quality Mangement Unit, San Filippo Neri Hospital, Rome, Italy
Official's Role
Principal Investigator
Facility Information:
Facility Name
San Filippo Neri General Hospital
City
Rome
ZIP/Postal Code
I-00135
Country
Italy

12. IPD Sharing Statement

Citations:
PubMed Identifier
20367555
Citation
Colivicchi F, Tubaro M, Mocini D, Genovesi Ebert A, Strano S, Melina G, Uguccioni M, Santini M. Full-dose atorvastatin versus conventional medical therapy after non-ST-elevation acute myocardial infarction in patients with advanced non-revascularisable coronary artery disease. Curr Med Res Opin. 2010 Jun;26(6):1277-84. doi: 10.1185/03007991003751496.
Results Reference
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Full-dose Atorvastatin After Acute Coronary Syndrome (ACS) in Non-revascularisable Coronary Artery Disease

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