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- Ensaio Clínico NCT01357499
Lower Leg Remote Ischemic Preconditioning in Elective Percutaneous Coronary Intervention (PCI) (REMOTE)
Effects of Lower Leg Remote Ischemic Preconditioning in Combination With Electric Muscle Stimulation in Elective Coronary Artery Revascularisation
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
It has been demonstrated that protection from ischemia reperfusion can be achieved by brief periods of ischemia applied at a remote site during an injurious ischemic event (remote postconditioning). The purpose of this study is to investigate if the combination of brief periods of limb ischemia in combination with electric muscle stimulation at the same site could exceed the preconditioning effect of limb ischemia alone.
Therefore the investigators thought to perform 2 different forms of remote ischaemic preconditioning in patients undergoing elective coronary angioplasty.
In the first patient group a blood pressure cuff will be applied at the lower leg. Ischemia will be induced by inflating the cuff to a pressure of 200 mmHg for 5 minutes. Afterwards reperfusion will be allowed for further 5 minutes. This cycle will be repeated 3 times.
In a second patient group electric muscle stimulation at the same site (HiToP 191) will be performed additionally throughout the whole preconditioning cycle.
After preconditioning, the percutaneous coronary intervention (PCI) will be performed by 3 PCI-ballon inflations, each lasting for 2 minutes. Between the inflations coronary reperfusion will be allowed for 5 minutes.
The Effects of preconditioning will be evaluated by analysing the ST-deviation, caused by angioplasty in an intracoronary (derived by PCI wire) and surface ecg.
Also the maximum of chest pain during the 3 inflation cycles and troponin levels 24 h after PCI will be evaluated.
Tipo de estudo
Contactos e Locais
Locais de estudo
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MVP
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Greifswald, MVP, Alemanha, 17489
- Ernst Moritz Arndt Universität Greifswald
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Método de amostragem
População do estudo
Descrição
Inclusion Criteria:
- planned PCI of one of the main coronary artery (artery diameter distal of the stenotic area at least 2,5 mm)
- patient age 18 years or older
- stable angina pectoris symptoms
Exclusion Criteria:
- presence of collateral vessels
- electrocardiographic bundle branch blocks
- multiple coronary stenosis
- occlusion of a coronary artery
- renal insufficiency (GFR (MDRD) < 50 ml/min/1,73 m2)
- presence of coronary bypass grafts
- history or presence of myocardial infarction.
- echocardiographic signs of left ventricular hypertrophy (septal and/or posterior wall diameter greater than 14 mm)
- some sort of medications (adenosine, morphine and derivates, immunosuppressive agents, oral antibiotics, theophyllin, alpha receptor blockers)
- peripheral arterial disease
- exercise tests performed within 24 h before study start.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
Intervenção / Tratamento |
---|---|
control group
A Blood pressure cuff and and the muscle stimulator pads will be applied to one lower leg but without inflating the cuff and without stimulating the muscle.
Now 25 minutes will have to pass by before beginning the coronary angioplasty.
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|
intervention group 1
A Blood pressure cuff and and the muscle stimulator pads will be applied to one lower leg.
The blood pressure Cuff will be inflated with 200 mmHg for 5 minutes.
Next reperfusion will be allowed for 5 minutes.
This cycle will be repeated for 3 times.
There will be no electrical muscle stimulation in this group.
|
A Blood pressure cuff and and the muscle stimulator pads will be applied to one lower leg.
The blood pressure cuff will be inflated with 200 mmHg for 5 minutes.
Next reperfusion will be allowed for 5 minutes.
This cycle will be repeated for 3 times.
|
intervention group 2
A Blood pressure cuff and the muscle stimulator pads will be applied to one lower leg.
The blood pressure Cuff will be inflated with 200 mmHg for 5 minutes.
Next reperfusion will be allowed for 5 minutes.
This cycle will be repeated for 3 times.
In addition electrical muscle stimulation will be performed throughout the whole preconditioning cycle
|
A Blood pressure cuff and and the muscle stimulator pads will be applied to one lower leg.
The blood pressure Cuff will be inflated with 200 mmHg for 5 minutes.
Next reperfusion will be allowed for 5 minutes.
This cycle will be repeated for 3 times.
In addition electrical muscle stimulation will be performed throughout the whole preconditioning cycle.
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
ST deviation
Prazo: 120 seconds after angioplasty
|
Immediately after the preconditioning cycle the PCI ballon will be positioned in the coronary artery lesion and inflated for 2 minutes followed by 5 minutes of reperfusion. This cycle will be repeated for 3 times without any interruption. Intracoronary ECGs and 12 lead surface ecgs will be taken immediately before and at the end of each ballon inflation (two minutes after beginning the intracoronary ballon inflation). after taking the ecgs the ballon will be deflated. The st-deviations will be analysed. |
120 seconds after angioplasty
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
troponin I
Prazo: 24 hours after PCI
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Troponin levels will be evaluated 24 h after PCI
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24 hours after PCI
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chest pain (Maximum)
Prazo: time period 2 minutes
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the maximal chest pain occuring during each of the Pci balloon inflations will be documented as a number out of 10. 0 is determined as no pain and 10 is determined as the heaviest pain which the patient ever experienced.
A specific timepoint has not been defined.
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time period 2 minutes
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Markus Reinthaler, MD, Ernst Moritz Arndt University Greifswald
- Investigador principal: Thorsten Reffelmann, MD, Ernst Moritz Arndt University Greifswald
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Estimativa)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- 1-reinthaler
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