- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05514067
Electroacupuncture for Heart Protection: Clinical Application in Patients Undergoing Cardiac Bypass Surgery (EA-CABG)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
There are currently no effective therapies for protecting the heart against PMI during CABG surgery and therefore, new therapeutic interventions are required to reduce the magnitude of PMI, in order to preserve LV systolic function and improve health outcomes in CAD patients undergoing CABG surgery. In this regard, electroacupuncture (EA) may provide a novel treatment strategy for protecting the heart and reducing PMI during CABG surgery, and is investigated in this TCM research proposal. The magnitude of PMI can be quantified by measuring post-operative levels of serum cardiac biomarkers such CK-MB, Troponin-T, or Troponin-I, the release of which have been associated with worse clinical outcomes following CABG surgery.
This study aims to show the benefit of EA at cardiac-related acupoints in reducing injury to the heart in terms of less PMI in patients undergoing CABG surgery and also test the possibility that EA will have benefits in other organs in terms of less acute kidney injury and preserved cognitive function, given that the blood-borne humoral factors generated by EA may also be reno- and neuroprotective. As such, the findings for this research proposal will build on evidence for the safety and efficacy of EA in the clinical setting of CABG surgery for the benefit of patients with CAD. The expected clinical benefits of reducing PMI will include improvement in short term clinical outcomes in terms of preserving LV systolic function, preventing the onset of heart failure, and improving quality of life in patients undergoing CABG surgery. This study also intends to identify and assess the cardioprotective humoral factors generated by EA at cardiac-related acupoints in stable CAD and CABG patients, providing novel therapeutic strategies for cardioprotection. In this regard, the findings from this research proposal will add new knowledge in the field of EA cardioprotection.
60 stable CAD patients undergoing planned CABG surgery will be randomized to receive either EA at cardiac-related acupoints (N=30) or standard care (N=30). A single application of EA at cardiac-related acupoints will be administered for 30 min prior to surgery. For 10 recruited CABG patients administered EA, blood samples will be collected prior to and immediately following EA, and subjected to plasma proteomics analysis to identify the factor(s) which mediate EA cardioprotection. PMI will be measured as the 48-hour area under-the-curve serum high-sensitive Troponin-T. Blood samples will be taken at pre-op and 6, 12, 24, 48 hours (post-coming off cardiac bypass) for this evaluation.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Derek Hausenloy, PHD
- Phone Number: 67042196
- Email: derek.hausenloy@nhcs.com.sg
Study Contact Backup
- Name: Pei Yi Ho, BSc
- Phone Number: 67042234
- Email: ho.pei.yi@nhcs.com.sg
Study Locations
-
-
-
Singapore, Singapore, 169609
- Recruiting
- National Heart Centre Singapore
-
Contact:
- Derek Hausenloy, PHD
- Phone Number: 67042196
- Email: derek.hausenloy@nhcs.com.sg
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients with stable CAD undergoing planned CABG surgery on cardiopulmonary bypass using blood cardioplegia.
- Patients aged 21 years and above.
Exclusion Criteria:
- Patients with recent myocardial infarction (<30 days)
- Patients with significant hepatic dysfunction (If available, INR>2)
- Patients with significant pulmonary disease (If available, FEV1<40% predicted). - Patients with known renal failure with a GFR≤30 mL/min/1.73 m2.
- Patients recruited into another study which may impact on this study.
Study Plan
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 |
---|---|
Experimental: Electro-acupuncture (EA) arm
Patients with stable CAD going for coronary artery bypass graft (CABG) surgery randomized to receive EA before surgery.
|
A single application of EA at cardiac-related acupoints administered for 30 min prior to CABG surgery.
|
No Intervention: Standard Care arm
Patients with stable CAD going for coronary artery bypass graft (CABG) surgery.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change of Troponin-T test result from baseline to 6 hours post-op (post coming off bypass) to assess the extend of peri-operative myocardial injury (PMI)
Time Frame: Blood samples will be taken at pre-op and 6 hours (post coming off bypass).
|
The investigators will be assessing the cardioprotective efficacy of EA at cardiac-related acupoints in terms of changing the magnitude of PMI when compared to standard care.
PMI will be measured as the 48-hour area-under-the-curve serum high-sensitive Troponin-T.
|
Blood samples will be taken at pre-op and 6 hours (post coming off bypass).
|
Change of Troponin-T test result from 6 hours to 12 hours post-op (post coming off bypass) to assess the extend of peri-operative myocardial injury (PMI)
Time Frame: Blood samples will be taken at 12 hours (post coming off bypass).
|
The investigators will be assessing the cardioprotective efficacy of EA at cardiac-related acupoints in terms of changing the magnitude of PMI when compared to standard care.
PMI will be measured as the 48-hour area-under-the-curve serum high-sensitive Troponin-T.
|
Blood samples will be taken at 12 hours (post coming off bypass).
|
Change of Troponin-T test result from 12 hours to 24 hours post-op (post coming off bypass) to assess the extend of peri-operative myocardial injury (PMI)
Time Frame: Blood samples will be taken at 24 hours (post coming off bypass).
|
The investigators will be assessing the cardioprotective efficacy of EA at cardiac-related acupoints in terms of changing the magnitude of PMI when compared to standard care.
