- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT00229515
Multicentre 2x2 Factorial Randomised Study Comparing Tirofiban Versus Abciximab and SES Versus BMS in AMI
Multicentre 2x2 Factorial Randomised Study Comparing Tirofiban Administered With the Single High-Dose Bolus Versus Abciximab and Sirolimus Eluting Stent Versus Bare Metal Stent in Acute Myocardial Infarction - MULTI-STRATEGY Trial
Studieöversikt
Status
Betingelser
Detaljerad beskrivning
The combination abciximab plus bare metal stent (BMS) is currently considered the standard therapy for AMI. The use of sirolimus eluting stent (SES) is related to a reduction of the need for urgent target vessel revascularization (TVR). With current acquisition prices for abciximab and SES, replacing abciximab with tirofiban, administered as a single high-dose bolus (SHDB) regimen, is a promising strategy that would preserve financial resources. In a recent study the combination tirofiban and SES resulted to be associated to an overall lower major adverse cardiovascular events (MACE) rate with respect to the abciximab plus BMS. However, since no conclusion can be drawn yet regarding the relative contribution of a specific GP IIb/IIIa inhibitor or a stent type with respect to the other, the combination of abciximab and SES may be associated to an even lower event rate with respect to SHDB tirofiban and SES, thus offsetting the higher initial cost.
Comparison(s): four strategies (SHDB tirofiban + BMS, SHDB tirofiban + SES, abciximab + BMS, abciximab + SES) are compared to determine the possible gold standard treatment for ST-segment elevation myocardial infarction in terms of efficacy and cost-efficacy.
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 4
Kontakter och platser
Studieorter
-
-
-
Ferrara, Italien, 44100
- Cattedra di Cardiologia, Azienda Ospedaliera Universitaria di Ferrara
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- ST segment elevation myocardial infarction
- Schedule for primary percutaneous coronary intervention
- Informed consent
Exclusion Criteria:
- Administration of fibrinolytic or any GP IIb/IIIa inhibitors for the treatment of current acute myocardial infarction or within 1 month before it
- History of bleeding diathesis or allergy to the studies drug
- Major surgery within 30 days
- Limited life expectancy, e.g. neoplasms, others
- Pregnancy
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Faktoriell uppgift
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
---|---|
Aktiv komparator: 1
Patients will receive abciximab infusion at standard regimen prior undergoing percutaneous coronary intervention for STEMI followed by BMS implantation in the culprit lesion
|
Patients will receive infusion of abciximab at standard regimen before undergoing intervention for STEMI and then bare metal stent implantation in the culprit lesion
Andra namn:
|
Experimentell: 2
Abciximab followed by implantation of sirolimus-eluting stent in the culprit lesion
|
Patients will receive abciximab infusion at standard regimen followed by implantation of sirolimus-eluting stent in the culprit lesion
Andra namn:
|
Experimentell: 3
tirofiban infusion followed by bare metal stent implantation
|
Patients will receive tirofiban infusion at high loading dose followed by standard infusion for 18-24 hours and subsequently they will be treated with bare metal stent implantation
Andra namn:
|
Experimentell: 4
tirofiban and sirolimus-eluting stent
|
Patients will receive tirofiban infusion at high loading dose followed by standard infusion for 18-24 hours and subsequently they will be treated with sirolimus-eluting stent implantation
Andra namn:
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Tidsram |
---|---|
The evaluation of the degree of ST-segment resolution after the mechanical intervention.
Tidsram: 90 minutes after last balloon inflation
|
90 minutes after last balloon inflation
|
The cumulative rate of death for any cause, reinfarction and target vessel revascularisation
Tidsram: 8 months
|
8 months
|
Sekundära resultatmått
Resultatmått |
Tidsram |
---|---|
Death, recurrent acute myocardial infarction, target vessel revascularization and target lesion revascularisation, considered separately or in combination.
Tidsram: at any time during follow-up
|
at any time during follow-up
|
The evaluation of the cost-effectiveness of the involved experimental treatments.
Tidsram: 8 months, 1,3 and 5 years
|
8 months, 1,3 and 5 years
|
stent thrombosis according to the ARC classification
Tidsram: any time during follow-up
|
any time during follow-up
|
the degree of cumulative or single lead ST segment resolution at time frames different from the primary endpoint. the degree of residual ST segment elevation.
Tidsram: immediately after intervention, at 90 minutes and at discharge
|
immediately after intervention, at 90 minutes and at discharge
|
bleeding rate defined according to different classifications including TIMI, Acuity, GUSTO and Steeple.
