REVEAL: Reduction of Infarct Expansion and Ventricular Remodeling With Erythropoietin After Large Myocardial Infarction
8. maj 2017 opdateret af: National Institute on Aging (NIA)
Effects of Erythropoietin on Infarct Size and Left Ventricular Remodeling in Survivors of Large Myocardial Infarctions
The purpose of this study is to evaluate whether erythropoietin can help limit the damage to the heart in patients with acute heart attacks.
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
REVEAL is a randomized, double-blinded, placebo-controlled, parallel phase II clinical study that will evaluate the effects of erythropoietin administration on infarct size, left ventricular remodeling and circulating endothelial progenitor cells in patients with large myocardial infarctions (MI).
The study will be conducted in two phases: a dose-escalation safety phase and a single dose efficacy phase.
Eligible patients who present to the hospital with an acute ST-elevation MI and who agree to participate in this study will be randomly assigned to receive a single infusion of study medication consisting either of erythropoietin or placebo.
The size of the infarction and the dimensions of the heart will be assessed by cardiac magnetic resonance imaging (MRI) within 2-6 days of the infusion of the study medication, and again approximately 3 months later.
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
223
Fase
- Fase 2
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
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District of Columbia
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Washington, D.C., District of Columbia, Forenede Stater, 20010
- Washington Hospital Center
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Florida
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Miami, Florida, Forenede Stater, 33136
- University of Miami, School of Medicine
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Georgia
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Atlanta, Georgia, Forenede Stater, 30322
- Emory University Hospital
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Michigan
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Detroit, Michigan, Forenede Stater, 48202
- Henry Ford Hospital
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Royal Oak, Michigan, Forenede Stater, 48073-6769
- William Beaumont Hospital
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Minnesota
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Rochester, Minnesota, Forenede Stater, 55905
- Mayo Clinic, Rochester
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New York
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Brooklyn, New York, Forenede Stater, 11215
- New York Methodist Hospital
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New York, New York, Forenede Stater, 10021-4872
- Cornell University
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New York, New York, Forenede Stater, 10021
- NY Presbyterian Hospital
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New York, New York, Forenede Stater, 10021
- Weill Medical College
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North Carolina
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Durham, North Carolina, Forenede Stater, 27710
- Duke University
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Winston-Salem, North Carolina, Forenede Stater, 27103
- Wake Forest University
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Ohio
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Columbus, Ohio, Forenede Stater, 43210
- Ohio State University Medical Center
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Pennsylvania
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Hershey, Pennsylvania, Forenede Stater, 17033
- Penn State Heart and Vascular Institute
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Tennessee
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Brentwood, Tennessee, Forenede Stater, 37027
- Nashville Cardiovascular Magnetic Resonance Institute
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Virginia
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Richmond, Virginia, Forenede Stater, 23298
- Virginia Commonwealth University Medical Center
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
21 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
- INCLUSION CRITERIA:
Age greater than 21 years
Acute ST-elevation myocardial infarction
Referral for primary or rescue angioplasty
Revascularization procedure within 8 hours from the onset of ischemic symptoms
TIMI (Thrombolysis in myocardial infarction) flow grade 0 or 1 in the culprit coronary artery at the beginning of coronary angiography
Successful revascularization of infarct-related artery
EXCLUSION CRITERIA:
Clinical indication for erythropoietin
STEMI (ST-elevation myocardial infarction) due to occlusion of a branch vessel
Any history of prior MI, PCI (Percutaneous coronary intervention), CABG (Coronary artery bypass graft), cardiomyopathy, myocarditis, or CHF (congestive heart failure)
Hypersensitivity to human albumin, mammalian cell-derived products, or erythropoietin
Hematocrit greater than 42% in men or greater than 40% in women at the time of study drug administration
Uncontrolled hypertension at the time of study drug administration
Cardiogenic shock
Need for coronary surgical revascularization as determined at the time of the index coronary catheterization
History of hypercoagulable disorder, thromboembolic event, or venous thrombosis
History of stroke or TIA (transient ischemic attack)
History of seizures
Contraindication to MRI
Pregnancy or nursing mother
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Tredobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Placebo komparator: Dose Escalation Safety
The objective of the first phase is to evaluate the safety of escalating doses of Epoetin alfa in patients with STEMIs.
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Randomized
Andre navne:
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Placebo komparator: Single Dose Efficacy
Single parenteral administration of 60000 U of epoetin alfa.
The objectives of the second phase are to investigate the effects of the highest safe dose on infarct size, left ventricular remodeling and endothelial progenitor cells.
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Randomized
Andre navne:
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Infarct Size in the Territory of the Infarct Related Artery
Tidsramme: performed 2 to 6 days after study medication administration (first CMR)
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Infarct size, expressed as percentage of LV mass, assessed by cardiac magnetic resonance (CMR) imaging.
