The Saint Francis Remote Ischemic Preconditioning Trial (SaFR) (SaFR)
This study tests the hypothesis that repeated inflation of a blood pressure cuff on the arm will improve results of coronary stent implantation by:
- reducing chest pain and electrocardiogram changes during balloon inflation to place the stent
- reducing leakage of heart muscle protein(troponin) into the blood stream after stent placement, indicated reduced damage to heart muscle during stent implantation
- increases in molecules in the blood that promote dilation of arteries
- reduced evidence of heart muscle damage on MRI immediately after stenting
- improved patient outcomes over six months with fewer adverse cardiovascular events(heart attack, acute coronary syndrome,renarrowing of the stented artery, heart failure, death, stroke, transient ischemic attack)
- improved heart structure and function at 6 months after stenting
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
New York
-
Roslyn, New York, United States, 11576
- St. Francis Hospital-The Heart Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with stable chronic coronary artery disease scheduled for elective percutaneous intervention.
Exclusion Criteria:
- Recent (1 month) myocardial infarction
- Acute coronary syndrome
- Chest pain at res
- Estimated glomerular filtration rate(GFR)<45 mL/min/1.73 m2
- Frequent premature atrial or ventricular contractions or atrial fibrillation
- Any contraindication to MRI including implanted non MRI compatible medical devices or ferromagnetic materials such as shrapnel
- Inability to breath-hold
- Severe claustrophobia
- Deafness
- Persistent tremor
- Inability to follow instructions.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Remote Ischemic Preconditioning (RIPC)
Randomized subjects who are treated immediately prior to stenting with remote ischemic preconditioning consisting of 3 5 minute blood pressure cuff inflations to occlude the brachial artery in their nondominant arms, with intervening 5 minute rest periods.
|
Randomized subjects are treated immediately prior to stenting with remote ischemic preconditioning consisting of 3 5 minute blood pressure cuff inflations to occlude the brachial artery in their nondominant arms, with intervening 5 minute rest periods.
|
|
Placebo Comparator: Sham Remote Ischemic Preconditioning
Patients who prior to stenting have the RIPC blood pressure cuff placed but not inflated for 3 5 minute episodes with 5 minute rest periods.
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Randomized subjects who are exposed immediately prior to stenting to sham remote ischemic preconditioning consisting of 3 5 minute blood pressure cuff placements without inflation on their nondominant arms, with intervening 5 minute rest periods.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
MACE
Time Frame: 6 months post-stenting
|
MACE is defined as a combined endpoint including: heart attack, acute coronary syndrome,restenosis of the stented artery, new heart failure stroke, transient ischemic attack or death
|
6 months post-stenting
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
troponin I
Time Frame: 24 hours
|
prevalence of cTn I > 0.12 nG/ml in active RIPC and placebo groups
|
24 hours
|
|
chest pain during stenting
Time Frame: immediate during procedure
|
compare frequency, severity(1-10 scale) and duration of chest pain during stent implantation
|
immediate during procedure
|
|
ST segment changes during stent implantation
Time Frame: immediate
|
compare prevalence and severity of electrocardiographic ST segment elevation or depression during stent implantation between active and placebo groups
|
immediate
|
|
MRI delayed enhancement
Time Frame: 1-7 days after stenting
|
Compare prevalence and volume of myocardial delayed gadolinium enhancement in active and placebo groups
|
1-7 days after stenting
|
|
Late left ventricular volumes and ejection fraction
Time Frame: 6 months
|
Compare left ventricular ejection fraction, end-diastolic and end-systolic volumes between active and placebo groups at 6 months
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Nathaniel Reichek, MD, St. Francis Hospital-The Heart Center, Roslyn, NY
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 09-25
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