- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02512978
Thyroid Hormone Replacement for Hypothyroidism and Acute Myocardial Infarction(ThyroHeart-AMI)
July 13, 2018 updated by: Yi-Da Tang, Chinese Academy of Medical Sciences, Fuwai Hospital
Thyroid Hormone Replacement for Hypothyroidism and Acute Myocardial Infarction
Based on accumulating evidences showing that hypothyroid status is associated with poor prognosis among acute myocardial infarction (AMI) patients, the study is designed to evaluate whether replacement treatment with levothyroxine could have beneficial effects on patients with AMI and hypothyroidism.
This is a multicenter prospective computerized-randomized trial stratified by ejection fraction with a 1:1 ratio to levothyroxine group or standard therapy group.
Study Overview
Status
Unknown
Conditions
Intervention / Treatment
Detailed Description
The primary hypothesis is that reversing the hypothyroid status with levothyroxine on top of standard therapy for AMI is safe and has beneficial effects on cardiac function, myocardial perfusion/metabolism and myocardial fibrosis.
Study Type
Interventional
Enrollment (Anticipated)
160
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Wen-Yao Wang, MD,PhD Candidate
- Phone Number: 861088396171 8618810488381
- Email: wwypumc@126.com
Study Contact Backup
- Name: Jing Chen, MD
- Phone Number: 861088396171 8618618285284
- Email: tyler_1985@163.com
Study Locations
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Beijing, China, 100037
- Recruiting
- Fuwai Cardiovascular Hospital
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Contact:
- Kuo Zhang, MD,PhD Candidant
- Phone Number: +86 18813019602
- Email: zk1989y@163.com
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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 to 75 years (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age 18 - 75, male or non-pregnant female;
- Is diagnosed acute myocardial infarction and received primary percutaneous coronary intervention (PCI);
- With presence of hypothyroid status (i.e., TSH >7.0 mIU/L and (or) fT3 <1.79 pg/mL);
- Is able to understand the objective of the trial, takes part voluntarily and signs the written informed consent form.
Exclusion Criteria:
- Those who have participated in other drug or therapeutic equipment clinical trials but do not reach the main study endpoint time limit;
- Symptoms of severe heart failure (Killip Class III and above);
- Severely impaired renal function before surgery: serum creatinine > 2.0mg/dl;
- Impaired liver function before surgery: Serum GPT > 120U/L;
- Those who have prior thyroid diseases and already on levothyroxine or anti-thyroid medicines;
- Those taking medicine which can affect the test of thyroid function;
- Patients who plan to undergo coronary artery bypass grafting or other surgery within 3 months;
- Those having prior myocardial infarction;
- Patients who are deemed by the researchers to have low compliance and unable to abide by the requirements and complete the study.
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
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Levothyroxine group
The patients allocated to levothyroxine group receive levothyroxine with a starting dose of 12.5ug.
|
Levothyroxine is used to normalize the thyroid hormone level of patients allocated to levothyroxine.
Other Names:
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NO_INTERVENTION: Standard therapy group
The patients in this group receive standard therapy in consistent with the local clinical practice.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The improvement of Left Ventricular ejection fraction assessed by cardiac magnetic resonance imaging
Time Frame: within 6 months of patient enrolled
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within 6 months of patient enrolled
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Myocardial perfusion and metabolism detected by 99Tcm-MIBI SPECT and 18F-FDG PET imaging
Time Frame: Within 6 months of patient enrolled
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Patterns of myocardial perfusion/metabolism were classified as normal, mismatch, mild-moderate match and severe match
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Within 6 months of patient enrolled
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The severity of myocardial fibrosis assessed by late-gadolinium enhancement cardiac magnetic resonance imaging(cMRI-LGE)
Time Frame: Within 6 months of patient enrolled
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Within 6 months of patient enrolled
|
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Major adverse cardiac and cerebrovascular events
Time Frame: within 12 months of patient enrolled
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The composite endpoint of cardiac death, myocardial infarction, target vessel revascularization and cerebrovascular accident.
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within 12 months of patient enrolled
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Death by any cause
Time Frame: Within 12 months of patient enrolled
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Within 12 months of patient enrolled
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Yi-Da Tang, MD,PhD, Chinese Academy of Medical Sciences, Fuwai 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
- Li J, Li X, Wang Q, Hu S, Wang Y, Masoudi FA, Spertus JA, Krumholz HM, Jiang L; China PEACE Collaborative Group. ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data. Lancet. 2015 Jan 31;385(9966):441-51. doi: 10.1016/S0140-6736(14)60921-1. Epub 2014 Jun 23.
