A Study to Investigate the Procoagulant Effect of Tenecteplase (TNK-tPA), Alteplase (Rt-PA) and Streptokinase (SK) Administered to Patients With Acute Myocardial Infarction (AMI)
An Open-label, Randomised, Parallel-group Comparison to Investigate the Procoagulant Effect of Tenecteplase (TNK-tPA), Alteplase (Rt-PA) and Streptokinase (SK) Administered to Patients With AMI
Primary objective: to evaluate the procoagulant effect of TNK-tPA compared to rt-PA and streptokinase, administered to patients with AMI, by measuring the concentration of TAT at 2 hours after the start of treatment versus baseline values.
Secondary objective: change from baseline in concentration of TAT at 6 and 24 hours; change from baseline in concentration of D-dimers, F1+2, PAI-1, PAP at 2, 6 and 24 hours. Incidence of adverse events (AE's), in -hospital complications, major or minor bleedings and serious adverse events.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Onset of symptoms of AMI within 6 hours from randomisation
- A twelve-lead electrocardiogram (ECG) showing ST-segment elevation ≥ 0.1 millivolt (mV) in two or more limb leads, or ≥ 0.2 mV in two or more contiguous precordial leads indicative of AMI, or new left bundle-branch block
- Age ≥ 18
Exclusion Criteria:
- Hypertension defined as blood pressure > 180/110 mmHg (systolic BP > 180 mmHg and/or diastolic BP > 110 mmHg) on repeated measurements during current admission prior to randomisation
- Use of abciximab (ReoPro®) within the preceding 7 days or eptifibatide (Integrilin®) or tirofiban (aggrastat®) within the past 48 hours
- Use of heparin within the preceding 12 hours
- Current therapeutic oral anticoagulation
- Major surgery, biopsy of a parenchymal organ, or significant trauma within 2 months
- Any minor head trauma and any other trauma occurring after the onset of the current myocardial infarction
- Any known history of stroke or transient ischemic attack or dementia
- Any known structural damage of the central nervous system
- Ruptured aortic aneurism
- Active bleeding
- Prolonged cardiopulmonary resuscitation (> 10 minutes) in the previous two weeks
- Pregnancy or lactation, parturition within the previous 30 days. Women of childbearing potential must have a negative pregnancy test
- Any known active participation in another investigative drug study or device protocol in the past 30 days
- Previous enrolment in this study
- Any other condition that the investigator feels would place the patient at increased risk if the investigational therapy were initiated
- Inability to follow the protocol and comply with follow-up requirements
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 |
|---|---|
|
Experimental: Tenecteplase
Single i.v.
bolus followed by infusion, weight adjusted
|
|
|
Active Comparator: Alteplase
Single i.v.
bolus followed by infusion
|
|
|
Active Comparator: Streptokinase
I.V. infusion
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Changes from baseline in concentration of thrombin anti-thrombin complex (TAT)
Time Frame: Baseline, 2 hours after start of treatment
|
Baseline, 2 hours after start of treatment
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Changes from baseline in TAT
Time Frame: Baseline, 6 and 24 hours after start of treatment
|
Baseline, 6 and 24 hours after start of treatment
|
|
Changes from baseline in D-dimers
Time Frame: Baseline, 2, 6 and 24 hours after start of treatment
|
Baseline, 2, 6 and 24 hours after start of treatment
|
|
Changes from baseline in prothrombin fragments 1+2 (F1+F2)
Time Frame: Baseline, 2, 6 and 24 hours after start of treatment
|
Baseline, 2, 6 and 24 hours after start of treatment
|
|
Changes from baseline in plasminogen-activator inhibitor-1 (PAI-1)
Time Frame: Baseline, 2, 6 and 24 hours after start of treatment
|
Baseline, 2, 6 and 24 hours after start of treatment
|
|
Changes from baseline in plasmin-antiplasmin complex (PAP)
Time Frame: Baseline, 2, 6 and 24 hours after start of treatment
|
Baseline, 2, 6 and 24 hours after start of treatment
|
|
Occurrence of adverse events (AE's)
Time Frame: Up to 30 days
|
Up to 30 days
|
|
Occurrence of major bleedings
Time Frame: Up to 30 days
|
Up to 30 days
|
|
Occurrence of minor bleedings
Time Frame: Up to 30 days
|
Up to 30 days
|
|
Occurrence of serious adverse events (SAE's)
Time Frame: Up to 30 days
|
Up to 30 days
|
|
Occurrence of in-hospital complications
Time Frame: Start of treatment until discharge from hospital
|
Start of treatment until discharge from hospital
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary 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
- 1123.5
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