心脏 MRI 引导的去铁酮治疗急性心肌梗死患者 (MIRON-DFP)
The objective of this randomized, controlled pilot study is to determine the efficacy of Deferiprone to reduce the amount of free iron inside the hemorrhagic zone of myocardial infarction among hemorrhagic myocardial infarction patients.
研究概览
详细说明
Patients with newly diagnosed STEMI (ST-segment elevation myocardial infarction) who appear to meet eligibility criteria will be recruited for participation. Those who agree to participate and are confirmed to be eligible will undergo a cardiac MRI scan and will be randomized to take either deferiprone or placebo daily for 60 days. Total study participation will last 6 months, during which study participants will attend 7 study visits for blood draws, ECGs, and a repeat cardiac MRI at Day 180.
研究类型
注册 (估计的)
阶段
- 阶段2
联系人和位置
学习联系方式
- 姓名：Clinical Research Coordinator
- 电话号码：(317) 274-0985
- 邮箱：csaha@iu.edu
学习地点
-
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Indiana
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Indianapolis、Indiana、美国、46202
- 招聘中
- IU Methodist Hospital (IUHealth)
-
接触：
- Chandana Saha, PhD
- 电话号码：317-274-0985
- 邮箱：csaha@iu.edu
-
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Minnesota
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Minneapolis、Minnesota、美国、55407
- 招聘中
- Minneapolis Heart Institute Foundation
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首席研究员：
- Jay Traverse, MD
-
接触：
- Colleen Quinlan
- 电话号码：763-688-7451
- 邮箱：colleen.quinlan@allina.com
-
-
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
- At least 18 years of age
- Index Anterior wall STEMI
- Emergency coronary angiogram with primary PCI
Exclusion Criteria
- Prior history of MI / PCI / coronary artery bypass graft (CABG) within previous 1 year
- Patients with previous history of left ventricular ejection fraction (LVEF) < 40%
- Use of investigational drugs or devices 30 days prior to randomization
- Known allergy or contra-indication to gadolinium/contrast agents
- eGFR < 30 ml/kg/min
- Any contraindication against cardiac MRI (such as metal implants)
- Women who are pregnant or breastfeeding. Women of reproductive potential must have a negative pregnancy test prior to randomization
- Body weight > 140 kg (or 309 lbs.)
- Absolute neutrophil count - ANC < 1.5 k/cumm
- History of Chronic Liver Disease
- Elevated hepatic enzymes (BOTH ALT and AST) > 2 times of upper normal limit
- Patients with iron storage disease (hemochromatosis, thalassemia) or who are already treated with iron chelators
- Any clinically significant abnormality identified prior to randomization that in the judgment of the Sponsor-Investigator or Delegate would preclude safe completion of the study or confound the anticipated benefit of deferiprone.
- Life expectancy of less than 1 year due to non-cardiac pathology
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：三倍
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
有源比较器：Hemorrhagic Myocardial Infarction - Deferiprone
Enrolled patients with CMR confirmed presence of intramyocardial hemorrhage |
Deferiprone tablets are the active medication for the active arm of the study groups. Randomization will be done by investigational drug services pharmacist and intervention will be double-blinded to investigators and patients. |
|
有源比较器：Non-hemorrhagic Myocardial Infarction - Deferiprone
Enrolled patients with CMR confirmed absence of intramyocardial hemorrhage |
Deferiprone tablets are the active medication for the active arm of the study groups. Randomization will be done by investigational drug services pharmacist and intervention will be double-blinded to investigators and patients. |
|
安慰剂比较：Hemorrhagic Myocardial Infarction - Placebo
Enrolled patients with CMR confirmed presence of intramyocardial hemorrhage |
Deferiprone placebo is the non-medicated formulation for a control arm of the study groups. |
|
安慰剂比较：Non-hemorrhagic Myocardial Infarction - Placebo
Enrolled patients with CMR confirmed absence of intramyocardial hemorrhage |
Deferiprone placebo is the non-medicated formulation for a control arm of the study groups. |
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 |
|---|---|---|
|
Treatment Efficacy
大体时间：6 months
|
Percentage reduction of hemorrhagic zone iron content by cardiac magnetic resonance at 6 months relative to baseline |
6 months
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Treatment Effect: Clinical Outcomes of Acute Heart Failure
大体时间：6 months
|
The proportion of subjects who experience an acute heart failure event |
6 months
|
|
Treatment Effect: Clinical Outcomes of Non-Fatal Cardiovascular morbidity
大体时间：6 months
|
The proportion of subjects who experience other non-fatal cardiovascular morbidity such as recurrent myocardial infarction, ventricular arrhythmia and CVA |
6 months
|
|
Safety and Tolerability - Rate of Discontinuation
大体时间：6 months
|
Rate of discontinuation of therapy due to side effects |
6 months
|
|
Safety and Tolerability - Severe Side Effects
大体时间：6 months
|
Rate of severe side effects requiring hospitalization, extension of length-of-stay. |
6 months
|
|
Safety and Tolerability - Reversibility of Side Effects without Treatment
大体时间：6 months
|
Percentage of Reversible of Side Effects without treatment |
6 months
|
其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Treatment Effect: Fat Infiltration
大体时间：6 months
|
Percentage difference of fat infiltration within the hemorrhagic myocardial infarction arms at 6 months between deferiprone and placebo groups |
6 months
|
合作者和调查者
调查人员
- 首席研究员：Rohan Dharmakumar, PhD、Medical Imaging Research Institute, Indiana University School of Medicine
- 首席研究员：Keyur P Vora, MD FACP FACC、Medical Imaging Research Institute, Indiana University School of Medicine
出版物和有用的链接
一般刊物
- Kali A, Kumar A, Cokic I, Tang RL, Tsaftaris SA, Friedrich MG, Dharmakumar R. Chronic manifestation of postreperfusion intramyocardial hemorrhage as regional iron deposition: a cardiovascular magnetic resonance study with ex vivo validation. Circ Cardiovasc Imaging. 2013 Mar 1;6(2):218-28. doi: 10.1161/CIRCIMAGING.112.000133. Epub 2013 Feb 12.
