Efficacy of Lipoic Acid on Chronic Ischemic Heart Failure Patients
Lipoic Acid in Chronic Ischemic Heart Failure: Assessment of Reduction in Major Adverse Cardiovascular Events
Chronic heart failure is a clinical condition caused by structural heart disease and is characterized by reduced pumping function, fluid retention, and abnormal activation of neurohormonal systems. It represents the advanced stage of many cardiovascular diseases and remains a major global health challenge. Despite progress in medical and interventional therapies, patients with chronic heart failure continue to experience high rates of death, hospitalization, and long-term disability.
Ischemic heart failure, which develops as a result of coronary artery disease and prior myocardial infarction, is the most common form of chronic heart failure. Current treatment strategies, including guideline-directed medical therapy and revascularization procedures, can improve symptoms and outcomes but do not fully address the residual risk of adverse cardiovascular events. Therefore, additional therapeutic approaches are needed to further improve long-term prognosis in this population.
Abnormal myocardial energy metabolism is a key pathological feature of heart failure. Mitochondria play a central role in energy production, and impaired mitochondrial function contributes to disease progression. Previous studies by our group have identified mitochondrial aldehyde dehydrogenase 2 (ALDH2) as an important regulator of myocardial metabolic homeostasis and cardiac protection under ischemic and stress conditions.
Alpha-lipoic acid is a vitamin B-related compound with antioxidant properties and has been widely used in clinical practice for other indications. Increasing evidence suggests that alpha-lipoic acid may also exert protective effects in cardiovascular diseases, potentially through modulation of mitochondrial function. Experimental studies have shown that alpha-lipoic acid can restore ALDH2 activity and improve cardiac function in models of heart failure.
Based on these findings, we conducted an exploratory randomized controlled trial between 2019 and 2023 to evaluate the safety and potential efficacy of alpha-lipoic acid in patients with ischemic heart failure. In this multicenter study, patients receiving alpha-lipoic acid showed favorable trends toward reduced risk of death and heart failure-related hospitalization, as well as significant improvements in left ventricular ejection fraction and exercise capacity, without an increase in adverse events.
Taken together, prior mechanistic research and early clinical evidence support the hypothesis that alpha-lipoic acid may provide additional benefit when used as adjunctive therapy in patients with chronic ischemic heart failure. The present study is designed to further evaluate whether long-term supplementation with alpha-lipoic acid can reduce major adverse cardiovascular events and improve clinical outcomes in this population.
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Faza 3
Kontakty i lokalizacje
Kontakt w sprawie studiów
Kontakt w sprawie studiów
- Nazwa: Aijun Sun
- Numer telefonu: 021-64041990
- E-mail: sun.aijun@zs-hospital.sh.cn
Lokalizacje studiów
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Dalian, Chiny
- The First Affiliated Hospital of Dalian Medical University
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Kontakt:
- Ying Liu
- Numer telefonu: 0411-83635963
- E-mail: yingliu.med@gmail.com
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Guangdong, Chiny
- Guangdong Provincial People's Hospital
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Kontakt:
- Liwen Li
- Numer telefonu: 020-83827812
- E-mail: gdghllw@163.com
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Anhui
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Hefei, Anhui, Chiny, 230001
- The First Affiliated Hospital of USTC (Anhui Provincial Hospital)
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Kontakt:
- Kangyu Chen
- Numer telefonu: +86-551-62283114
- E-mail: ahslyycky@126.com
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Fujian
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Fuzhou, Fujian, Chiny, 35000
- Fujian Provincial Hospital
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Kontakt:
- Yansong Guo
- Numer telefonu: 0591-87557768
- E-mail: ysguo1234@126.com
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Guangdong
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Guangzhou, Guangdong, Chiny, 510080
- The First Affiliated Hospital, Sun Yat-sen University
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Kontakt:
- Chen Liu
- Numer telefonu: +86-20-87755766
- E-mail: liuch75@mail.sysu.edu.cn
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Henan
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Luoyang, Henan, Chiny, 471009
- Luoyang Central Hospital Affiliated to Zhengzhou University
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Kontakt:
- Xuewei Chang
- Numer telefonu: +86-379-63892222
- E-mail: xueway@126.com
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Zhengzhou, Henan, Chiny, 450052
- The First Affiliated Hospital of Zhengzhou University
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Kontakt:
- Junnan Tang
- Numer telefonu: +86-371-66913114
- E-mail: fcctangjn@zzu.edu.cn
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Jiangsu
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Nanjing, Jiangsu, Chiny, 210009