Tidsram: at 30 days, 1 year, 3 and 5 years
|
at 30 days, 1 year, 3 and 5 years
|
Samarbetspartners och utredare
Sponsor
Utredare
- Studiestol: Roberto Ferrari, Professor, Cattedra di Cardiologia, Azienda Ospedaliera Universitaria di Ferrara, Italy
Publikationer och användbara länkar
Allmänna publikationer
- Valgimigli M, Percoco G, Malagutti P, Campo G, Ferrari F, Barbieri D, Cicchitelli G, McFadden EP, Merlini F, Ansani L, Guardigli G, Bettini A, Parrinello G, Boersma E, Ferrari R; STRATEGY Investigators. Tirofiban and sirolimus-eluting stent vs abciximab and bare-metal stent for acute myocardial infarction: a randomized trial. JAMA. 2005 May 4;293(17):2109-17. doi: 10.1001/jama.293.17.2109.
- Garg S, Sarno G, Serruys PW, Rodriguez AE, Bolognese L, Anselmi M, De Cesare N, Colangelo S, Moreno R, Gambetti S, Monti M, Bristot L, Bressers M, Garcia-Garcia HM, Parrinello G, Campo G, Valgimigli M; STRATEGY and MULTISTRATEGY Investigators. Prediction of 1-year clinical outcomes using the SYNTAX score in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a substudy of the STRATEGY (Single High-Dose Bolus Tirofiban and Sirolimus-Eluting Stent Versus Abciximab and Bare-Metal Stent in Acute Myocardial Infarction) and MULTISTRATEGY (Multicenter Evaluation of Single High-Dose Bolus Tirofiban Versus Abciximab With Sirolimus-Eluting Stent or Bare-Metal Stent in Acute Myocardial Infarction Study) trials. JACC Cardiovasc Interv. 2011 Jan;4(1):66-75. doi: 10.1016/j.jcin.2010.09.017.
- Valgimigli M, Campo G, Percoco G, Bolognese L, Vassanelli C, Colangelo S, de Cesare N, Rodriguez AE, Ferrario M, Moreno R, Piva T, Sheiban I, Pasquetto G, Prati F, Nazzaro MS, Parrinello G, Ferrari R; Multicentre Evaluation of Single High-Dose Bolus Tirofiban vs Abciximab With Sirolimus-Eluting Stent or Bare Metal Stent in Acute Myocardial Infarction Study (MULTISTRATEGY) Investigators. Comparison of angioplasty with infusion of tirofiban or abciximab and with implantation of sirolimus-eluting or uncoated stents for acute myocardial infarction: the MULTISTRATEGY randomized trial. JAMA. 2008 Apr 16;299(15):1788-99. doi: 10.1001/jama.299.15.joc80026. Epub 2008 Mar 30.
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Förväntat)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
- Ischemi
- Patologiska processer
- Nekros
- Myokardischemi
- Hjärtsjukdom
- Hjärt-kärlsjukdomar
- Kärlsjukdomar
- Hjärtinfarkt
- Infarkt
- Läkemedels fysiologiska effekter
- Molekylära mekanismer för farmakologisk verkan
- Anti-infektionsmedel
- Antivirala medel
- Fibrinolytiska medel
- Fibrinmodulerande medel
- Trombocytaggregationshämmare
- Antineoplastiska medel
- Immunsuppressiva medel
- Immunologiska faktorer
- Skyddsmedel
- Antibakteriella medel
- Adjuvans, immunologiska
- Antibiotika, antineoplastiska
- Antifungala medel
- Antikoagulantia
- Interferoninducerare
- Strålskyddsmedel
- Tirofiban
- Sirolimus
- Abciximab
- polysackarid-K
Andra studie-ID-nummer
- TSES-02-III
Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .
Kliniska prövningar på Hjärtinfarkt
-
University of Southern CaliforniaAktiv, inte rekryterandeNSTEMI - Icke-ST Segment Elevation MI | Akut kranskärlssyndrom (ACS) | STEMI - ST Elevation Myocardial Infarction (MI) | Instabil angina (UA)Förenta staterna
-
Sichuan Provincial People's HospitalAnmälan via inbjudanRest Gated Myocardial Perfusion Imaging vid hjärtsviktKina
-
Azienda Ospedaliero Universitaria Maggiore della...Università degli Studi del Piemonte Orientale "Amedeo Avogadro"Rekrytering
-
Medinet Heart CentreOkändKranskärlsbypass | Ischemisk efterkonditionering | Myocardial Reperfusion Injur | Ischemisk förkonditionering, myokardialPolen
-
University of MessinaNatasha Irrera; Gianluca Di Bella; Antonio Micari; Roberto LicordariRekryteringHjärtinfarkt | Myokardfibros | Myocardial Remodeling, VentrikulärItalien
-
Peking University Third HospitalAvslutad
-
Stanford UniversityUpphängdMyocardial BridgingFörenta staterna
-
Izmir Bakircay UniversityAvslutadMyokardbro av kransartärenKalkon
-
Fondazione Policlinico Universitario Agostino Gemelli...Avslutad
-
ITAB - Institute for Advanced Biomedical TechnologiesAzienda Ospedaliero, Universitaria Ospedali RiunitiAvslutadMyokardbro av kransartärenItalien