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performed 2 to 6 days after study medication administration (first CMR)
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Infarct Size in the Territory of the Infarct Related Artery
Tidsramme: 12 ± 2 weeks after study medication
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Infarct size, expressed as percentage of LV mass, assessed by cardiac magnetic resonance (CMR) imaging.
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12 ± 2 weeks after study medication
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LV Ejection Fraction
Tidsramme: 2 to 6 days after study medication administration (first CMR) and 12 ± 2 weeks later (second CMR)
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2 to 6 days after study medication administration (first CMR) and 12 ± 2 weeks later (second CMR)
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LV Volume Indexed to BSA
Tidsramme: 2 to 6 days after study medication administration (first CMR) and 12 ± 2 weeks later (second CMR)
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2 to 6 days after study medication administration (first CMR) and 12 ± 2 weeks later (second CMR)
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LV Mass Indexed to BSA
Tidsramme: 2 to 6 days after study medication administration (first CMR) and 12 ± 2 weeks later (second CMR)
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2 to 6 days after study medication administration (first CMR) and 12 ± 2 weeks later (second CMR)
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Vital Signs
Tidsramme: baseline, 24 hours, 48 hours, 14 (+/- 5) days, and 30 (+/- 5) days
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baseline, 24 hours, 48 hours, 14 (+/- 5) days, and 30 (+/- 5) days
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Hemoglobin Levels
Tidsramme: baseline, 24 hours, 48 hours, 14 (+/- 5) days, and 30 (+/- 5) days
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baseline, 24 hours, 48 hours, 14 (+/- 5) days, and 30 (+/- 5) days
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Reticulocyte Counts
Tidsramme: baseline, 24 hours, 48 hours, 14 (+/- 5) days, and 30 (+/- 5) days
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baseline, 24 hours, 48 hours, 14 (+/- 5) days, and 30 (+/- 5) days
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Number of Participants With Clinical Events
Tidsramme: from randomization to second CMR
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from randomization to second CMR
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Efterforskere
- Ledende efterforsker: Edward G Lakatta, M.D., National Institute on Aging (NIA)
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Bogoyevitch MA. An update on the cardiac effects of erythropoietin cardioprotection by erythropoietin and the lessons learnt from studies in neuroprotection. Cardiovasc Res. 2004 Aug 1;63(2):208-16. doi: 10.1016/j.cardiores.2004.03.017.
- Parsa CJ, Matsumoto A, Kim J, Riel RU, Pascal LS, Walton GB, Thompson RB, Petrofski JA, Annex BH, Stamler JS, Koch WJ. A novel protective effect of erythropoietin in the infarcted heart. J Clin Invest. 2003 Oct;112(7):999-1007. doi: 10.1172/JCI18200.
- Maiese K, Li F, Chong ZZ. New avenues of exploration for erythropoietin. JAMA. 2005 Jan 5;293(1):90-5. doi: 10.1001/jama.293.1.90.
- Povsic TJ, Najjar SS, Prather K, Zhou J, Adams SD, Zavodni KL, Kelly F, Melton LG, Hasselblad V, Heitner JF, Raman SV, Barsness GW, Patel MR, Kim RJ, Lakatta EG, Harrington RA, Rao SV. EPC mobilization after erythropoietin treatment in acute ST-elevation myocardial infarction: the REVEAL EPC substudy. J Thromb Thrombolysis. 2013 Nov;36(4):375-83. doi: 10.1007/s11239-013-0944-6.
- Najjar SS, Rao SV, Melloni C, Raman SV, Povsic TJ, Melton L, Barsness GW, Prather K, Heitner JF, Kilaru R, Gruberg L, Hasselblad V, Greenbaum AB, Patel M, Kim RJ, Talan M, Ferrucci L, Longo DL, Lakatta EG, Harrington RA; REVEAL Investigators. Intravenous erythropoietin in patients with ST-segment elevation myocardial infarction: REVEAL: a randomized controlled trial. JAMA. 2011 May 11;305(18):1863-72. doi: 10.1001/jama.2011.592.
- Melloni C, Rao SV, Povsic TJ, Melton L, Kim RJ, Kilaru R, Patel MR, Talan M, Ferrucci L, Longo DL, Lakatta EG, Najjar SS, Harrington RA. Design and rationale of the Reduction of Infarct Expansion and Ventricular Remodeling with Erythropoietin after Large Myocardial Infarction (REVEAL) trial. Am Heart J. 2010 Nov;160(5):795-803.e2. doi: 10.1016/j.ahj.2010.09.007.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. september 2005
Primær færdiggørelse (Faktiske)
1. juli 2009
Studieafslutning (Faktiske)
1. januar 2011
Datoer for studieregistrering
Først indsendt
18. september 2006
Først indsendt, der opfyldte QC-kriterier
18. september 2006
Først opslået (Skøn)
20. september 2006
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
9. maj 2017
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
8. maj 2017
Sidst verificeret
1. maj 2017
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 999905255
- 05-AG-N255 (Anden identifikator: NIH)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Ingen
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