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ST-elevation Myocardial InfarctionGOODINCT03074214

Prognostic Value of Copeptin for Infarct Size and Prognosis in Patients With ST-elevation Myocardial Infarction

An observational study of ST-elevation Myocardial Infarction, run by Shengjing Hospital at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

ST-elevation myocardial infarction (STEMI) has a serious health threaten to population. PCI, which can timely restore the blood flow to the ischemic myocardium, is a well-proved measure in STEMI management. However, the process of the restoration can induce injury. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
ST-elevation Myocardial Infarction
What is being tested?
percutaneous coronary intervention
Type of treatment
Surgery or procedure
How many people
275 participants
Where
1 siteChina
Study dates
6 Mar 2017to 31 Aug 2019
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: 275 patients with STEMI receiving PPCI in department of Cardiology, Shengjing Hospital of China Medical University from March 1, 2017 to February 28, 2019

Who may be able to join

  • chest pain present less than 12 hours from onset of pain to time of catheterization;
  • significant ST-segment elevation (at least 0.1 mV in two or more standard leads or at least 0.2 mV in two or more contiguous precordial leads) or a new left bundle branch block;
  • receiving primary PCI.

Who cannot join

  • Patients with conditions other than STEMI that could cause increased copeptin levels, such as renal dysfunction (eGFR<30 ml/min), liver failure, respiratory tract infection, stroke, sepsis, hyponatremia (Serum sodium concentration<135mmol/L), central diabetes insipidus or malignancy;
  • Patients with contraindications to perform cardiac magnetic resonance;
  • Patients with cardiogenic shock (Killip class IV);
  • Patients in whom reperfusion therapy failed;
  • Patients who were referred for emergency coronary artery bypass grafting (CABG) in view of unfavourable coronary anatomy.

Trial locations and contacts

1 site in 1 country.

China1 site, 1 recruiting
  • Shengjing Hospital of China Medical University

    Shenyang, Liaoning, 8611004

    Hong Wang, Doctor, 8602496615 ext. 10026, llwyh@sj-hospital.org

    Qiyong Guo, Doctor, 8602496615 ext. 10027, guoqy@sj-hospital.org

    Recruiting

Other trials in China

About this study

Official title: Study of Prognostic Value of Copeptin for Myocardial Infarct Size and 6-month Prognosis in Patients With ST-elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention: GOOD I Study

ST-elevation myocardial infarction (STEMI) has a serious health threaten to population. PCI, which can timely restore the blood flow to the ischemic myocardium, is a well-proved measure in STEMI management. However, the process of the restoration can induce injury. The phenomenon is defined as ischemia/reperfusion (I/R) injury. The studies indicate that I/R injury accounts for up to 50% of the final myocardial infarct size. However, previous attempts to target known mediators of myocardial I/R injury in patients have been disappointing, leading to calls for a reevaluation of factors affecting myocardial I/R injury [1]. Arginine vasopressin (AVP), that response to acute illness, is unstable and cleared rapidly from the circulation. However, copeptin, the C-terminal portion of provasopressin, is released in equimolar amounts to AVP and is easy to determine. So, copeptin can be a surrogate marker for AVP secretion. Recently, copeptin was found to serve as a potential prognostic biomarker in heart failure and acute myocardial infarction (AMI). AMI can activate the AVP axis, which have a causative role in the evolution of heart failure. Increasing copeptin was shown to correlate with myocardial remodeling, mortality and morbidity. In patients with STEMI, myocardial infarct size is a stronger outcome predictor than LV function, and is related to LV remodeling, which often indicates a significant worse prognosis after AMI. As the gold standard for characterisation of cardiac structure and function, cardiac magnetic resonance (CMR) parameters can serve as surrogate end points in clinical trials of STEMI. We hypothesised that plasma copeptin values, tested before and after PCI, are related to myocardial infarct size, myocardial function both and outcomes at baseline and 6 months follow-up as assessed by CMR in patients with STEMI.