- Pingitore A, Chen Y, Gerdes AM, Iervasi G. Acute myocardial infarction and thyroid function: new pathophysiological and therapeutic perspectives. Ann Med. 2012 Dec;44(8):745-57. doi: 10.3109/07853890.2011.573501. Epub 2011 May 13.
- Mourouzis I, Forini F, Pantos C, Iervasi G. Thyroid hormone and cardiac disease: from basic concepts to clinical application. J Thyroid Res. 2011;2011:958626. doi: 10.4061/2011/958626. Epub 2011 Jun 19.
- Cakar M, Demirbas S, Demirkol S, Karaman M, Balta S, Unlu M. Chicken or egg? Which one is first? Myocardial infarction or low thyroid hormones? Intern Med. 2013;52(5):645. doi: 10.2169/internalmedicine.52.9285. Epub 2013 Mar 1. No abstract available.
- Ceremuzynski L, Gorecki A, Czerwosz L, Chamiec T, Bartoszewicz Z, Herbaczynska-Cedro K. Low serum triiodothyronine in acute myocardial infarction indicates major heart injury. Kardiol Pol. 2004 May;60(5):468-80; discussion 473-4. English, Polish.
- Chen YF, Kobayashi S, Chen J, Redetzke RA, Said S, Liang Q, Gerdes AM. Short term triiodo-L-thyronine treatment inhibits cardiac myocyte apoptosis in border area after myocardial infarction in rats. J Mol Cell Cardiol. 2008 Jan;44(1):180-7. doi: 10.1016/j.yjmcc.2007.09.009. Epub 2007 Oct 26.
- Bai MF, Gao CY, Yang CK, Wang XP, Liu J, Qi DT, Zhang Y, Hao PY, Li MW. Effects of thyroid dysfunction on the severity of coronary artery lesions and its prognosis. J Cardiol. 2014 Dec;64(6):496-500. doi: 10.1016/j.jjcc.2014.03.009. Epub 2014 Jun 17.
- Wang WY, Tang YD, Yang M, Cui C, Mu M, Qian J, Yang YJ. Free triiodothyronine level indicates the degree of myocardial injury in patients with acute ST-elevation myocardial infarction. Chin Med J (Engl). 2013 Oct;126(20):3926-9.
- Zhang B, Peng W, Wang C, Li W, Xu Y. A low fT3 level as a prognostic marker in patients with acute myocardial infarctions. Intern Med. 2012;51(21):3009-15. doi: 10.2169/internalmedicine.51.7902. Epub 2012 Nov 1.
- Mourouzis I, Giagourta I, Galanopoulos G, Mantzouratou P, Kostakou E, Kokkinos AD, Tentolouris N, Pantos C. Thyroid hormone improves the mechanical performance of the post-infarcted diabetic myocardium: a response associated with up-regulation of Akt/mTOR and AMPK activation. Metabolism. 2013 Oct;62(10):1387-93. doi: 10.1016/j.metabol.2013.05.008. Epub 2013 Jun 15.
- Mourouzis I, Mantzouratou P, Galanopoulos G, Kostakou E, Roukounakis N, Kokkinos AD, Cokkinos DV, Pantos C. Dose-dependent effects of thyroid hormone on post-ischemic cardiac performance: potential involvement of Akt and ERK signalings. Mol Cell Biochem. 2012 Apr;363(1-2):235-43. doi: 10.1007/s11010-011-1175-9. Epub 2011 Dec 2.
- Tang YD, Kuzman JA, Said S, Anderson BE, Wang X, Gerdes AM. Low thyroid function leads to cardiac atrophy with chamber dilatation, impaired myocardial blood flow, loss of arterioles, and severe systolic dysfunction. Circulation. 2005 Nov 15;112(20):3122-30. doi: 10.1161/CIRCULATIONAHA.105.572883. Epub 2005 Nov 7.
Helpful Links
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 (ACTUAL)
August 1, 2015
Primary Completion (ANTICIPATED)
December 1, 2018
Study Completion (ANTICIPATED)
June 1, 2019
Study Registration Dates
First Submitted
July 27, 2015
First Submitted That Met QC Criteria
July 29, 2015
First Posted (ESTIMATE)
July 31, 2015
Study Record Updates
Last Update Posted (ACTUAL)
July 16, 2018
Last Update Submitted That Met QC Criteria
July 13, 2018
Last Verified
July 1, 2018
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- Z15110700400000
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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