- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00699452
The Potential of Candesartan to Retard the Progression of Aortic Stenosis (ROCK-AS)
May 18, 2009 updated by: University of Helsinki
The Potential of Candesartan to Retard the Progression of Aortic Stenosis Influences of Medical Therapy to the Atheroinflammatory Process in Stenotic Aortic Valves
The present study defines a blinded, randomized, placebo-controlled, prospective study, the aim of which is to determine the influence of effective treatment with Type 1 angiotensin II (Ang II) receptor (AT-1R) antagonist, using candesartan (target dose 16 mg) on stenotic aortic valves.
The investigators will specifically quantify whether candesartan attenuates the key pathogenic mechanisms of aortic valve stenosis, namely inflammation, fibrosis, elastin degradation, calcification, and neovascularization.
Study Overview
Status
Unknown
Conditions
Intervention / Treatment
Detailed Description
We will include in the study 120 consecutive patients with clinically significant, symptomatic aortic stenosis referred to the Helsinki University Central Hospital for consideration of valve replacement surgery.
Patients who can be put on the hospital's normal waiting list for elective angiography (i.e who do not need urgent surgery) and who give their informed consent, will be randomized into two groups to start therapy with candesartan (8 mg/d for 2 weeks, and then 16 mg/d until surgery) or placebo.
On average, the overall duration of the drug intervention will be 3 months, i.e., the average time in our institution from referral to surgery.
In addition, patients (n=50) undergoing aortic valve replacement surgery due to aortic regurgitation caused by dilation of the aortic root will be included.
This population consists of both patients with early sclerotic, i.e., pre-stenotic, changes in their aortic valves (n=30) and of patients without any sclerotic or stenotic changes in their aortic valves (n=20).
The group with sclerotic changes in their aortic valves (n=30) will be divided into two groups to receive candesartan (8 mg/d 2 wk, and then 16 mg/d until surgery) (n=15) or placebo (n=15).
The removed aortic valves will be examined utilizing real-time PCR, autoradiography, fluorometry, immunohistochemistry, double immunofluorescence, confocal microscopy, and enzyme immunoassays.
With these techniques, several markers of inflammation, calcification, fibrosis, and the amount of lipid accumulation and oxidation of LDL in the valves will be examined.
Study Type
Interventional
Enrollment (Anticipated)
120
Phase
- Phase 3
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
-
Helsinki, Finland, 00029
- Recruiting
- Division of Cardiology, Helsinki University Central Hospital
-
Contact:
- Markku Kupari, MD, PhD
- Phone Number: 358-9-4717-2441
- Email: markku.kupari@hus.fi
-
Contact:
- Satu Helske, MD, PhD
- Phone Number: 358-9-681-411
- Email: satu.helske@wri.fi
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Principal Investigator:
- Markku Kupari, MD, PhD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- 120 consecutive patients with clinically significant, symptomatic aortic stenosis referred to the Helsinki University Central Hospital for consideration of valve replacement surgery.
Exclusion Criteria:
- Individuals with past myocardial infarction, more than mild mitral valve disease, or previous cardiac surgery will be excluded.
- Patients with heart failure who need urgent surgery or those with hypotension (systolic blood pressure below 110 mm Hg) will be excluded.
- Patients already taking ACE inhibitors or AT-1R antagonists will be excluded from the study population.
Other exclusion criteria include the following:
- Complicated diabetes
- Primary cardiomyopathy
- Pregnant women, women who are breast feeding, and women of childbearing potential who are not using chemical or mechanical contraception or have a positive serum pregnancy test
- History of malignancy (unless a documented disease free period exceeding 5-years is present) with the exception of basal cell or squamous cell carcinoma of the skin. Women with a history of cervical dysplasia would be permitted to enter the study provided they had 3 consecutive clear Papanicolaou (Pap) smears
- Hypothyroidism (TSH 1.5xULN)
- History of alcohol or drug abuse within the last 5 years (this may affect compliance)
- Unexplained creatine kinase (CK 3xULN) (To protect patient safety)
- Serum creatinine >176 umol/L (2.0mg/dL)
- Participation in another investigational drug study less than 4 weeks before enrolment in the study, or according to subjects local ethics committee requirements where a larger period is stipulated (to avoid potential misinterpretation of overlapping adverse events)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: 2
Placebo
|
placebo
|
Active Comparator: 1
Candesartan 8 mg/d for two weeks, then 16 mg/d until valve replacement surgery (approximately 3 months)
|
Candesartan 8 mg/d for two weeks, then 16 mg/d until valve replacement surgery (approximately 3 months)
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The degree of inflammation in stenotic aortic valves
Time Frame: 3-5 months
|
3-5 months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The degree of calcification, lipid accumulation, and fibrosis in stenotic aortic valves
Time Frame: 3-5 months
|
3-5 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Markku Kupari, MD, PhD, Division of Cardiology, Helsinki University Central Hospital
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
May 1, 2009
Primary Completion (Anticipated)
December 1, 2012
Study Completion (Anticipated)
December 1, 2014
Study Registration Dates
First Submitted
June 16, 2008
First Submitted That Met QC Criteria
June 17, 2008
First Posted (Estimate)
June 18, 2008
Study Record Updates
Last Update Posted (Estimate)
May 19, 2009
Last Update Submitted That Met QC Criteria
May 18, 2009
Last Verified
May 1, 2009
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Heart Diseases
- Cardiovascular Diseases
- Pathological Conditions, Anatomical
- Aortic Valve Disease
- Heart Valve Diseases
- Ventricular Outflow Obstruction
- Aortic Valve Stenosis
- Constriction, Pathologic
- Molecular Mechanisms of Pharmacological Action
- Antihypertensive Agents
- Angiotensin II Type 1 Receptor Blockers
- Angiotensin Receptor Antagonists
- Candesartan
Other Study ID Numbers
- ROCK-AS
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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