- Kali A, Cokic I, Tang R, Dohnalkova A, Kovarik L, Yang HJ, Kumar A, Prato FS, Wood JC, Underhill D, Marban E, Dharmakumar R. Persistent Microvascular Obstruction After Myocardial Infarction Culminates in the Confluence of Ferric Iron Oxide Crystals, Proinflammatory Burden, and Adverse Remodeling. Circ Cardiovasc Imaging. 2016 Nov;9(11):e004996. doi: 10.1161/CIRCIMAGING.115.004996.
- Wang G, Yang HJ, Kali A, Cokic I, Tang R, Xie G, Yang Q, Francis J, Li S, Dharmakumar R. Influence of Myocardial Hemorrhage on Staging of Reperfused Myocardial Infarctions With T2 Cardiac Magnetic Resonance Imaging: Insights Into the Dependence on Infarction Type With Ex Vivo Validation. JACC Cardiovasc Imaging. 2019 Apr;12(4):693-703. doi: 10.1016/j.jcmg.2018.01.018. Epub 2018 Apr 18.
- Liu T, Howarth AG, Chen Y, Nair AR, Yang HJ, Ren D, Tang R, Sykes J, Kovacs MS, Dey D, Slomka P, Wood JC, Finney R, Zeng M, Prato FS, Francis J, Berman DS, Shah PK, Kumar A, Dharmakumar R. Intramyocardial Hemorrhage and the "Wave Front" of Reperfusion Injury Compromising Myocardial Salvage. J Am Coll Cardiol. 2022 Jan 4;79(1):35-48. doi: 10.1016/j.jacc.2021.10.034.
- Dharmakumar R. "Rusty Hearts": Is It Time to Rethink Iron Chelation Therapies in Post-Myocardial-Infarction Setting? Circ Cardiovasc Imaging. 2016 Oct;9(10):e005541. doi: 10.1161/CIRCIMAGING.116.005541. No abstract available.
- Dharmakumar R. Colors of Myocardial Infarction: Can They Predict the Future? Circ Cardiovasc Imaging. 2017 Dec;10(12):e007291. doi: 10.1161/CIRCIMAGING.117.007291. No abstract available.
- Dharmakumar R, Nair AR, Kumar A, Francis J. Myocardial Infarction and the Fine Balance of Iron. JACC Basic Transl Sci. 2021 Jul 26;6(7):581-583. doi: 10.1016/j.jacbts.2021.06.004. eCollection 2021 Jul.
- Guan X, Chen Y, Yang HJ, Zhang X, Ren D, Sykes J, Butler J, Han H, Zeng M, Prato FS, Dharmakumar R. Assessment of intramyocardial hemorrhage with dark-blood T2*-weighted cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2021 Jul 15;23(1):88. doi: 10.1186/s12968-021-00787-4.
- Kali A, Tang RL, Kumar A, Min JK, Dharmakumar R. Detection of acute reperfusion myocardial hemorrhage with cardiac MR imaging: T2 versus T2. Radiology. 2013 Nov;269(2):387-95. doi: 10.1148/radiology.13122397. Epub 2013 Jul 11.
- Cokic I, Kali A, Yang HJ, Yee R, Tang R, Tighiouart M, Wang X, Jackman WS, Chugh SS, White JA, Dharmakumar R. Iron-Sensitive Cardiac Magnetic Resonance Imaging for Prediction of Ventricular Arrhythmia Risk in Patients With Chronic Myocardial Infarction: Early Evidence. Circ Cardiovasc Imaging. 2015 Aug;8(8):10.1161/CIRCIMAGING.115.003642 e003642. doi: 10.1161/CIRCIMAGING.115.003642.
- Cokic I, Kali A, Wang X, Yang HJ, Tang RL, Thajudeen A, Shehata M, Amorn AM, Liu E, Stewart B, Bennett N, Harlev D, Tsaftaris SA, Jackman WM, Chugh SS, Dharmakumar R. Iron deposition following chronic myocardial infarction as a substrate for cardiac electrical anomalies: initial findings in a canine model. PLoS One. 2013 Sep 16;8(9):e73193. doi: 10.1371/journal.pone.0073193. eCollection 2013.
- Nair AR, Johnson EA, Yang HJ, Cokic I, Francis J, Dharmakumar R. Reperfused hemorrhagic myocardial infarction in rats. PLoS One. 2020 Dec 2;15(12):e0243207. doi: 10.1371/journal.pone.0243207. eCollection 2020.
- Chen Y, Ren D, Guan X, Yang HJ, Liu T, Tang R, Ho H, Jin H, Zeng M, Dharmakumar R. Quantification of myocardial hemorrhage using T2* cardiovascular magnetic resonance at 1.5T with ex-vivo validation. J Cardiovasc Magn Reson. 2021 Sep 30;23(1):104. doi: 10.1186/s12968-021-00779-4.
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
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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