- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01633502
Danish Cardiogenic Shock Trial (DanShock)
July 13, 2023 updated by: Jacob Moller, Odense University Hospital
Effects of Advanced Mechanical Circulatory Support in Patients With ST Segment Elevation Myocardial Infarction Complicated by Cardiogenic Shock. The Danish Cardiogenic Shock Trial
Cardiogenic shock a serious complication of a heart attack (myocardial infarction).
Despite rapid invasive treatment, circulatory support using positive inotropes and mechanical support with intra-aortic balloon counterpulsation (IABP), and evaluation of several new treatments during the last decade, the mortality in patients with cardiogenic shock still exceeds 50%.
An alternative to current management is restoration of the volume of blood pumped by the heart (cardiac output) using a ventricular assist device.
In the acute setting this is difficult but can be done using the Impella device which is a catheter-based, axial flow pump that pumps blood directly from the left ventricle into the circulation thereby restoring blood flow to the failing organs.
In 2012 a more powerful Impella has been introduced that is able to deliver 3.5l/min (approximately 75% of a normal cardiac output).
The hypothesis of the current study is to reduce mortality and morbidity of patients with cardiogenic shock using the Impella CP.
The study will be carried out as a randomized multicenter study where eligible patients will be randomized to receive conventional circulatory support or support with the Impella device and inotropic support if needed.
A total of 360 patients are planned to be enrolled, and the primary endpoint will be death.
Study Overview
Status
Active, not recruiting
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
360
Phase
- Not Applicable
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
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Aarhus, Denmark, 8200
- Aarhus University Hospital Skejby
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Copenhagen, Denmark, 2100
- Copenhagen University Hospital Rigshospitalet
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Odense, Denmark, DK-5000
- Odense University Hospital
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Berlin, Germany
- Charite Berlin
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Bonn, Germany
- University Hospital Bonn
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Dresden, Germany
- Dresden University Hospital
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Düsseldorf, Germany
- Düsseldorf University Hospital
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Hamburg, Germany
- UKE Hamburg
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Hannover, Germany
- Hannover Medical School
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Jena, Germany
- Jena University Hospital
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Trier, Germany
- Brüderkrankenhaus Trier
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Würzburg, Germany
- University Hospital Würzburg
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London, United Kingdom
- NHs Harefield Hospital
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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
Description
Inclusion Criteria:
- ST segment elevation myocardial infarction of less than 36 hours' duration, confirmed by new onset ST-segment elevation, or emergency angiography demonstrating acute occlusion of coronary artery, and
Cardiogenic shock of less than 24 hours' duration, confirmed by:
- peripheral signs of tissue hypoperfusion (arterial blood lactate ≥2.5mmol/l and/or SvO2 <55% with a normal PaO2) and
- systolic blood pressure less than 100mmHg and/or need for vasopressor therapy (dopamine/ norepinephrine or epinephrine), and
- Left ventricular ejection fraction of less than 45% visually estimated or by wall motion score index >1,6.
Exclusion Criteria:
- Other causes of shock (hypovolemia, hemorrhage, sepsis, pulmonary embolism or anaphylaxis).
- Shock due to mechanical complication to myocardial infarction (papillary muscle rupture, rupture of the ventricular septum or rupture of free wall).
- Severe aorta valve regurgitation/stenosis.
- Predominant right ventricular failure.
- Out of hospital cardiac arrest with persistent Glasgow coma scale <8 after return of spontaneous circulation.
- Shock duration>24 hours.
- Known heparin intolerance.
- Already established mechanical circulatory support
- Do not resuscitate wish.
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: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Placebo Comparator: Conventional circulatory support
Patients randomized to conventional circulatory support.
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Control group treated with conventional circulatory support and observed in intensive care unit for a minimum of 48 hrs.
Other Names:
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Active Comparator: Impella
Patients randomized to Impella CP
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Control group treated with Impella CP for a minimum of 48 hrs.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Death
Time Frame: up to 6 months
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Death from all causes
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up to 6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
MACE
Time Frame: minimum follow-up 6 months
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Major cardiovascular events, death, cardiac transplant, escalation to permanent left ventricular assist device, re-hospitalization for heart failure.
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minimum follow-up 6 months
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Composite saftey
Time Frame: up to 6 months
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Combined safety comprising major bleeding, vascular complications, and significant hemolysis.
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up to 6 months
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Days alive out of hospital
Time Frame: up tp 6 months
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Days alive and out of hospital; calculated by subtracting the number of days spent in hospital, from time of randomization to end of follow-up (180 days) for each patient.
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up tp 6 months
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Hemodynamics
Time Frame: up to 7 days
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Cardiac power index
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up to 7 days
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Hemodynamics
Time Frame: up to 7 days
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Lactate clearence
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up to 7 days
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Hemodynamics
Time Frame: up to 7 days
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Pulmonary artery pulsatility index
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up to 7 days
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Health economics
Time Frame: up to 6 months
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Cost of treatments
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up to 6 months
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Renal function
Time Frame: up to 30 days
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Development of acute kidney injury and need for dialysis
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up to 30 days
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Bleeding
Time Frame: up to 30 days
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Bleeding complications during admission
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up to 30 days
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Revascularization strategy
Time Frame: During procedure
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Syntax score ( a grading system that evaluates the complexity and prognosis of patients undergoing percutaneous coronary intervention, higher scores denotes more complex disase and higher risk)
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During procedure
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Revascularization strategy
Time Frame: up to 6 months
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Additional non culprit revascularization
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up to 6 months
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Jacob E Moller, MD, Department of Cardiology, Odense University Hospital, Odense
- Study Chair: Anders Junker, MD, Department of Cardiology, Odense University Hospital
- Study Chair: Christian Hassager, MD, Department of Cardiology, Copenhagen University Hospital Gentofte
- Study Chair: Andreas Shaefer, MD, Hannover Medical School
- Study Chair: Nikos Werner, MD, University Hospital Trier
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
- Moller JE, Gerke O; DanGer Shock Investigators. Danish-German cardiogenic shock trial-DanGer shock: Trial design update. Am Heart J. 2023 Jan;255:90-93. doi: 10.1016/j.ahj.2022.10.078. Epub 2022 Oct 19.
- Udesen NJ, Moller JE, Lindholm MG, Eiskjaer H, Schafer A, Werner N, Holmvang L, Terkelsen CJ, Jensen LO, Junker A, Schmidt H, Wachtell K, Thiele H, Engstrom T, Hassager C; DanGer Shock investigators. Rationale and design of DanGer shock: Danish-German cardiogenic shock trial. Am Heart J. 2019 Aug;214:60-68. doi: 10.1016/j.ahj.2019.04.019. Epub 2019 May 6.
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
December 1, 2012
Primary Completion (Actual)
July 1, 2023
Study Completion (Estimated)
January 1, 2024
Study Registration Dates
First Submitted
June 28, 2012
First Submitted That Met QC Criteria
June 29, 2012
First Posted (Estimated)
July 4, 2012
Study Record Updates
Last Update Posted (Actual)
July 17, 2023
Last Update Submitted That Met QC Criteria
July 13, 2023
Last Verified
July 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- DanShock-01
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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