Pretreatment With Unfractionated Heparin for ST Elevation Myocardial Infarction (UFH-STEMI)
Rupture of a coronary artery plaque leads to thrombotic occlusion of the coronary artery and would present as ST segment elevation myocardial infarction. Early treatment with aspirin and early primary percutaneous coronary intervention are indicated. Anticoagulation therapy, usually with unfractionated heparin, is required during percutaneous coronary intervention.
Investigators hypothesis is that pretreatment with unfractionated heparin in addition to aspirin at first medical contact may facilitate spontaneous reperfusion of culprit artery and procedural thrombotic complication in patients with ST elevation myocardial infarction without significant risk of bleeding complications.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Randomization of patients with STEMI at first medical contact in a 1:1 ratio into an intervention group receiving 100 IU of unfractionated heparin (UFH) per kilogram of body weight IV and later additionally UFH after diagnostic coronary angiography according to the activated clotting time (ACT) and a control group receiving only UFH after diagnostic coronary angiography at the dose of 100 IU per kilogram of body weight.
The primary end point of the study is TIMI flow at coronary angiography. Secondary endpoints are: Bleeding complications (defined by BARC score), occurrence of cardiogenic shock, and 30-day mortality.
Investigators plan to randomize 600 patients.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Miša Fister, MD, PhD
- Phone Number: +38615229825
- Email: misa.fister@gmail.com
Study Contact Backup
- Name: Tomaz Goslar, MD, PhD
- Phone Number: +38615229825
- Email: tomaz.goslar@gmail.com
Study Locations
-
-
-
Ljubljana, Slovenia, 1000
- UMC Ljubljana
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult patients with STEMI referred for primary PCI
- Duration of symptoms less than 6 hours before presentation
Exclusion Criteria:
- Pregnancy
- Cardiogenic shock at presentation (hemodynamic instability)
- Cardiac arrest before randomization
- Duration of symptoms for more than 6 hours before presentation
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: Early unfractionated heparin
Administration of UFH at a dose of 100 IU/kg body weight at first medical contact.
Addition of UFH before coronary intervention according to ACT measurement after coronary angiography before coronary intervention.
|
Unfractionated heparin at dose of 100 IU /kg body weight
|
|
No Intervention: Control - Unfractionated heparin for coronary intervention only
Control arm with administration of UFH at a dose of 100 IU/kg body weight after coronary angiography before coronary intervention.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
TIMI flow
Time Frame: Day 0
|
TIMI flow in culprit coronary artery at first coronary angiography
|
Day 0
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Bleeding
Time Frame: Day 0
|
Bleeding assessed by Bleeding Academic Research Consortium (BARC) score.
BARC incorporates 5 bleeding types, ranging from BARC 0 - no bleeding to BARC 5 - fatal bleeding.
|
Day 0
|
|
Cardiogenic shock
Time Frame: Day 0 to 10
|
Presence of cardiogenic shock at any time after randomization
|
Day 0 to 10
|
|
30 day mortality after STEMI
Time Frame: 30 days
|
30-day mortality after STEMI
|
30 days
|
|
Troponin I concentration 24 h after primary PCI
Time Frame: 24 h
|
Troponin I concentration 24 h after primary PCI
|
24 h
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Miša Fister, MD, PhD, UMC Ljubljana
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 (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
Additional Relevant MeSH Terms
- Vascular Diseases
- Cardiovascular Diseases
- Pathologic Processes
- Heart Diseases
- Necrosis
- Myocardial Ischemia
- Ischemia
- ST Elevation Myocardial Infarction
- Myocardial Infarction
- Infarction
- Molecular Mechanisms of Pharmacological Action
- Fibrin Modulating Agents
- Fibrinolytic Agents
- Anticoagulants
- Heparin
- Calcium heparin
Other Study ID Numbers
Other Study ID Numbers
- Heparin-STEMI
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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