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Università Vita-Salute San Raffaele |
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Information provided by: | Università Vita-Salute San Raffaele |
ClinicalTrials.gov Identifier: | NCT00364637 |
Patients undergoing stenting procedures, or cardiac or non-cardiac surgery could develop myocardial damage as testified by cardiac troponin release.
Sevoflurane (volatile anesthetic), routinely used in cardiac and non-cardiac anesthesia, has cardioprotective properties that could be useful to reduce cardiac damage, as indicated by cardiac troponin release in different contexts:
Condition | Intervention | Phase |
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Anesthesia |
Drug: Sevoflurane (Volatile Anesthetic) |
Phase IV |
Study Type: | Interventional |
Study Design: | Prevention, Randomized, Double Blind (Subject, Caregiver, Outcomes Assessor), Active Control, Parallel Assignment, Efficacy Study |
Official Title: | Pharmacological Preconditioning Properties of Volatile Anesthetics |
Study Start Date: | January 2005 |
Estimated Study Completion Date: | December 2010 |
Stenting procedures, cardiac and non-cardiac surgical procedures may carry a significant risk of cardiac damage ultimately leading to prolonged hospital stay and even a non-negligible periprocedural mortality rate. According to the American College of Cardiology/American Heart Association Guidelines all anesthetic techniques and drugs have known cardiac effects that should be considered in the perioperative plan. There appears to be no one best myocardium protective anesthetic technique: the choice of anesthesia is best left to the discretion of the anesthesia care team. To date no anesthesiological drug or techniques proved to reduce perioperative morbidity and mortality in cardiac surgery, only Beta-blockers and locoregional analgesia showed improved outcomes after non-cardiac surgery and no study on anesthesiological drugs has been performed in stenting procedures.
Volatile anesthetics, which are commonly used in general anesthesia to induce and maintain hypnosis, analgesia, amnesia and mild muscle relaxation, have been shown to improve post-ischemic recovery at the cellular level, in isolated hearts, and in animals, both through a pharmacological preconditioning and postconditioning action. Whether the cardioprotective effects of volatile anesthetics are clinically applicable and associated with improved cardiac function, ultimately resulting in a better outcome in patients undergoing cardiac surgery, is still debated. No data exist on patients undergoing non-cardiac surgery or stenting procedures. A recently published meta-analysis including studies considering all volatile anesthetics showed no reduction in myocardial infarction and perioperative death rate. However the newer volatile anesthetics (desflurane and sevoflurane) seem to have more prominent cardioprotective properties and numerous apparently positive reports targeted to surrogate end-points, yet severely underpowered, have appeared in the literature. Of interest, many of these studies were not included in the above cited meta-analysis. To address the question of whether the choice of an anesthetic regimen might influence patients' outcome we have planned a RCT to determine the impact of sevoflurane on perioperative cardiac damage in patients undergoing cardiac surgery, non-cardiac surgery and stenting procedures.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Giovanni Landoni, MD | +39.347.2520801 | landoni.giovanni@hsr.it |
Italy | |
Università Vita-Salute San Raffaele, Milano, Italia e Istituto Scientifico San Raffaele, Milano, Italia | Recruiting |
Milano, Italy, 20132 |
Principal Investigator: | Giovanni Landoni, MD | Università Vita-Salute San Raffaele, Milano, Italia e Istituto Scientifico San Raffaele, Milano, Italia |
Study Director: | Alberto Zangrillo, MD | Università Vita-Salute San Raffaele, Milano, Italia e Istituto Scientifico San Raffaele, Milano, Italia |
Responsible Party: | Vita-Salute University of Milano, Itay ( Zangrillo Alberto ) |
Study ID Numbers: | DS/URC/ER/mm 51/DG |
Study First Received: | August 11, 2006 |
Last Updated: | January 12, 2009 |
ClinicalTrials.gov Identifier: | NCT00364637 History of Changes |
Health Authority: | Italy: Ministry of Health |
Sevoflurane Anesthesia Troponin Myocardial Preconditioning |
Surgery, Cardiac Stents Non-cardiac Surgery Surgery |
Anesthetics, Inhalation Anesthetics, General Central Nervous System Depressants |
Anesthetics Platelet Aggregation Inhibitors Sevoflurane |
Anesthetics, Inhalation Anesthetics, General Therapeutic Uses Hematologic Agents Physiological Effects of Drugs Central Nervous System Depressants |
Anesthetics Platelet Aggregation Inhibitors Central Nervous System Agents Pharmacologic Actions Sevoflurane |