Read the detailed description

Acute myocardial infarction (AMI) is a major concern in public health in China. Ischemia/reperfusion injury cripples the treatment effect of reperfusion management, and increases the final myocardial infarct size. Copeptin is related to the prognosis of heart failure and AMI, and may be a potential prognostic biomarker for myocardial infarct size, myocardial function and outcomes in patients with STEMI undergoing PCI.This study will enroll consecutive STEMI patients undergoing PCI, who meet the inclusion and exclusion criteria, in a large-scale hospital in Northeast China. After obtaining an informed consent, blood samples will be drawn at the time of before, immediately after, and 3 days after PPCI. They will be collected in EDTA tubes and centrifuged for 10 min at 2000 g within 0.5 h. Plasma will be stored at -80°C until analysis. Plasma copeptin concentrations will be determined by a commercially available automated immunofluorescent assay (R\&D Systems Inc. Minneapolis, USA). And other information about symptoms, functioning, quality of life, medical care, demographic characteristics, medical history, clinical features, diagnostic tests, medications and procedural data will be also collected. Baseline CMR will be performed 3-5 days after PPCI. All scans were performed on a 3.0 Tesla scanner. At 1 month, 3 month, and 12 month after discharge, participants will receive a follow-up by phone. At 6 month after discharge, participants will return to the clinic for follow up visits, and a face-to-face interview will be conducted to get information about clinical events, symptoms, functioning, quality of life, and medical care during the recovery period. Follow-up CMR scan will be conducted. Follow-up blood samples will be drawn for testing copeptin.

Sample Size Calculation A study size analysis was performed using PASS (version 11.0.4, 2011, NCSS, LLC, USA). In a previous study, the 90-day primary composite end point of all-causes death, ventricular fibrillation, cardiogenic shock, and congestive heart failure requiring rehospitalization or an emergency room visit through 90 days was 10.3% in STEMI patients undergoing PCI. [1] Although available data for detecting clinically relevance between copeptin and prognosis in STEMI patients undergoing PCI was limited, a previous study demonstrated that a high concentration (quartile 4 vs. quartiles 1 to 3) of copeptin identified an increased risk of CV death or HF (HR:2.80,95%CI:2.24-3.51,P<0.001). [2] When the ratio between groups1 and 2 is 3:1, an overall sample size of 275 subjects, of which 207 are in group 1 and 68 are in group 2, achieves 90% power at a 0.0500 significance level to detect a difference of 0.1280 between 0.9290 and 0.8010--the proportions surviving in groups 1 and 2, respectively. The proportion of patients lost during follow up was 0.1000.

Being tested
percutaneous coronary intervention
Keywords
copeptin, myocardial infarct size, prognosis, ST-elevation myocardial infarction, percutaneous coronary intervention
Medical subject headings
ST Elevation Myocardial Infarction, Diabetes Insipidus

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • percutaneous coronary interventionProcedure or surgery

    All STEMI patients enrolled will at first receive "Device"(such as: stent or balloon) treatment for their coronary artery.

Study groups in NCT03074214
Study groupRoleWhat they receive
STEMI patients receiving PCIpatients with STEMI receiving percutaneous coronary intervention
Receives: Procedure: percutaneous coronary intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Major adverse cardiovascular events (MACE)

    Composite of MACE including cardiac death, non-fatal myocardial reinfarction, unplanned repeat revascularization, congestive heart failure or angina requiring rehospitalization or an emergency room visit, ventricular fibrillation or ventricular tachycardia with hemodynamic instability

    Measured: 6 months

Secondary outcomes (17)
  1. All-cause death

    All-cause death

    Measured: 6 months

  2. Cardiac death

    Cardiac death

    Measured: 6 months

  3. unplanned repeat revascularization

    unplanned repeat revascularization which included any unplanned repeat PCI or surgical bypass of target or non-target vessels

    Measured: 6 months

  4. congestive heart failure requiring rehospitalization or an emergency room visit

    congestive heart failure requiring rehospitalization or an emergency room visit

    Measured: 6 months

  5. angina requiring rehospitalization or an emergency room visit

    angina requiring rehospitalization or an emergency room visit

    Measured: 6 months

  6. ventricular fibrillation or severe ventricular tachycardia

    ventricular fibrillation or severe ventricular tachycardia with hemodynamic instability occurring more than 2 hours after PCI

    Measured: 6 months

  7. acute heart failure during the index hospitalization

    acute heart failure during the index hospitalization

    Measured: 6 months

  8. in-stent stent thrombosis

    acute, subacute or chronic in-stent stent thrombosis

    Measured: 6 months

  9. contrast-induced nephropathy

    Contrast-induced nephropathy was defined as an increase in serum creatinine concentration ≥0.5 mg/dl (44.2 mmol/l) or ≥25% above baseline 72 h after exposure to the contrast medium.

