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Sponsored by: |
Mayo Clinic |
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Information provided by: | Mayo Clinic |
ClinicalTrials.gov Identifier: | NCT00588042 |
Ischemic preconditioning (IP) has been shown in animal studies to increase the myocardial tolerance to subsequent ischemia. Our primary hypothesis is that remote IP reduces myocardial ischemic injury during PCI.
Condition | Intervention |
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Coronary Artery Ischemia |
Device: Blood pressure cuff Device: blood pressure cuff |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Single Blind (Investigator), Dose Comparison, Parallel Assignment, Efficacy Study |
Official Title: | Remote Myocardial Ischemic Preconditioning in Humans |
Estimated Enrollment: | 156 |
Study Start Date: | October 2007 |
Estimated Study Completion Date: | June 2009 |
Estimated Primary Completion Date: | June 2009 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Active Comparator
Arm ischemia will be induced using a blood pressure cuff that will be placed around the upper part of the arm, and inflated to 200 mm Hg for 3-minutes and then deflated for 3-minutes
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Device: Blood pressure cuff
Arm ischemia will be induced using a blood pressure cuff that will be placed around the upper part of the arm, and inflated to 200 mm Hg for 3-minutes and then deflated for 3-minutes
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2: Sham Comparator
3-cycles of cuff inflation (10 mmHg)-deflation will also be performed in the control group for similar durations without inducing ischemia
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Device: blood pressure cuff
3-cycles of cuff inflation (10 mmHg)-deflation will also be performed in the control group for similar durations without inducing ischemia
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Our primary hypothesis is that remote IP reduces myocardial ischemic injury during PCI. We will also test the hypotheses that IP diminishes the inflammatory response to PCI, and that higher baseline blood endothelial progenitor cell counts are predictive of a favorable response to IP.
Aim 1: To evaluate whether remote ischemic preconditioning reduces the frequency of myonecrosis (troponin T≥0.03 ng/ml following PCI).
Aim 2: To evaluate whether remote ischemic preconditioning reduces the inflammatory response to PCI (post PCI hsCRP level).
Aim 3: To evaluate whether pre-procedure circulating endothelial progenitor cell counts correlate with the effect of remote ischemic preconditioning on myonecrosis.
Background: Percutaneous coronary intervention (PCI) frequently results in ischemic myonecrosis. Ischemic preconditioning (IP) has been shown in animal studies to increase the myocardial tolerance to subsequent ischemia. Our primary hypothesis is that remote IP reduces myocardial ischemic injury during PCI. Aims: The aims of the study are to assess in patients with coronary artery disease requiring PCI, whether remote IP reduces: 1) the frequency of myonecrosis; and 2) the inflammatory response to PCI; and 3) whether the effect of IP correlates with pre-procedure circulating endothelial progenitor cell counts. Methods: The study is a prospective, randomized trial to assess the efficacy of remote IP as adjunctive non-pharmacological therapy for PCI in patients with stable or unstable angina. Remote IP will be performed by 3 cycles of 3-minutes of arm ischemia alternating with 3- minutes of reperfusion of the arm immediately before PCI. Myonecrosis and inflammation will be detected by measuring serum troponin T and high sensitivity C-reactive protein, respectively. Blood EPC counts will also be measured before the procedure.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients will be eligible for randomization if they meet the following criteria:
Exclusion Criteria:
Patients will be ineligible for the study if one or more of the following conditions exist:
Contact: Abhiram Prasad, M.D. | 507-255-6092 | prasad.abhiram@mayo.edu |
Contact: Lynn E. Polk, R.N. | 507-255-2527 | polk.lynn@mayo.edu |
United States, Minnesota | |
Mayo Clinic | Recruiting |
Rochester, Minnesota, United States, 55905 | |
Contact: Abhiram Prasad, M.D. 507-255-6092 prasad.abhiram@mayo.edu | |
Contact: Lynn E. Polk, R.N. 507-255-2527 polk.lynn@mayo.edu | |
Principal Investigator: Abhiram Prasad, M.D. |
Principal Investigator: | Abhiram Prasad, MBBS | Mayo Clinic |
Responsible Party: | Mayo Clinic ( Abhiram Prasad, M.D. ) |
Study ID Numbers: | 06-005081, Remote MIPH |
Study First Received: | December 21, 2007 |
Last Updated: | May 20, 2008 |
ClinicalTrials.gov Identifier: | NCT00588042 History of Changes |
Health Authority: | United States: Institutional Review Board |
Angioplasty, Transluminal, Percutaneous Coronary Coronary Artery Disease Coronary Occlusion |
Coronary Occlusion Coronary Disease Ischemia Coronary Artery Disease |
Pathologic Processes Ischemia |