- Zhongda Hospital, Southeast University
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Kontakt:
- Jiayi Tong
- Numer telefonu: +86-25-83272114
- E-mail: 101007925@seu.edu.cn
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Liaoning
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Dalian, Liaoning, Chiny
- Affiliated Zhongshan Hospital of Dalian University
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Kontakt:
- Qin Yu
- Numer telefonu: 0411-62893000
- E-mail: yuqin@dlu.edu.cn
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Shaanxi
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Xi'an, Shaanxi, Chiny, 710061
- The First Affiliated Hospital of Xi'an Jiaotong University
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Kontakt:
- Ling Bai
- Numer telefonu: +86-29-85323805
- E-mail: bailingb21@sina.com
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Shandong
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Jinan, Shandong, Chiny, 250012
- Qilu Hospital of Shandong University
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Kontakt:
- Xiaoping Ji
- Numer telefonu: +86-531-82169400
- E-mail: jxp64@163.com
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Jining, Shandong, Chiny, 272029
- Affiliated Hospital of Jining Medical University
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Kontakt:
- Cheng Shen
- Numer telefonu: +86-537-5667777
- E-mail: shenc1988@mail.jnmc.edu.cn
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Qingdao, Shandong, Chiny, 266000
- The Affiliated Hospital of Qingdao University
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Kontakt:
- Wenzhong Zhang
- Numer telefonu: +86-532-96166
- E-mail: xxmczwz@163.com
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Shanghai Municipality
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Shanghai, Shanghai Municipality, Chiny, 200032
- Zhongshan hospital, Fudan university
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Kontakt:
- Aijun Sun
- Numer telefonu: 021-64041990
- E-mail: sun.aijun@zs-hosipital.sh.cn
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Shanghai, Shanghai Municipality, Chiny, 200120
- Shanghai East Hospital, Tongji University School of Medicine
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Kontakt:
- Wei Han
- Numer telefonu: +86-21-38804518
- E-mail: dr.hanwei@foxmail.com
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Shanghai, Shanghai Municipality, Chiny, 200237
- Shanghai Xuhui Central Hospital, Zhongshan-Xuhui Hospital
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Kontakt:
- Jing Yang
- Numer telefonu: +86-21-36682220
- E-mail: jing_yang@fudan.edu.cn
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Shanghai, Shanghai Municipality, Chiny, 200940
- Wusong Hospital, Zhongshan Hospital, Fudan University
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Kontakt:
- Lei Shen
- Numer telefonu: +86-21-56162417
- E-mail: 13818947416@163.com
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Shanghai, Shanghai Municipality, Chiny, 201700
- Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University
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Kontakt:
- Haibo Liu
- Numer telefonu: +86-21-67009999
- E-mail: haiboliu@fudan.edu
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Shanxi
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Taiyuan, Shanxi, Chiny, 030024
- Shanxi Cardiovascular Hospital
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Kontakt:
- Xiurui Ma
- Numer telefonu: +86-351-5275550
- E-mail: 1234maer@163.com
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Taiyuan, Shanxi, Chiny, 030001
- The Second Hospital of Shanxi Medical University
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Kontakt:
- Huiyu Yang
- Numer telefonu: +86-351-3365400
- E-mail: yanghuiyu2010@126.com
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Zhejiang
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Quzhou, Zhejiang, Chiny, 324000
- Quzhou People's Hospital (Quzhou Affiliated Hospital of Wenzhou Medical University)
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Kontakt:
- Yunkai Wang
- Numer telefonu: +86-570-8895120
- E-mail: cloudopen002@126.com
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Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
Inclusion Criteria:
- Aged 18 years or older and younger than 75 years at the time of enrollment.
- A history of chronic heart failure for more than 3 months, or clinical symptoms of heart failure lasting more than 3 months, diagnosed according to the 2023 European Society of Cardiology guidelines for the diagnosis and treatment of chronic heart failure.
- Left ventricular ejection fraction (LVEF) of 40% or less, as assessed by echocardiography.
- A history of acute myocardial infarction more than 3 months prior to enrollment, diagnosed according to the Fourth Universal Definition of Myocardial Infarction.
- New York Heart Association (NYHA) functional class II to IV, with stable clinical symptoms.
- Receipt of guideline-directed medical therapy for heart failure for at least 2 weeks, without dose adjustment or intravenous therapy during this period. Guideline-directed medical therapy includes: Angiotensin-converting enzyme inhibitors (ACEIs), or Angiotensin receptor blockers (ARBs), or Angiotensin receptor-neprilysin inhibitors (ARNIs), Beta-blockers, and Mineralocorticoid receptor antagonists,unless contraindicated or not tolerated, and prescribed at optimal tolerated doses.
