- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT00640991
REsearching Coronary REduction by Appropriately Targeting Euglycemia (RECREATE Pilot Study) (RECREATE Pilot)
An International Multicentre Randomized Controlled Trial of Intensive Insulin Therapy Targeting Normoglycemia In Acute Myocardial Infarction: the RECREATE (REsearching Coronary REduction by Appropriately Targeting Euglycemia) Pilot Study
연구 개요
상세 설명
Patients will be randomly assigned to either the control arm and will receive usual AMI care or the experimental arm, which will include routine AMI care as well as intensive therapy intervention.
In addition to the capillary blood glucose measurements obtained to titrate insulin doses in the experimental arm patients, laboratory plasma glucose will be drawn in all patients at randomization, 10, 24, 48, and 72 hours post randomization, 7 days post randomization (or hospital discharge if that occurs first), and 30 days post randomization.
연구 유형
등록 (예상)
단계
- 3단계
연락처 및 위치
연구 장소
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Buenos Aires
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Adrogue,, Buenos Aires, 아르헨티나
- Instituto Médico Adrogué
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Nagpur, 인도, 440012
- Avanti Institute of Cardiology
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Assam
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Dt. Dibrugarh, Assam, 인도, 786002
- Assam Medical College Hospital
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Chattisgarh
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Raipur, Chattisgarh, 인도, 492001
- Lifeworth Super Specialty Hospital
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Haryana
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Rohtak, Haryana, 인도, 124001
- Post Graduate Institute of Medical
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Karnataka
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Bangalore, Karnataka, 인도, 560034
- St. Johns Medical College
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Shimoga, Karnataka, 인도, 577201
- Nanjappa Hospital
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Kerala
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Calicut, Kerala, 인도, 673004
- Baby Memorial Hospital
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Kottayam, Kerala, 인도, 686016
- Caritas Hospital
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Maharashtra
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Mumbai, Maharashtra, 인도, 400012
- KEM Hospital
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Wardha, Maharashtra, 인도, 442102
- MGIMS
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Tamilnadu
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Chennai, Tamilnadu, 인도, 600023
- Railway Hospital
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Ontario
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Hamilton, Ontario, 캐나다, L8L 2X2
- Hamilton Health Sciences, General Site
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참여기준
자격 기준
공부할 수 있는 나이
- 어린이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
Both nondiabetic patients and patients with non-insulin-requiring type 2 diabetes mellitus admitted with a suspected AMI are eligible if they meet the following criteria:
- Signs or symptoms of AMI with definite ECG changes, defined as persistent ST-segment elevation (> or = than 1 mm)in two or more contiguous leads, or new left bundle branch block
- Onset of symptoms within 24 hours before hospital presentation
- Capillary blood glucose level on presentation > or = 8.0 mmol/L (144 mg/dL)
Exclusion Criteria:
Patient with conditions that REQUIRE the administration of insulin, including:
- Type 1 diabetes mellitus, defined by a documented history of diabetes mellitus before the age of 30
- Type 2 diabetes mellitus that was treated with insulin prior to AMI presentation
- Type 2 diabetes mellitus that is known to be very poorly controlled (e.g. admission capillary blood glucose > 16.0 mmol/L (288 mg/dL)or marked elevation in glucose for which the site investigator plans to treat with insulin therapy)
- A history of severe hypoglycemic episodes (defined as hypoglycemia with symptoms which the patient is unable to reverse without the assistance of another person) within the past two years
- Known or suspected end-stage liver disease (due to the risk of hypoglycemia in the setting of liver dysfunction and consequent impaired regulation of glucose homeostasis)
- Cardiogenic shock on admission (due to the inaccuracy of glucose meter readings)
- Documented pregnancy
- Any concomitant disease (e.g. cancer) that might limit life expectancy to less than 90 days
- Anticipated poor adherence with study treatments or an other factor that might jeopardize 90-day follow-up (e.g. no fixed address, long distance to hospital, etc.)
- Prior enrollment in this trial or current enrollment in another trial of ST-segment elevation myocardial infarction
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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간섭 없음: Control
Patients assigned to the control arm will receive usual care for AMI, according to local practice of each participating centre.
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실험적: Intervention
The experimental arm will have an IV infusion of glulisine insulin started directly after randomization for at least 24 hours and for as long as CCU-level care is required, and the insulin infusion will be adjusted to achieve and maintain a target glucose range of 5.0-6.6 mmol/L (90-118 mg/dL).
Once transferred to the ward, patients in the experimental arm will switch to glargine insulin and will continue this treatment for the remainder of their hospitalization and after hospital discharge, for a total duration of 30 days post randomization.
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IV infusion of glulisine, SC injection of glargine
다른 이름들:
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
기간 |
|---|---|
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The 24-hour difference in mean glucose between the two study groups.
기간: 24 hours
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24 hours
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2차 결과 측정
결과 측정 |
기간 |
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The difference in mean glucose level achieved at 7 days or hospital discharge (whichever is first)
기간: 7 days or discharge
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7 days or discharge
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The difference in mean glucose level achieved at 30 days between study groups
기간: 30 days
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30 days
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Nonfatal recurrent myocardial infarction, nonfatal stroke, or cardiovascular death (as a composite and as separate outcomes)
기간: Discharge, 30 days, 90 days, 1 year
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Discharge, 30 days, 90 days, 1 year
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Rehospitalization for congestive heart failure
기간: Discharge, 30 days, 90 days, 1 year
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Discharge, 30 days, 90 days, 1 year
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All cause mortality
기간: Discharge, 30 days, 90 days, 1 year
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Discharge, 30 days, 90 days, 1 year
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Resuscitated cardiac arrest or life-threatening arrhythmia (as a composite and as separate outcomes)
기간: Discharge, 30 days, 90 days, 1 year
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Discharge, 30 days, 90 days, 1 year
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Cardiogenic shock
기간: Discharge, 30 days, 90 days, 1 year
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Discharge, 30 days, 90 days, 1 year
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Cardiac procedures
기간: Discharge, 30 days, 90 days, 1 year
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Discharge, 30 days, 90 days, 1 year
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Rehospitalization for any cause
기간: Discharge, 30 days, 90 days, 1 year
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Discharge, 30 days, 90 days, 1 year
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Symptomatic and severe hypoglycemic episodes
기간: Discharge, 30 days, 90 days, 1 year
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Discharge, 30 days, 90 days, 1 year
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Hypokalemic episodes
기간: Discharge
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Discharge
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공동 작업자 및 조사자
수사관
- 수석 연구원: Hertzel Gerstein, MD, MSc, FRCPC, McMaster University
- 수석 연구원: Salim Yusuf, DPhil, FRCPC, FRSC, McMaster University
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (추정)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
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