Protection During Cardiac Surgery. (ProCCard)
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
-
-
-
Annecy, France
- CH Annecy
-
Bron, France, 69500
- Service d'Anesthésie-Réanimation, Hôpital Cardiologique et Pneumologique Louis Pradel
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Caen, France
- CHU de Caen
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Clermont-Ferrand, France
- service de Chirurgie Cardiaque CHU Gabriel Montpied
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Grenoble, France
- Unité de Réanimation Cardiovasculaire et Thoracique, Hôpital Michallon
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Lyon, France
- Clinique de la Sauvegarde
-
Saint-Etienne, France
- CHU Saint-Etienne
-
Saint-Laurent-du-Var, France
- Institut Arnault Tzanck - Saint-Laurent du Var
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age > 18 years old
- Aortic valve surgery (aortic valve replacement associated or not with coronary artery bypass graft, Bentall surgery or Tirone David surgery)
- Signed informed consent
Exclusion Criteria:
- Emergency surgery
- Redo surgery
- Patient treated with Nicorandil, repaglinid or sulfonylurea 48 hours prior to surgery
- Low cardiac output requiring catecholamine infusion or circulatory assistance prior to surgery
- Severe renal failure: dialysis or glomerular filtration rate < 30 mL/min
- Severe liver failure (spontaneous INR >2)
- Severe respiratory insufficiency (VEMS <40% of predicted value)
- Contra-indication to sevoflurane and propofol
- Myocardial infarction < 7 days
- Severe upper limb arterial disease
- Heparin-induced thrombopenia
- Active infection under antibiotic treatment
- Any other surgery combined with the aortic valve surgery: myotomia of Morrow (hypertrophic myocardiopathy), treatment of heart rhythm disorder, inter-atrial communication closure, mitral valve replacement, tricuspid valve replacement, pulmonary valve replacement.
- Pregnant women
- Currently participating in another trial which may interfere with ProCCard results
- Not benefiting from a social insurance or similar system
- Patient under legal protection
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Multimodal cardioprotection therapeutic strategy
|
Multimodal cardioprotection therapeutic strategy will include (1) remote ischemic preconditioning, (2) volatile anesthetic sevoflurane-induced preconditioning, (3) blood glucose control every 30 minutes during cardiac surgery, (4) temporary respiratory acidosis prior to the aortic cross-unclamping and (5) gradual restoration of blood flow after aortic cross-unclamping (gentle reperfusion).
|
|
Active Comparator: Traditional anesthetic and therapeutic
standard anesthetic procedure No intervention (Control).
|
standard anesthetic procedure will include: anesthesia under propofol throughout the cardiac surgery, blood glucose control every 60 minutes, arterial pH maintained at 7.40, theoric blood flow restored at the earliest after aortic cross-unclamping.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Area under the plasma concentration versus time curve (AUC) of Hypersensitive Troponin I
Time Frame: at 72 hours
|
Area under the plasma concentration versus time curve (AUC) of Hypersensitive Troponin I determined for each patient with the serial measurement from of troponin I assays.
|
at 72 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Length of mechanical ventilation
Time Frame: 30 days
|
30 days
|
|
|
Length of stay in hospital
Time Frame: 30 days
|
30 days
|
|
|
Adverse events incidence during the first 30 days following surgery of the multimodal cardioprotection strategy
Time Frame: 30 days
|
Adverse events will include death, myocardial infarction, heart failure,arrhythmia requiring medical therapy, neurological disorder such as stroke,respiratory insufficiency, any infectious event, major bleeding requiring transfusion of ≥ 5 U packed red blood cells or surgical intervention or surgical complication
|
30 days
|
|
Troponin I serum peak value
Time Frame: 72 hours
|
Highest serum value recorded for each patient within 72 hours
|
72 hours
|
|
Troponin I serum value
Time Frame: 24 hours
|
Serum value recorded for each patient within 24 hours
|
24 hours
|
|
Length of stay in intensive care unit (ICU)
Time Frame: 30 days
|
30 days
|
|
|
Index Gravity Score (IGS II, the scoring system measuring the severity of disease for patients admitted to ICU)
Time Frame: 24 hours
|
Index Gravity Score provides an estimate of the risk of death: the higher the score is, the higher the risk to die is.
The maximum score is 163.
The Index Gravity Score includes 17 variables: 12 physiology variables, age, type of admission (scheduled surgical, unscheduled surgical, or medical), and three underlying disease variables (acquired immunodeficiency syndrome, metastatic cancer, and hematologic malignancy).
|
24 hours
|
|
Number of participants with catecholaminergic support
Time Frame: baseline and 30 days
|
baseline and 30 days
|
|
|
Dose of catecholaminergic support
Time Frame: baseline and 30 days
|
baseline and 30 days
|
|
|
3-level version of EQ-5D (EQ-5D-3L) health status score (quality of life score)
Time Frame: Baseline and 30 days
|
The 3-level version of EQ-5D consists of 2 pages: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS).It comprises the following five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.
Each dimension has 3 levels: no problems, some problems, and extreme problems.
The patient is asked to indicate his health state by ticking the box next to the most appropriate statement in each of the five dimensions.
This decision results into a 1-digit number that expresses the level selected for that dimension.
The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.
The EQ VAS records the patient's self-rated health on a vertical visual analogue scale where the endpoints are labelled 'Best imaginable health state' and 'Worst imaginable health state'.
The VAS can be used as a quantitative measure of health outcome that reflects the patient's own judgement.
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Baseline and 30 days
|
|
number of death
Time Frame: 30 days
|
30 days
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jean-Luc FELLAHI, Hospices Civils de Lyon
Publications and helpful links
General Publications
- Chiari P, Durand M, Desebbe O, Fischer MO, Lena-Quintard D, Palao JC, Mercier C, Samson G, Varillon Y, Pozzi M, Mewton N, Maucort-Boulch D, Ovize M, Fellahi JL. Multimodal cardioprotective strategy in cardiac surgery (the ProCCard trial): Study protocol for a multicenter randomized controlled trial. Trials. 2019 Sep 11;20(1):560. doi: 10.1186/s13063-019-3638-3.
- Chiari P, Mewton N, Maucort-Boulch D, Desebbe O, Durand M, Fischer MO, Lena-Quintard D, Palao JC, Ovize M, Fellahi JL. Multimodal Strategy for Myocardial Protection During Cardiac Surgery: The ProCCard Study. J Am Coll Cardiol. 2021 Feb 16;77(6):827-829. doi: 10.1016/j.jacc.2020.12.020. No abstract available.
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
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
- 69HCL17_0174
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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