ANG-First Trial (Angiotensin II as First-Line Vasopressor Therapy in Cardiac Surgery)
Angiotensin II as First-Line Vasopressor Therapy in Cardiac Surgery (ANG-First Trial)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Aja Janyavula
- Phone Number: 410-427-5459
- Email: ajanyavula@umm.edu
Study Contact Backup
- Name: Sam Rudow
- Phone Number: 410-427-5459
- Email: samuel.rudow@umm.edu
Study Locations
-
-
Maryland
-
Towson, Maryland, United States, 21204
- Recruiting
- University of Maryland St. Joseph Medical Center
-
Contact:
- Sam Rudow
- Phone Number: 410-427-5459
- Email: samuel.rudow@umm.edu
-
Principal Investigator:
- Rawn Salenger, MD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult patients ≥ 18 years of age undergoing cardiac surgery requiring CPB
- Patients must have clinical features of vasodilation as determined by a MAP < 65 mmHg that is non-transient in the opinion of the treating physician
- Patients must be adequately volume resuscitated in the opinion of the treating physician
- Systemic Vascular Resistance index (SVRi) < 1970 dynes·sec/cm⁵/m² to support the clinical diagnosis of vasodilation; if no pulmonary artery catheter is in place, vasodilatory hypotension diagnosis according to the judgement of the critical care team
- Biventricular systolic function is at or greater than pre-cardiopulmonary bypass baseline as demonstrated by echocardiographic evaluation, or the patient is concomitantly treated with
Exclusion Criteria:
- Bleeding as primary etiology of hypotension, as determined by > 4 units RBC transfusion in 24 hours.
- Patients on ECMO
- Patients with active endocarditis
- Patients already on renal replacement therapy or creatinine of > 4 mg/dl within 2 weeks of surgery
- Patients with contraindications to Angiotensin II including women who are pregnant or breastfeeding or have active coronary ischemia, mesenteric ischemia, limb ischemia, or high potassium (> 5.5 meq/L) while receiving Angiotensin II
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: Study Drug Arm - Angiotensin II arm
Angiotensin II
|
Angiotensin II: Starting dose of 2.5 ng/kg/min administered IV; may dose escalate up to 80 ng/kg/min in order to achieve a MAP of 65 mmHg or higher in the first 3 hours.
After 3 hours, may escalate dose up to 40 ng/kg/min in order to achieve a MAP of 65 mmHg.
Dose titration in increments of 10 ng/kg/min every 2 minutes.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of postoperative acute kidney injury, atrial fibrillation
Time Frame: 28 days
|
The primary endpoint will be measured by comparing the incidence of new-onset atrial fibrillation or acute kidney injury
|
28 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
30-day mortality
Time Frame: 30 days
|
30 days
|
|
Hours on Vasopressors
Time Frame: 28 days
|
28 days
|
|
Total IVF
Time Frame: 28 days
|
28 days
|
|
ICU LOS
Time Frame: 28 days
|
28 days
|
|
Postoperative LOS
Time Frame: 28 days
|
28 days
|
|
Any major STS complication
Time Frame: 28 days
|
28 days
|
|
Cost
Time Frame: 28 days
|
28 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
- Hypotension
- Aneurysm
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Peptide Hormones
- Neuropeptides
- Peptides
- Amino Acids, Peptides, and Proteins
- Oligopeptides
- Nerve Tissue Proteins
- Proteins
- Biological Factors
- Autacoids
- Inflammation Mediators
- Angiotensins
- Angiotensin II
Other Study ID Numbers
Other Study ID Numbers
- 00109542
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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