Sidlenafil in Combination With Oral Anticoagulants in Patients With Intermediate-high Risk of Pulmonary Embolism (PSCAT)
Pilot Randomized Study of the Sidlenafil Efficacy in Combination With Oral Anticoagulants in the Treatment of Patients With Intermediate-high Risk of Pulmonary Embolism
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Andrey Karpenko, MD/PhD
- Email: a_karpenko@meshalkin.ru
Study Locations
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-
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Novosibirsk, Russian Federation, 630055
- Recruiting
- Federal State Institution Academician E.N.Meshalkin Novosibirsk State Research Institute Of Circulation Pathology Rusmedtechnology
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- pulmonary embolism confirmed by CT scan with contrast, with localization of thrombusa in at least one main or proximal lobar pulmonary artery.
- Right-left ventricular ratio (RV / LV) ≥1 derived from the apical four-chamber view
- Who gave written informed consent to participate in research
Exclusion Criteria:
- Age <18 or >80 years
- Symptoms of pulmonary embolism> 14 days
- Inadequate echocardiographic image quality in the apical four-chamber projection, which limits the measurement of RV / LV ratio
- A significant risk of bleeding
- The administration of thrombolytic drugs within the previous 4 days
- Active bleeding
- Known coagulopathy
- Thrombocytopenia <100,10^9 / l
- Previous use of vitamin K antagonists with an INR> 2.5 at admission
- History of any intracranial or spinal surgery or trauma or intracranial / spinal bleeding
- Intracranial neoplasm
- Arteriovenous malformations or aneurysms
- GIH <3 months
- Cataract Surgery
- Obstetrical manipulation
- Cardiopulmonary resuscitation needed.
- Other invasive procedures <10 days
- Allergy, hypersensitivity, thrombocytopenia to heparin or tissue plasminogen activator
- Allergy to iodine contrast
- A well-known right-left cardiac shunt, for example, a large patent foramen ovale, or atrial septal defect; large (> 10 mm), or a blood clot in right atrium/right ventricle
- Systolic blood pressure <90 mm Hg for at least 15 minutes, or fall of systolic blood pressure is not less than 40 mm Hg for at least 15 min., with evidence of organ hypoperfusion (cold extremities or low diuresis <30 mL / h, or confusion), or the need for administration of catecholamines to maintain adequate perfusion of organs and systolic blood pressure> 90 mm Hg
- Severe hypertension (systolic> 180 mm Hg or diastolic> 105 mm Hg.).
- Pregnancy, lactation, delivery<30 days
- Participation in any other study (drug or device)
- Life expectancy <90 days
- Refusal to participate in the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: double drug therapy
|
After arrival to the emergency department, a series of surveys to determine the risk of death from pulmonary embolism are carried out.
Then angiography, tensiometry of SBCC, catheter thrombus fragmentation are scheduled.
Then puncture of the right jugular vein is performed.
PigTail catheter is inserted via guidewire into the pulmonary artery .
Angiography of the pulmonary arteries is performed.
Miller index is calculated.
Catheter thrombus fragmentation is performed by a PigTail catheter.
RV, RA pressures are measured.
In the ICU heparin is prescribed (of 1000 units per hour) under the control of PTT (50-75s).
The next day patients are randomizaed to assign them into 2 groups.
Dual drug therapy is going to be administered to this group (experimental): sildenafil 30mg 3p \ g + 10 mg apixaban 2p \ d for 14 days.
On the 7th day MSCT angiography of the pulmonary aretry with contrast and echocardiogram are performed.
On the 14th day the controlechocardiogram is performed .
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|
ACTIVE_COMPARATOR: mono drug therapy
|
After arrival to the emergency department, a series of surveys to determine the risk of death from pulmonary embolism are carried out.
Then angiography, tensiometry of SBCC, catheter thrombus fragmentation are scheduled.
Then puncture of the right jugular vein is performed.
PigTail catheter is inserted via guidewire into the pulmonary artery .
Angiography of the pulmonary arteries is performed.
Miller index is calculated.
Catheter thrombus fragmentation is performed by a PigTail catheter.
RV, RA pressures are measured.
In the ICU heparin is prescribed (of 1000 units per hour) under the control of PTT (50-75s).
The next day patients are randomizaed to assign them into 2 groups.Mono drug therapy is going to be administered to this group (active comparator): apixaban 10 mg 2p \ d for 14 days.
On the 7th day MSCT angiography of the pulmonary aretry with contrast and echocardiogram are performed.
On the 14th day the controlechocardiogram is performed .
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
MSCT RV \ LV Index
Time Frame: 7th day
|
on the 7th day of treatment RV \ LV Index (calculated according to MSCT angiography of the pulmonary arteries)
|
7th day
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Echocardiogram RV \ LV Index
Time Frame: 7th day
|
Echocardiogram (an index of RV \ LV) on 7th day
|
7th day
|
|
Echocardiogram RV \ LV Index
Time Frame: 14th day
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Echocardiogram (an index of RV \ LV) on 14th day
|
14th day
|
|
Echocardiogram RV \ LV Index
Time Frame: one month
|
Echocardiogram (an index of RV \ LV) on one month
|
one month
|
|
Echocardiogram pressure in the pulmonary artery
Time Frame: one month
|
the average pressure in the pulmonary artery according to echocardiography
|
one month
|
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hemodynamic instability
Time Frame: one month
|
in the hospital and within a month follow-up
|
one month
|
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death
Time Frame: one month
|
in the hospital and within a month follow-up
|
one month
|
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bleeding
Time Frame: one month
|
clinically significant bleeding on a scale HAS-BLED
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one month
|
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recurrent venous thrombosis
Time Frame: one month
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recurrent venous thrombosis
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one month
|
|
recurrent pulmonary embolism
Time Frame: one month
|
recurrent pulmonary embolism.
|
one month
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ANTICIPATED)
Primary Completion
Study Completion (ANTICIPATED)
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
- Cardiovascular Diseases
- Vascular Diseases
- Respiratory Tract Diseases
- Lung Diseases
- Embolism and Thrombosis
- Embolism
- Pulmonary Embolism
- Molecular Mechanisms of Pharmacological Action
- Vasodilator Agents
- Urological Agents
- Enzyme Inhibitors
- Protease Inhibitors
- Factor Xa Inhibitors
- Antithrombins
- Serine Proteinase Inhibitors
- Anticoagulants
- Phosphodiesterase Inhibitors
- Phosphodiesterase 5 Inhibitors
- Apixaban
- Sildenafil Citrate
Other Study ID Numbers
Other Study ID Numbers
- NRICP-45734
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