PMI will be measured as the 48-hour area-under-the-curve serum high-sensitive Troponin-T.
|
Blood samples will be taken at 24 hours (post coming off bypass).
|
Change of Troponin-T test result from 24 hours to 48 hours post-op (post coming off bypass) to assess the extend of peri-operative myocardial injury (PMI)
Time Frame: Blood samples will be taken at 48 hours (post coming off bypass).
|
The investigators will be assessing the cardioprotective efficacy of EA at cardiac-related acupoints in terms of changing the magnitude of PMI when compared to standard care.
PMI will be measured as the 48-hour area-under-the-curve serum high-sensitive Troponin-T.
|
Blood samples will be taken at 48 hours (post coming off bypass).
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Any Acute Kidney Injury
Time Frame: Urine output will be measured over the 3 day peri-operative period to derive the AKI grade.
|
The investigators will investigate the reno-protective effects of EA at cardiac-related acupoints by comparing the AKI grade following CABG surgery between the 2 study arms.
|
Urine output will be measured over the 3 day peri-operative period to derive the AKI grade.
|
Change in Cognitive Function measure
Time Frame: MMSE will be conducted prior to surgery, postoperative day 3 and postoperative week 6.
|
Patient cognitive function will be assessed using the Mini-Mental State Examination (MMSE) with a maximum score of 30.
Higher scores reflect better outcomes.
|
MMSE will be conducted prior to surgery, postoperative day 3 and postoperative week 6.
|
Change in Quality of life measure
Time Frame: The questionnaire will be done prior to surgery, postoperative day 3 and postoperative week 6.
|
The EuroQol EQ-5D Health-Related Quality of Life questionnaire will be used to assess patient quality of life.
Higher score given for health state imagined reflects better outcome.
|
The questionnaire will be done prior to surgery, postoperative day 3 and postoperative week 6.
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Derek Hausenloy, PHD, National Heart Centre Singapore
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2020/2028
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Coronary Artery Disease
-
Elixir Medical CorporationIstituto Clinico HumanitasActive, not recruitingCoronary Artery Disease | Chronic Total Occlusion of Coronary Artery | Multi Vessel Coronary Artery Disease | Bifurcation of Coronary Artery | Long Lesions Coronary Artery DiseaseItaly
-
Fundación EPICActive, not recruitingCoronary Artery Disease | Left Main Coronary Artery Disease | Left Main Coronary Artery Stenosis | Restenosis, CoronarySpain
-
Peking Union Medical College HospitalNot yet recruitingCoronary Artery Disease | Inflammation | Coronary Artery Disease Progression | Coronary Artery Stenosis | Coronary Artery Restenosis | Inflammatory Disease | Inflammation VascularChina
-
Peking Union Medical College HospitalRecruitingCoronary Artery Disease | Inflammation | Coronary Artery Disease Progression | Coronary Artery Stenosis | Coronary Artery Restenosis | Inflammatory Disease | Inflammation VascularChina
-
IGLESIAS Juan FernandoUniversity of BernNot yet recruiting
-
National Institutes of Health Clinical Center (CC)National Heart, Lung, and Blood Institute (NHLBI)CompletedCoronary Arteriosclerosis | Coronary Artery Disease (CAD) | Obstructive Coronary Artery DiseaseUnited States
-
Barts & The London NHS TrustImperial College London; Brunel UniversityNot yet recruitingCORONARY ARTERY DISEASE
-
Fundación EPICRecruitingCoronary Artery Disease | Coronary Disease | Coronary Occlusion | Left Main Coronary Artery Disease | Coronary Artery StenosisSpain
-
Abbott Medical DevicesCompletedCoronary Artery Disease | Coronary Disease | Coronary Occlusion | Chronic Total Occlusion of Coronary Artery | Coronary Restenosis | Coronary Artery Stenosis | Coronary Artery RestenosisBelgium
-
China National Center for Cardiovascular DiseasesRecruitingLeft Main Coronary Artery DiseaseChina
Clinical Trials on Electro-Acupuncture
-
Hubei Hospital of Traditional Chinese MedicineCompletedObesity, AbdominalChina
-
Guang'anmen Hospital of China Academy of Chinese...Ministry of Science and Technology of the People´s Republic of ChinaCompleted
-
Chengdu University of Traditional Chinese MedicineCompleted
-
University of SkövdeCompleted
-
University of California, IrvineRecruiting
-
zhoupingBeijing Friendship Hospital; Beijing Jishuitan HospitalUnknownOsteoarthritis Of KneeChina
-
Johns Hopkins UniversityCompletedRetinitis PigmentosaUnited States
-
National Taiwan University HospitalCompleted
-
Chinese University of Hong KongFood and Health Bureau, Hong KongUnknown