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Sponsors and Collaborators: |
Arcispedale Santa Maria Nuova Azienda Sanitaria Ospedaliera |
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Information provided by: | Arcispedale Santa Maria Nuova |
ClinicalTrials.gov Identifier: | NCT00639912 |
The aim of the study is to test the efficacy of low versus high volume hydration and two different solutions (sodium chloride versus sodium bicarbonate) in preventing contrast induced nephropathy (CIN) in ST elevation myocardial infarction (STEMI) patients undergoing primary PCI.
Condition | Intervention | Phase |
---|---|---|
Contrast Induced Nephropathy |
Drug: sodium chloride Drug: sodium bicarbonate |
Phase IV |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study |
Official Title: | Randomized Trial on the Effects of Hydration With Sodium Chloride Versus Sodium Bicarbonate to Prevent Contrast Induced Nephropathy, in Patients Undergoing Primary Coronary Interventions for Acute ST Elevation Myocardial Infarction. |
Estimated Enrollment: | 600 |
Study Start Date: | June 2007 |
Estimated Study Completion Date: | October 2009 |
Estimated Primary Completion Date: | September 2009 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
A: Active Comparator
Solution of 154 mEq/L of sodium chloride Rate of infusion: 1ml/Kg/hour for 12 hours, starting in the Cath Lab
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Drug: sodium chloride
Solution of 154 mEq/L of sodium chloride Rate of infusion: 1ml/Kg/hour for 12 hours
|
B: Active Comparator
Solution of 154 mEq/L of sodium chloride Rate of infusion: 3ml/Kg for 1 hour, followed by 1ml/Kg/hour for 12 hours, starting in the Cath lab
|
Drug: sodium chloride
Solution of 154 mEq/L of sodium chloride Rate of infusion: 3ml/Kg for 1 hour, followed by 1ml/Kg/hour for 12 hours
|
C: Active Comparator
Solution of 154 mEq/L of sodium bicarbonate Rate of infusion: 1ml/Kg/hour for 12 hours, starting in the Cath Lab
|
Drug: sodium bicarbonate
Solution of 154 mEq/L of sodium bicarbonate Rate of infusion: 1ml/Kg/hour for 12 hours
|
D: Active Comparator
Solution of 154 mEq/L of sodium bicarbonate Rate of infusion: 3ml/Kg for 1 hour, followed by 1ml/Kg/hour for 12 hours, starting in the Cath Lab
|
Drug: sodium bicarbonate
Solution of 154 mEq/L of sodium chloride Rate of infusion: 3ml/Kg for 1 hour, followed by 1ml/Kg/hour for 12 hours
|
Contrast-induced nephropathy (CIN) is associated with increased morbidity and mortality after percutaneous coronary interventions (PCI). Patients with ST elevation myocardial infarction (STEMI) are at high risk for CIN because of hemodynamic instability of the patient, inability to prevent the phenomenon (hydration) and the possible exposure to high volume of contrast media. Recent reports have shown incidence of CIN up to 19% in this population and a related increase of in-hospital mortality. Mertan e coll. (JAMA 2004) reported that sodium bicarbonate infusion before and after contrast exposure in patients with chronic renal failure and without myocardial infarction (AMI) is more effective than sodium chloride in preventing CIN.
Up to date there is no evidence of any effective prophylactic measures in patients with STEMI undergoing primary PCI.
The aim of the study is to test the efficacy of low versus high volume hydration and the efficacy of two different solutions (sodium chloride versus sodium bicarbonate) in preventing CIN in STEMI patients undergoing primary PCI.
The infusion of the randomized solution will start just after randomization and after determination of baseline serum creatinine.
Determination of serum creatinine will be repeated at 24, 48 and 72 hours after randomization. Creatinine clearance will be calculated with Cockroft-Gault formula.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Antonio Manari, MD | 00390522295846 | manari.antonio@asmn.re.it |
Contact: Gianluca Pignatelli, MD | 00390522296595 | pignatelli.gianluca@asmn.re.it |
Italy, Emilia-Romagna | |
Azienda Ospedaliera Universitaria S. Anna | Recruiting |
FERRARA, Emilia-Romagna, Italy | |
Contact: Gianfranco Percoco, MD | |
Principal Investigator: Gianfranco Percoco, MD | |
Arcispedale S. Maria Nuova | Recruiting |
Reggio Emilia, Emilia-Romagna, Italy, 42100 | |
Contact: Antonio Manari, MD 00390522295846 manari.antonio@asmn.re.it | |
Principal Investigator: Antonio Manari, MD | |
Azienda Ospedaliera Policlinico Baggiovara | Recruiting |
Modena, Emilia-Romagna, Italy, 41100 | |
Contact: Paolo Magnavacchi, MD 0039059437316 p.magnavacchi@ausl.mo.it | |
Principal Investigator: Paolo Magnavacchi, MD |
Principal Investigator: | Antonio Manari, MD | Arcispedale S. Maria Nuova Reggio Emilia |
Responsible Party: | Arcispedale S. Maria Nuova ( Manari Antonio ) |
Study ID Numbers: | MAN1374 |
Study First Received: | March 14, 2008 |
Last Updated: | March 19, 2008 |
ClinicalTrials.gov Identifier: | NCT00639912 History of Changes |
Health Authority: | Italy: Ethics Committee |
contrast induced nephropathy STEMI PCI |
Necrosis Heart Diseases Urologic Diseases Myocardial Ischemia Vascular Diseases |
Ischemia Kidney Diseases Infarction Myocardial Infarction |
Necrosis Heart Diseases Pathologic Processes Urologic Diseases Myocardial Ischemia Vascular Diseases |
Cardiovascular Diseases Ischemia Kidney Diseases Infarction Myocardial Infarction |