Cyclosporine in Acute Myocardial Infarction Complicated by Cardiogenic Shock (CLOTILDE)
研究概览
地位
条件
研究类型
阶段
- 阶段2
联系人和位置
学习地点
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Aix-en-Provence、法国、13616
- CH Pays d'Aix
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Bayonne、法国、64100
- Clinique de La Fourcade
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Bron、法国、69677
- CHU Hopital Cardiologique Louis Pradel
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Clermont-ferrand、法国、63003
- Hôpital Gabriel Montpied
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Dijon、法国、21034
- CHU Hopital du Bocage
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Grenoble、法国、38043
- Chu Hopital A Michallon
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Lyon、法国
- Hopital St Luc St Joseph
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Montpellier、法国、34295
- CHU Arnaud de Villeneuve
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Nantes、法国、44093
- Hopital Guillaume Et Rene Laennec
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Nimes、法国、30029
- CHU de Nîmes
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PAU、法国、64011
- Centre Hospitalier de Pau
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Paris、法国、75018
- APHP Hôpital Bichat
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Pessac、法国、33604
- CHU de Bordeaux
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Rouen、法国、76031
- Hôpital Charles Nicolle
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Strasbourg、法国、67091
- Nouvel hopital civil
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Toulouse、法国、31403
- CHU de Rangueil
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Tours、法国、37044
- CHRU de Tours
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Vandoeuvre Les Nancy、法国、54511
- CHU de Nancy Brabois
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Patients ( male or female), aged over 18, without any legal protection measure
- Having a health coverage
- Presenting within 12 hours of the onset of chest pain, with a ST segment elevation or non ST elevation and for whom the clinical decision was made to treat with percutaneous coronary intervention (PCI) primary or rescue
- Occlusion of culprit coronary artery (TIMI flow grade = 0 or 1) at the time of admission in the catheterism laboratory
- Patient presenting a cardiogenic shock defined by a SBP<90mmhg for a period over 30 minutes and do not answering to a test of vascular charge associated with signs peripheral hypoperfusion (cold extremities, cyanosis, oliguria with urine output <50 ml/h or alteration of higher mental functions).
- Clear information is delivered to the patient or a legal representative if present and preliminary oral consent obtained, followed by obtaining written consent signed as soon as possible, in accordance with ICH.
NB: Patients undergoing either primary PCI or rescue PCI are eligible for the study.
Patients with previous AMI, PCI or coronary artery bypass surgery (CABG) are eligible for the study.
Exclusion Criteria:
- TIMI flow grade >1
- Patients in cardiac arrest
- Patients with mechanical complication of myocardial infarction at admission (septal, broken pillar cracking or myocardial rupture, tamponade).
- Patients with other causes of hemodynamic shock: hemorrhagic, septic or anaphylactic.
- Patients with known hypersensitivity to cyclosporine, hypersensitivity to egg, peanut or Soya-bean proteins
- Renal insufficiency (either known creatinine clearance < 30 ml/min/1.73m² or current medical care for severe renal insufficiency)
- Patients treated with any compound containing Hypericum perforatum (St. John's Wort) or Stiripentol or Aliskiren or Bosentan or Rosuvastatine
- Female patients currently pregnant or women of childbearing age who were not using contraception (oral diagnosis).
- Patients with any disorder associated with immunological dysfunction more recently than 6 months prior to presentation, cancer, lymphoma, known positive serology for HIV, or hepatitis
- Participation to another clinical trial
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：四人间
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：CsA Group
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The investigational medicinal product is cyclosporine A (CicloMulsion®, Neurovive). Cyclosporine A is an immunosuppressive treatment usually used in the prevention of acute rejection after organ transplant, including cardiac transplantation. Usual dosages in organ transplantation are about 2.5 mg / kg per day in 2 doses. CicloMulsion® is ready-to-use lipid emulsions, i.e. do not need any step of preparation or dilution. Production blinded labelling, packaging and delivering the study drugs in every participating centre of the trial will be performed by a company following European Union's Good Manufacturing Practice. CicloMulsion® 5mg/ml is provided in colourless glass bottles sealed with a rubber stopper, containing a nominal fill volume of 50 ml. The study treatment will be directly taken into the vial and injected via a catheter positioned within an antecubital vein. The injection will be performed slowly over 2 to 3 minutes. |
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安慰剂比较：安慰剂组
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The matching placebo of CicloMulsion® (Neurovive) is composed with refined Soya-bean oil, medium-chain triglycerides, egg lecithin, water-free glycerol, sodium oleate, sodium hydroxide, water injection. The qualitative composition of CicloMulsion® and its placebo only differ in the presence or absence of Cyclosporine A, so the final emulsions will be visually indistinguishable. The placebo use here is ready-to-use lipid emulsions, i.e. do not need any step of preparation or dilution. The placebo is provided in colourless glass bottles sealed with a rubber stopper, containing a nominal fill volume of 50 ml. The study treatment will be directly taken into the vial and injected via a catheter positioned within an antecubital vein. The injection will be performed slowly over 2 to 3 minutes. |
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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multiorgan failure evaluated by the SOFA score
大体时间：At 24 hours after admission
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The SOFA clinico-biological score takes into account the respiratory status, cardiac, hepatic, renal, neurological and the biological parameters of coagulation of the patient.
This score is spread from 0 to 24 points.
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At 24 hours after admission
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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multiorgan failure by SOFA score
大体时间：At 48 hours after admission
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The SOFA clinico-biological score takes into account the respiratory status, cardiac, hepatic, renal,neurological and the biological parameters of coagulation of the patient.
This score is spread from 0 to 24 points.
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At 48 hours after admission
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multiorgan failure by SAPSII scores
大体时间：At 24 hours and at 48 hours
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The SAPSII score takes into account the hemodynamic, clinical, biological status of the patient.
The parameters are : history of patient (type of admission, chronic disease, age), clinical parameters as systolic pressure measurement, heart rate, temperature, urine output of 24 hours and biological parameters as measurement of blood count white, serum total bilirubin, serum urea, serum sodium, serum potassium and bicarbonate level serum.
pressure measurement arterial oxygen in arterial blood gases.
This score is spread from 0 to 163 points.
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At 24 hours and at 48 hours
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Cardiac output (CO)
大体时间：At 24 hours after inclusion
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The hemodynamic changes will be estimated by measuring the cardiac output (CO) obtained by echocardiography.
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At 24 hours after inclusion
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Reduction of infarct size
大体时间：during the first 72 hours after admission
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evaluation of the under curve area of serum creatinin kinase (CK) measured during the 72 first hours after admission (12 blood sampling).
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during the first 72 hours after admission
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Reduction of cardiovascular morbidity and mortality
大体时间：at 1 month
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The incidence that occurred in one month (D30) of the following clinical criteria will be collected: death, ventricular fibrillation or ventricular tachycardia requiring electrical cardioversion, placed under mechanical cardiac support (other than against drive-by intra-aortic balloon) , reinfarction, hospitalization for heart failure.
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at 1 month
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Reduction of Left ventricular remodeling
大体时间：at 1 month
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Left ventricular remodeling will be assessed at 1 month among surviving patients by measurement of left ventricular end-diastolic volume by transthoracic echocardiography
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at 1 month
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合作者和调查者
调查人员
- 首席研究员：Eric Bonnefoy-Cudraz, MD, PhD、CHU-Hôpital Cardiologique Louis Pradel BRON
研究记录日期
研究主要日期
学习开始
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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