- Ability and willingness to understand the study procedures and provide written informed consent.
Exclusion Criteria:
- Prior cardiac resynchronization therapy (CRT).
- Severe hepatic dysfunction, defined as liver transaminase levels greater than three times the upper limit of normal, or severe renal dysfunction, defined as an estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73 m².
- Presence of uncontrolled malignant arrhythmias or progressively worsening unstable angina.
- Presence of malignancy, lymphoma, leukemia, or other serious diseases with an expected life expectancy of less than 1 year.
- Participation in another investigational drug study within 4 weeks prior to enrollment, or current receipt of any investigational treatment other than the study intervention.
- Pregnant or breastfeeding women.
- Known allergy to vitamin B-related medications.
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Potroić
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
|---|---|
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Komparator placebo: grupa placebo
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After enrollment, patients received placebo drug at a dose of 600 mg per day for 24 months.
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Eksperymentalny: Alpha-Lipoic Acid (ALA)
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After enrollment, patients received Alpha-Lipoic Acid drug at a dose of 600 mg per day for 24 months.
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Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Major Adverse Cardiovascular Events (MACE)
Ramy czasowe: From enrollment to the end of treatment at 24 months.
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Major adverse cardiovascular events (MACE) are defined as a composite outcome that includes cardiovascular death, hospitalization for heart failure, non-fatal stroke, and non-fatal myocardial infarction occurring during the follow-up period.
The primary outcome is the occurrence of the first MACE event during follow-up, identified using standard clinical criteria and confirmed through medical records.
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From enrollment to the end of treatment at 24 months.
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Hospitalization for Heart Failure
Ramy czasowe: From enrollment to the end of treatment at 24 months.
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Unplanned admission to the hospital due to worsening heart failure symptoms that require intravenous treatment or intensified medical care during follow-up.
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From enrollment to the end of treatment at 24 months.
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Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Hospitalization for Heart Failure
Ramy czasowe: From enrollment to the end of treatment at 24 months.
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Unplanned hospitalization due to worsening heart failure symptoms occurring during the follow-up period.
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From enrollment to the end of treatment at 24 months.
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Non-fatal Stroke
Ramy czasowe: From enrollment to the end of treatment at 24 months.
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A new stroke event that does not result in death, diagnosed based on clinical symptoms and imaging findings, occurring during the follow-up period.
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From enrollment to the end of treatment at 24 months.
|
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Non-fatal Myocardial Infarction
Ramy czasowe: From enrollment to the end of treatment at 24 months.
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A new myocardial infarction that does not result in death, diagnosed according to standard clinical criteria, occurring during the follow-up period.
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From enrollment to the end of treatment at 24 months.
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All-cause Mortality
Ramy czasowe: From enrollment to the end of treatment at 24 months.
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Death from any cause occurring during the follow-up period.
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From enrollment to the end of treatment at 24 months.
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Change in Left Ventricular Ejection Fraction (LVEF)
Ramy czasowe: From enrollment to the end of treatment at 24 months.
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Change in left ventricular ejection fraction from baseline to 24 months after randomization, measured by echocardiography.
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From enrollment to the end of treatment at 24 months.
|
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Change in 6-Minute Walk Distance (6MWD)
Ramy czasowe: From enrollment to the end of treatment at 24 months.
|
Change in the distance walked during the 6-minute walk test from baseline to 24 months after randomization.
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From enrollment to the end of treatment at 24 months.
|
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Change in NT-proBNP Level
Ramy czasowe: From enrollment to the end of treatment at 24 months.
|
Change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels from baseline to 24 months after randomization.
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From enrollment to the end of treatment at 24 months.
|
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Change in Quality of Life Score (KCCQ)
Ramy czasowe: From enrollment to the end of treatment at 24 months.
|
Change in quality of life as assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ) score from baseline to 24 months after randomization.
|
From enrollment to the end of treatment at 24 months.
|
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Unplanned Coronary Revascularization
Ramy czasowe: From enrollment to the end of treatment at 24 months.
|
Unplanned coronary revascularization due to acute myocardial ischemia during follow-up, including percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).
This outcome is defined as a binary event.
|
From enrollment to the end of treatment at 24 months.
|
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Heart Transplantation
Ramy czasowe: From enrollment to the end of treatment at 24 months.
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Occurrence of orthotopic heart transplantation performed as definitive treatment for end-stage heart failure during the follow-up period.
This outcome is defined as a binary event.
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From enrollment to the end of treatment at 24 months.
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Współpracownicy i badacze
Sponsor
Sponsor
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- KY2026037
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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