Intracoronary Darbepoetin-alpha to Reduce The Infarct Size and Post-Infarct Remodeling

June 18, 2015 updated by: Dong-Ju Choi, Seoul National University Bundang Hospital

The Efficacy of IntraCoronary Erythropoietin Delivery BEfore Reperfusion: Gauging Infarct Size in Patients With Acute ST-segment Elevation Myocardial Infarction (ICEBERG).

Prospective, randomized and open label trial

Hypothesis

  • Infusion of intracoronary darbepoetin-alpha at the time of reperfusion may reduce infarct size and post-infarct pathologic left ventricular remodeling in patients with ST-segment elevation myocardial infarction.

Methods

  • Randomization into control group or treatment group
  • Treatment group : Darbepoetin-alpha 300ug intracoronary bolus infusion via over-the-wire balloon system simultaneously with first balloon inflation and conventional treatment
  • Control group : conventional treatment

Endpoints

  • peak CK-MB & troponin levels : baseline,6h,12hr,18hr, 24hr, 36hr and 48hr
  • MRI at baseline : infarct size, area at risk and salvaged myocardium
  • MRI at 4 months : prevalence of pathologic left ventricle remodeling (definition: increase of end-diastolic volume index > 20% compared to baseline)
  • safety endpoint : cardiac death, nonfatal myocardial infarction, stent thrombosis, ischemic stroke, hospital readmission with heart failure or ischemic symptom, bleeding and urgent target lesion revascularization

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

[Eligibility Criteria]

1. Patients, regardless of gender, at the age from 18 to 80 years were eligible if they had within 12 hours of onset of ST-segment myocardial infarction that was decided to treat with primary percutaneous coronary intervention.

[Exclusion criteria]

  1. Uncontrolled congestive heart failure (Killip classes II and III, or cardiogenic shock)
  2. History of malignancy
  3. Serious hematological disease
  4. Current infectious disease requiring antibiotic therapy
  5. Baseline creatinine level > 2.0 mg/dL or dependence on dialysis
  6. Known hypersensitivity to or contraindication for heparin, aspirin, clopidogrel, sirolimus, everolimus, contrast medium and darbepoetin-α

[Primary endpoint] Myocardial infarct size, estimated by measurement of peak levels of cardiac biomarker (CK-MB and troponin-I of the patients was followed for 48 hours at every 6 hours)

[Secondary end points]

  1. The infarct size, measured as the area of delayed enhancement seen with cardiac magnetic resonance (CMR) imaging on average four days after ST-segment elevation myocardial infarction (baseline)
  2. The proportion of area at risk (AAR) and salvaged myocardium, calculated by formula; [AAR - Infarct size] / AAR X 100 (%)
  3. The change of left ventricular ejection fraction (LVEF), LV end-diastolic volume (LVEDV), and LV end-systolic volume (LVESV) assessed by CMR between four days and four months
  4. LV remodeling index [(LVEDV at four months - baseline LVEDV) / baseline LVEDV X 100%] and the incidence of pathologic LV remodeling (LV remodeling index > 20%);

[Safety endpoints] The incidence of composites of the cardiovascular endpoints (cardiac death, nonfatal myocardial infarction, stent thrombosis, ischemic stroke, hospital readmission with heart failure or ischemic symptoms, bleeding and urgent target lesion revascularization) assessed at four months.

Study Type

Interventional

Enrollment (Actual)

80

Phase

  • Phase 2

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

  • Korea, Republic of
      • Seongnam, Korea, Republic of, 463707
        • Seoul National University Bundang Hospital

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 to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients with ST-elevation myocardial infarction (MI) within 12 hours of onset
  • Suitable coronary anatomy for PCI
  • Age < 80 yrs

Exclusion Criteria:

  • Uncontrolled congestive heart failure (Killip classes II and III, or cardiogenic shock)
  • History of malignancy
  • Serious hematological disease
  • Current infectious disease requiring antibiotic therapy
  • Baseline creatinine level > 2.0 mg/dL or dependence on dialysis
  • Known hypersensitivity to or contraindication for heparin, aspirin, clopidogrel, sirolimus, everolimus, contrast medium and darbepoetin-α

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: Control group
Received same volume of saline
Drug: Control Saline
Same volume of saline intracoronary bolus infusion via over-the-wire balloon before the 1st ballooning and conventional treatment
Other Names:
  • 0.9% normal saline
Active Comparator: Darbepoetin group
Darbepoetin alfa 300ug intracoronary bolus infusion via over-the-wire balloon before the 1st ballooning & conventional treatment
Drug: Darbepoetin alfa
Darbepoetin alfa 300ug intracoronary bolus infusion via over-the-wire balloon before the 1st ballooning and conventional treatment
Other Names:
  • Nesp PFS Prefilled Syringe (Jeilkirin Pharm. Korea)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Peak CK-MB/ Troponin-I levels
Time Frame: baseline, 6, 12,18,24,36,48hrs
baseline, 6, 12,18,24,36,48hrs

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Infarct size, area at risk and proportion of salvaged myocardium
Time Frame: Participants will be followed for the duration of hospital stay, an expected average of 4 days
Assessed by cardiac MRI
Participants will be followed for the duration of hospital stay, an expected average of 4 days
Pathologic left ventricle remodeling assessed by cardiac MRI
Time Frame: 4 months
Definition : Increase of end-diastolic volume of left ventricle >20%
4 months
Change of left ventricular ejection fraction, LV end-diastolic volume , and LV end-systolic volume assessed by cardiac MRI
Time Frame: Between four days and 4 months
Between four days and 4 months
Composites of cardiovascular endpoints
Time Frame: 4 Months
ccardiac death, nonfatal myocardial infarction, stent thrombosis, ischemic stroke, hospital readmission with heart failure or ischemic symptoms, bleeding and target lesion revascularization
4 Months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Seoul National University Bundang Hospital

Investigators

  • Principal Investigator: Dong-Ju Choi, MD, PhD, Seoul National University Bundang 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.

General Publications

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

November 1, 2009

Primary Completion (Actual)

September 1, 2012

Study Completion (Actual)

February 1, 2013

Study Registration Dates

First Submitted

February 15, 2012

First Submitted That Met QC Criteria

February 20, 2012

First Posted (Estimate)

February 24, 2012

Study Record Updates

Last Update Posted (Estimate)

June 19, 2015

Last Update Submitted That Met QC Criteria

June 18, 2015

Last Verified

June 1, 2015

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • DAMI

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

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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