    Measured: 6 months

  10. ischemia stroke

    ischemia stroke was defined as an acute event of non-hemorrhagic cerebrovascular origin causing focal or global neurologic dysfunction lasting >24 h, which was confirmed by both clinical and radiographic criteria.

    Measured: 6 months

  11. Bleeding Academic Research Consortium Definition for Bleeding: type 3 or 5

    Bleeding Academic Research Consortium Definition for Bleeding: Type 3 Type 3a Overt bleeding plus hemoglobin drop of 3 to 5 g/dL* (provided hemoglobin drop is related to bleed) Any transfusion with overt bleeding Type 3b Overt bleeding plus hemoglobin drop 5 g/dL* (provided hemoglobin drop is related to bleed) Cardiac tamponade Bleeding requiring surgical intervention for control (excluding dental/nasal/skin/hemorrhoid) Bleeding requiring intravenous vasoactive agents;Type 3c Intracranial hemorrhage (does not include microbleeds or hemorrhagic transformation, does include intraspinal) Subcategories confirmed by autopsy or imaging or lumbar puncture Intraocular bleed compromising vision Type 5: fatal bleeding Type 5a Probable fatal bleeding; no autopsy or imaging confirmation but clinically suspicious Type 5b Definite fatal bleeding; overt bleeding or autopsy or imaging confirmation

    Measured: 6 months

  12. Seattle angina questionnaire (SAQ)

    Seattle angina questionnaire (SAQ)

    Measured: 6 months

  13. Quality of life (EQ-5D)

    Quality of life (EQ-5D)

    Measured: 6 months

  14. Depression (PHQ-8)

    Depression (PHQ-8)

    Measured: 6 months

  15. Stress (Chinese 14-item PSS)

    Stress (Chinese 14-item PSS)

    Measured: 6 months

  16. Cognitive function (MMSE)

    Cognitive function (MMSE)

    Measured: 6 months

  17. myocardial infarct size

    myocardial infarct size

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Mar 2017
  2. Study start6 Mar 2017
  3. Primary completion28 Feb 2019 (estimated)
  4. Study completion31 Aug 2019 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
275 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03074214
Sponsor's protocol ID
2016PS373K
Acronym
GOODI
Status last verified
Mar 2017
First submitted
28 Feb 2017
Last updated
10 Mar 2017
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: We will not share IPD to protect our data very well.

Publications

  • Ellis SG, Tendera M, de Belder MA, van Boven AJ, Widimsky P, Janssens L, Andersen HR, Betriu A, Savonitto S, Adamus J, Peruga JZ, Kosmider M, Katz O, Neunteufl T, Jorgova J, Dorobantu M, Grinfeld L, Armstrong P, Brodie BR, Herrmann HC, Montalescot G, Neumann FJ, Effron MB, Barnathan ES, Topol EJ; FINESSE Investigators. Facilitated PCI in patients with ST-elevation myocardial infarction. N Engl J Med. 2008 May 22;358(21):2205-17. doi: 10.1056/NEJMoa0706816.

    PubMed 18499565
  • O'Malley RG, Bonaca MP, Scirica BM, Murphy SA, Jarolim P, Sabatine MS, Braunwald E, Morrow DA. Prognostic performance of multiple biomarkers in patients with non-ST-segment elevation acute coronary syndrome: analysis from the MERLIN-TIMI 36 trial (Metabolic Efficiency With Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndromes-Thrombolysis In Myocardial Infarction 36). J Am Coll Cardiol. 2014 Apr 29;63(16):1644-53. doi: 10.1016/j.jacc.2013.12.034. Epub 2014 Feb 13.

    PubMed 24530676

Questions about this trial

What is this clinical trial studying?

An observational study of ST-elevation Myocardial Infarction, run by Shengjing Hospital at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 10 Mar 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Tongtong Yu, Doctor (8602496615 ext. 22211, workhard31@vip.163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Major adverse cardiovascular events (MACE) (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03074214, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Mar 2017.

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