- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03677466
Intramyocardial Haemorrhage in Patients With Primary STEMI (HaemInCor)
Clinical Trial Appreciating Intramyocardial Haemorrhage in Patients With Primary STEMI and Different Reperfusion Strategies (Pharmaco Invasive Strategy and Primary PCI)
Study Overview
Status
Intervention / Treatment
Detailed Description
The study non-randomized, opened, controlled. In half of patients despite on carried in-time reperfusion therapy intramyocardial haemorrhage determined after a long-term period of severe ischemia. Earlier, definition of intramyocardial haemorrhage was possible only by autopsy. Nowaday, cardiac contrast MRI is the best diagnostic method, which allows to assess the regional and global function of the LV, structural changes in myocardial tissue and also in T2 mode it became assessable to reveal intramyocardial haemorrhage.
Taking into account the results of previous researches, it can be concluded that the intramyocardial haemorrhage was determined in half of patients with primary PCI [1]. An influence of fibrinolytic therapy to the intramyocardial haemorrhage was conducted in small group of patients in one trial, and therefore further data will be actual and useful [2].
It is planned to study 60 patients with primary STEMI using standard therapy. The patients will be divided into 2 groups. Patients of the 1st group will be treated by pharmaco-invasive strategy. The 2nd group will be treated by primary PCI. Patients in all groups after reperfusion strategies will be conducted cardiac contrast MRI for detection intramyocardial haemorrhage within 2 days onset. At day 7 and through 3 months, the clinical condition of the patients will be assessed and cardiac ultrasound will be performed for the evaluation of myocardial contractile function and 2D global longitudinal strain. Also, the incidence rate of secondary endpoints will be evaluated.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Tomsk, Russia, 634012
- Cardiology Research Institute
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 18 years at time of randomization (18 years and older);
- Acute myocardial infarction;
- Reperfusion of the infarct-related coronary artery in terms within 12 h of symptom onset;
- Written the informed consent to participate in research;
Exclusion Criteria:
- Inability to obtain informed consent;
- Patients previously undergone endovascular / surgical revascularization of coronary artery;
- Severe comorbidity;
- History of myocardial infarction;
- History of intracranial haemorrhage;
- Pulmonary edema, cardiogenic shock;
- Creatinine clearance <30 mL/min or dialysis;
- Unable to undergo or contra-indications for MRI;
- Allergy for contrast agent;
- Indication or use of oral anticoagulant therapy;
- Major bleedind;
- Atrio-ventricular block II and III degree;
- Active gastroduodenal ulcer;
- Aortic dissection;
- Acute psychotic disorders
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: Pharmaco-invasive strategy
Fibrinolytic therapy (Streptokinase, Alteplasa, Tenecteplasa in standard dose) is conducted within 12 h of symptom onset in the pre-hospital setting if primary PCI cannot be performed within 120 min from STEMI diagnosis.
Then PCI is performed to all of patients.
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Patient with primary STEMI will received standard doses of fibrinolytics with following PCI. After reperfusion strategies will be conducted cardiovascular magnetic resonance (CMR) imaging with contrast (Gadovist) in regime inversion recovery time, regime T-2 weighted images, T1-weighted images. and Global Longitudinal Strain measured with echocardiography.
Other Names:
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Active Comparator: Primary PCI
Primary percutaneous coronary intervention (PCI) in patients with primary STEMI
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After primary PCI patients will be conducted cardiovascular magnetic resonance (CMR) imaging with contrast (Gadovist) in regime inversion recovery time, regime T-2 weighted images, T1-weighted images and Global Longitudinal Strain measured with echocardiography.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Intramyocardial haemorrhage in primary STEMI measure
Time Frame: 2 days
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Intramyocardial haemorrhage (%) in patients with primary STEMI as assessed by cardiac magnetic resonance imaging 2 days after reperfusion
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2 days
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Left ventricular ejection fraction (LVEF) recovery measure
Time Frame: 3 months (with intermediate measurement at day 7 after reperfusion)
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Left ventricular ejection fraction (LVEF) (%) recovery measured with echocardiography 7 days and 3 months after reperfusion strategies
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3 months (with intermediate measurement at day 7 after reperfusion)
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Global Longitudinal Strain
Time Frame: 3 months (with intermediate measurement at day 7 after reperfusion)
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Global Longitudinal Strain (%) measured with echocardiography 7 days and 3 months after reperfusion strategies
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3 months (with intermediate measurement at day 7 after reperfusion)
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Recurrent myocardial infarction measure
Time Frame: 3 months
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Incidence of recurrent myocardial infarction (%) 3 months after STEMI
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3 months
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Heart failure incidence measure
Time Frame: 3 months
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Incidence of heart failure (%) 3 months after STEMI
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3 months
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Stroke incidence measure
Time Frame: 3 months
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Incidence of stroke (%) 3 months after STEMI
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3 months
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Mortality measure
Time Frame: 3 months
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Mortality rate (%) 3 months after STEMI
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3 months
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Major bleeding incidence measure
Time Frame: 3 months
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Incidence of major bleeding (%) 3 months after STEMI
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3 months
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Collaborators and Investigators
Investigators
- Principal Investigator: Evgeny V. Vyshlov, Tomsk NRMC
Publications and helpful links
General Publications
- Hamirani YS, Wong A, Kramer CM, Salerno M. Effect of microvascular obstruction and intramyocardial hemorrhage by CMR on LV remodeling and outcomes after myocardial infarction: a systematic review and meta-analysis. JACC Cardiovasc Imaging. 2014 Sep;7(9):940-52. doi: 10.1016/j.jcmg.2014.06.012.
- Carrick D, Haig C, Ahmed N, McEntegart M, Petrie MC, Eteiba H, Hood S, Watkins S, Lindsay MM, Davie A, Mahrous A, Mordi I, Rauhalammi S, Sattar N, Welsh P, Radjenovic A, Ford I, Oldroyd KG, Berry C. Myocardial Hemorrhage After Acute Reperfused ST-Segment-Elevation Myocardial Infarction: Relation to Microvascular Obstruction and Prognostic Significance. Circ Cardiovasc Imaging. 2016 Jan;9(1):e004148. doi: 10.1161/CIRCIMAGING.115.004148.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Vascular Diseases
- Cardiovascular Diseases
- Pathologic Processes
- Heart Diseases
- Infarction
- Necrosis
- Arteriosclerosis
- Arterial Occlusive Diseases
- Coronary Disease
- Myocardial Ischemia
- Ischemia
- Pathological Conditions, Signs and Symptoms
- ST Elevation Myocardial Infarction
- Coronary Artery Disease
- Myocardial Infarction
- Amino Acids, Peptides, and Proteins
- Proteins
- Biological Factors
- Hydrolases
- Enzymes
- Enzymes and Coenzymes
- Blood Proteins
- Endopeptidases
- Peptide Hydrolases
- Serine Endopeptidases
- Serine Proteases
- Plasminogen Activators
- Blood Coagulation Factors
- Tenecteplase
- Tissue Plasminogen Activator
- Streptokinase
Other Study ID Numbers
- CRI-5
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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