Intracoronary rhTNK-tPA Versus Tirofiban in Patients With STEMI and High Thrombus Burden (H2-THROMBUS)
Effects of Intracoronary Recombinant Human TNK Tissue-type Plasminogen Activator Versus Tirofiban on Myocardial Perfusion and Clinical Prognosis in Patients With ST-segment Elevation Myocardial Infarction and High Thrombus Burden: a Multicenter, Randomized, Controlled, Single-blind, Non-inferior Study
The goal of this clinical trial is to compare the efficacy and safety of intracoronary rhTNK-tPA or Tirofiban in patients with ST-segment elevation myocardial infarction and high thrombus burden. The main questions it aims to answer are:
- Is the efficacy of intracoronary rhTNK-tPA non-inferior to intracoronary Tirofiban for the treatment of ST-segment elevation myocardial infarction in patients wiht high thrombus burden?
- Does intracoronary rhTNK-tPA increase the incidence of bleeding events?
This multicenter RCT study plans to enroll 300 patients, who are randomly divided into two groups: intracoronary rhTNK-tPA or Tirofiban by 1:1. The primary efficacy endpoint was post-PCI corrected TIMI frame count (CTFC). Major adverse events (death, recurrent myocardial infarction, ischemic stroke, or hospitalization for heart failure) were observed at 1 year follow-up.
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: You Zhang
- Phone Number: +86 37158681037
- Email: 13598019682@126.com
Study Locations
-
-
Henan
-
Zhengzhou, Henan, China
- Recruiting
- Fuwai Central China Cardiovascular Hospital
-
Contact:
- You Zhang
- Phone Number: +8637158681037
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18-75 years old;
- STEMI within 12 hours of onset;
- TIMI flow grade 0-2 or TIMI thrombus grade ≥4 after thrombus aspiration or balloon dilation
- Radial artery access
Exclusion Criteria:
- A functional coronary collateral supply (Rentrop grade≥2) to the infarctrelated artery
- Known or suspected old myocardial infarction of target vessels
- Rescue PCI
- Cardiogenic shock
- Contraindications to Tirofiban or rhTNK-tPA
- Severe hepatic and renal insufficiency (alanine aminotransferase ≥5 upper limit of normal; estimated glomerular filtration rate <30ml/min/1.73m2, or on dialysis)
- Prolonged (> 10 minutes) cardiopulmonary resuscitation
- Definite mechanical complications (including ventricular septal perforation, or rupture of the Papillary tendon bundle, or rupture of the left ventricular free wall)
- Severe chronic obstructive pulmonary disease or respiratory failure
- Severe infection
- Neurological disorders
- Malignant tumors or other pathophysiological conditions with an expected survival time of less than 1 year
- Pregnant or lactating women
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: Intracoronary rhTNK-tPA
|
Intracoronary influsion of rhTNK-tPA (4 mg).
After 10 minutes of administration, 4 mg may be given again if the thrombus burden is not significantly reduced.
|
|
Active Comparator: Intracoronary Tirofiban
|
Intracoronary influsion of Tirofiban (10 µg/kg) , and then administered intravenously at 0.075-0.15
µg/kg.min
for 36 h or longer
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Corrected TIMI frame count (CTFC)
Time Frame: At the end of Percutaneous Coronary Intervention procedure
|
At the end of Percutaneous Coronary Intervention procedure
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
TIMI flow grade
Time Frame: At the end of Percutaneous Coronary Intervention procedure
|
At the end of Percutaneous Coronary Intervention procedure
|
|
Complete ST-segment resolution (STR)
Time Frame: 1 hour post PCI procedure
|
1 hour post PCI procedure
|
|
Left ventricular ejection fraction (LVEF)
Time Frame: Baseline, 1 month, 6 months and 12 months
|
Baseline, 1 month, 6 months and 12 months
|
|
A composite of all-cause death, recurrent myocardial infarction, ischemic stroke, and hospitalization for heart failure
Time Frame: 1 month, 6 months and 12 months
|
1 month, 6 months and 12 months
|
|
Bleeding events according to the BARC bleeding classification
Time Frame: At hospital discharge, an average of 2 days after primary PCI, 1 month, 6 months and 12 months
|
At hospital discharge, an average of 2 days after primary PCI, 1 month, 6 months and 12 months
|
Collaborators and Investigators
Sponsor
Sponsor
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
- Pathologic Processes
- Heart Diseases
- Infarction
- Necrosis
- Myocardial Ischemia
- Myocardial Infarction
- Ischemia
- Pathological Conditions, Signs and Symptoms
- ST Elevation Myocardial Infarction
- Amino Acids, Peptides, and Proteins
- Amino Acids
- Amino Acids, Aromatic
- Amino Acids, Cyclic
- Tyrosine
- Tirofiban
Other Study ID Numbers
Other Study ID Numbers
- HenanICE202412
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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