Effekt af Dapagliflozin på mikrovaskulær funktion hos kvinder med symptomer på koronararteriesygdom (SMILE)
En enkeltcenter, randomiseret, dobbeltblind, placebo-kontrolleret undersøgelse til evaluering af mikrovaskulær sygdom efter 12 ugers behandling med natrium-glucose co-transporter 2-hæmmer sammenlignet med placebo hos symptomatiske kvinder med ikke-obstruktiv koronararteriesygdom
The goal of this clinical trial is to test the effects of a drug (in the drug class called sodium-glucose cotransporter 2 inhibitors) in women who have symptoms of ischemic heart disease. The main questions the study aims to answer are:
Does blood flow in the heart improve with study drug?
Participants will be randomly assigned to a 12-week course of the study drug, dapagliflozin 10mg, or placebo. Blood flow in the heart will be assessed using stress cardiac magnetic resonance imaging at baseline and 12 weeks. The researchers will compare the results from the two groups.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
This single-center clinical investigation is a randomized, double-blind, placebo controlled trial of dapagliflozin in women who have symptoms of myocardial ischemia but in whom obstructive coronary artery disease has been ruled out by testing within 2 years.
Aim: Determine whether dapagliflozin improves coronary blood flow in women.
Participants will be randomly assigned to a 12-week course of dapagliflozin 10mg oral or placebo. Participants will complete study assessments at baseline, 6 weeks of treatment, and 12 weeks of treatment. Peak myocardial blood flows at rest and with pharmacological stress will be assessed using cardiac magnetic resonance imaging at baseline and 12 weeks. Symptom surveys and lab work will be collected at baseline, 6 weeks, and 12 weeks of treatment. Participants will be closely monitored throughout study participation for adverse events. Results will be captured in a database and published in a peer-reviewed journal.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 1
Kontakter og lokationer
Studiesteder
-
-
Virginia
-
Charlottesville, Virginia, Forenede Stater, 22908
- University of Virginia
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Willing to provide written informed consent.
- Signs and symptoms of suspected ischemia that prompted referral for further evaluation by cardiac catheterization or coronary computed tomography within two years of consent.
- No evidence of obstructive epicardial coronary artery disease (stenosis >50%) of a major epicardial vessel (>3mm) or a fractional flow reserve >0.80 by invasive catheterization or coronary computed tomography. (Participants who have not undergone cardiac catheterization or coronary angiogram within the last 2 years for their clinical care will be screened with computed angiogram of the coronary arteries to confirm eligibility).
- Estimated glomerular filtration rate ≥30ml/min/1.73m2 at enrollment
- For subjects having a history of type 2 diabetes mellitus: approval of diabetes care/prescribing provider
Exclusion Criteria:
- History of non-ischemic cardiomyopathy with left ventricular ejection fraction <40% or hypertrophic cardiomyopathy.
- History of congestive heart failure, severe pulmonary disease, liver disease
- History of Acute coronary syndrome within previous 30 days
- Stroke within the last 180 days or intracranial hemorrhage at any time.
- Severe Valvular disease
- Life expectancy <3 years, due to non-cardiovascular comorbidity.
- Pregnancy or women who are breast-feeding
- Type 1 diabetes mellitus
- History of diabetic ketoacidosis in subjects with Type 2 Diabetes Mellitus
- Symptomatic hypotension or systolic blood pressure <95 mmHg on 2 consecutive measurements
- Active malignancy requiring treatment at the time of visit
- Severe, unstable, or rapidly progressing renal disease at the time of randomization
- History of recurrent urinary tract, bladder, or kidney infections
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Dapagliflozin
Dapagliflozin 10mg oral tablet. |
Once daily oral dapagliflozin 10mg
Andre navne:
|
|
Placebo komparator: Placebo
Placebo matching tablet. |
Placebo capsules formulated by pharmacy to be indistinguishable from active drug
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change From Baseline in Endocardial Myocardial Perfusion Reserve at Week 12
Tidsramme: Baseline to Week 12
|
Endocardial myocardial perfusion reserve (MPR) was assessed using stress cardiac magnetic resonance (CMR) imaging. MPR represents the ratio of endocardial myocardial blood flow during pharmacologic vasodilator stress to endocardial myocardial blood flow at rest and is expressed as a unitless ratio. Higher values indicate greater myocardial perfusion reserve. Change from baseline was calculated as the Week 12 MPR ratio minus the baseline MPR ratio, with positive values indicating an increase in MPR and negative values indicating a decrease. The protocol did not prespecify a study-specific clinical threshold for interpretation of MPR. |
Baseline to Week 12
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Patricia Rodriguez-Lozano, MD, University of Virginia Health System
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- HSR220123
- KL2TR003016 (U.S. NIH-bevilling/kontrakt)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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