Reduction in Infarct Size by Remote Per-postconditioning in Patients With ST-elevation Myocardial Infarction (RECOND)
Reduction in Infarct Size by Remote Per-postconditioning in Patients With ST-elevation Myocardial Infarction in Stockholm (RECOND)
- Trial objective: To test the hypothesis that remote per-postconditioning in connection with primary PCI will reduce myocardial infarct size patients with STEMI.
- Trial Design: Placebo controlled randomized study with parallel groups
- Primary Endpoint: Myocardial infarct size expressed as a percentage of the myocardium at risk determined by Cardiac Magnetic Resonance (CMR) day 4-7
- Efficacy Parameters: Myocardial infarct size expressed as a percentage to the myocardium at risk determined by CMR at 6 months.
- Global left ventricular function determined by left ventricular ejection fraction determined by CMR.
- Microvascular obstruction determined by CMR day 4-7. Quantified ECV (extracellular volume) in left ventricular as myocardium at risk day 4-7 and remodelling parameters day 180.
- Safety Parameters: Major adverse cardiovascular events.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Stockholm, Sweden
- Södersjukhuset
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Stockholm, Sweden
- Danderyds hospital
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Stockholm, Sweden, S-17176
- Karolinska University Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patient planned for primary PCI.
- Chest pain indicating myocardial ischemia with a duration >30 minutes and < 6 hours prior to randomization.
- ST elevations >0.1 mV (>0.2 mV in V2-V3) in > two contiguous leads in V1-V6.
- Informed consent.
Exclusion Criteria:
- Previous myocardial infarction based on medical history or Q-wave on ECG in other area
- Left Bundle Branch Block on ECG.
- Previous CABG
- Cardiac arrest
- Any contraindication for CMR.
- Clinical symptoms of claudication
- Treatment with glibenclamide or cyclosporine on admission.
- Any condition that may interfere with the possibility for the patient to comply with or complete the study protocol.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Active Comparator: Remote Ischemic per-postconditioning
Remote conditioning is induced by inflation of a blood pressure cuff around the left thigh to 200 mmHg or 20 mmHg above systolic blood pressure (if >180 mmHg) for 5 min followed by deflation for 5 min.
At least one of these conditioning cycles is performed before PCI is initiated.
If time allows, cycles of remote conditioning (5 min leg ischemia and 5 min reperfusion) are repeated until PCI is performed.
Following reperfusion, defined as first balloon inflation, four additional cycles of remote conditioning will be performed.
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Primary Percutanous Coronary Intervention is performed in both Groups.
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Sham Comparator: Sham
The sham procedures include application of the cuff around the thigh but it is not inflated. Otheriwize normal primary PCI. |
Primary Percutanous Coronary Intervention is performed in both Groups.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Myocardial infarct size expressed as a percentage of the myocardium at risk determined by Cardiac Magnetic Resonance
Time Frame: 4-7 days following index event
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4-7 days following index event
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Myocardial infarct size expressed as a percentage to the myocardium at risk determined by Cardiac Magnetic Resonance
Time Frame: 6 months following index event
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6 months following index event
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Global left ventricular function determined by left ventricular ejection fraction determined by CMR.
Time Frame: 4-7 days and 6 months following index event
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4-7 days and 6 months following index event
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Microvascular obstruction determined by CMR
Time Frame: 4-7 days following index event
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4-7 days following index event
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Quantified ECV (extracellular volume) in left ventricular as myocardium at risk
Time Frame: 4-7 days following index event
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4-7 days following index event
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Myocardial infarct size by CMR expressed as a percentage to the myocardium at risk determined by Bari or modified Approach Score with coronary angiography.
Time Frame: 5-7 days following index event
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5-7 days following index event
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: John Pernow, Professor, Karolinska Institutet
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 (Estimate)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- RECOND
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