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Non ST Segment Elevation Acute Coronary SyndromeIN HEARTNCT03300167

Study of the Vascular Response to Percutaneous Coronary Intervention in Patients With Non-ST-elevation Acute Coronary Syndromes Using Intravascular Blood Sampling

A study testing The Liquid Biopsy System in people with Non ST Segment Elevation Acute Coronary Syndrome, run by Sheffield Teaching Hospitals NHS Foundation Trust at 1 site in United Kingdom.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

This interventional study is using the PlaqueTec LBS will enrol participants already undergoing coronary angiography as a component of their standard care for NSTE-ACS. The study will involve no change to medication or overall treatment strategy, but will involve an additional procedure: use of a novel CE-marked… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
The Liquid Biopsy System
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
1 siteUnited Kingdom
Study dates
30 Nov 2017to 30 Jun 2020
Phase
Interventional
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged over 18 years
  • Admitted to hospital with non-ST-elevation ACS and plan for either coronary angiography with a view to PCI if appropriate or PCI following coronary angiography at a referring hospital
  • Current treatment with aspirin and ticagrelor or, if ticagrelor is not tolerated, prasugrel (DAPT)
  • Ability to give informed consent

Who cannot join

  • Treatment with antiplatelet medication apart from aspirin, ticagrelor, prasugrel or clopidogrel in the last 10 days (e.g. dipyridamole, abciximab, tirofiban).
  • Planned use of a glycoprotein IIb/IIIa antagonist for the PCI procedure.
  • Patients with haemodynamic instability, shock or angiographic evidence of intracoronary thrombus.
  • Current use of an oral anticoagulant (e.g. warfarin, dabigatran, rivaroxaban, apixaban).
  • Clinically significant liver disease.
  • Contraindication or allergy to unfractionated heparin.
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  • Receiving immunosuppressant medication (eg. cyclosporin, tacrolimus, mycophenolate, azathioprine).
  • Administration of doses of low molecular weight heparin or fondaparinux in the 12 hours preceding PCI.
  • Known severe left ventricular dysfunction (ejection fraction <30%).
  • Culprit lesion in left main coronary artery.
  • Women of childbearing potential unless pregnancy has been excluded during the index hospital admission.
  • Known serum creatinine above upper limit of local reference range.
  • Subjects with known active chronic inflammatory disease, e.g. systemic lupus erythematosus, rheumatoid arthritis, seropositive arthropathies and known seropositivity to HIV, Hepatitis B or Hepatitis C.
  • Severely diseased, excessively tortuous or calcified coronary vessels that increase the risk of snaring the LBS.
  • Culprit lesion in a coronary vessel with a reference diameter of less than 2.5 mm.
  • Need to cross a region of coronary vessel that contains a stent.
  • Evidence of ongoing sepsis.
  • Receiving a non-steroidal anti-inflammatory drug (NSAID) apart from aspirin, including selective COX2 inhibitors ('coxibs') and including regular or intermittent/as required use.
  • Receiving a strong inhibitor of CYP3A4 (eg, ketoconazole, itraconazole, voriconazole, telithromycin, clarithromycin [but not erythromycin or azithromycin], nefazadone, ritonavir, saquinavir, nelfinavir, indinavir, atanazavir, or over 1 litre daily of grapefruit juice).
  • Receiving simvastatin or lovastatin at doses higher than 40 mg daily.
  • Receiving a CYP3A substrate with a narrow therapeutic index (e.g. cyclosporine or quinidine).
  • Receiving a strong inducer of CYP3A (e.g. rifampin/rifampicin, rifabutin, phenytoin, carbamazepine, phenobarbital).
  • Current or recent (within 30 days) participation in a clinical trial of a drug or device or any other clinical study that might influence the results or safety of the study.
  • Any factor precluding ability to comply with follow-up.
  • Any other factor judged by the investigator or treating physician to preclude enrolment in the study.

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • Sheffield Teaching Hospitals NHS Foundation Trust

    Sheffield, South Yorkshire, S5 7AU

Other trials in United Kingdom

About this study

This interventional study is using the PlaqueTec LBS will enrol participants already undergoing coronary angiography as a component of their standard care for NSTE-ACS. The study will involve no change to medication or overall treatment strategy, but will involve an additional procedure: use of a novel CE-marked coronary artery catheter to obtain spatially-separated intravascular samples for laboratory measurement. As a safety objective and as a component of the required post-marketing surveillance, OCT will be performed before and after deployment of the LBS, and patients will be followed up for a significant period of time by the investigator's post-procedure.

Individual participants will not gain directly from taking part in the study, other than having access to more prolonged follow up than is standard. However, new insights will be gained into the microenvironment surrounding a ruptured plaque in NSTE-ACS, which has the potential to benefit patients with CAD in the future through greater understanding of the effects of current therapy, development of new treatment strategies and methods of assessing the efficacy of those treatment strategies.

Use of the LBS and the associated OCT examinations will require additional angiographic screening and therefore lead to greater exposure to radiation and higher contrast load. This will be closely monitored as per Trust policies in line with IRMER and local radiological guidelines. Patients at particular risk of developing complications from increased exposure to radiation and contrast (eg. those who are pregnant and those with abnormal baseline renal function) will not be included in order to minimise adverse effects.

Read the detailed description

This clinical protocol will be subject to peer review according to standard local procedures, including independent scientific review by the Scientific Advisory Board of the Clinical Research Facility, Sheffield Teaching Hospitals NHS Foundation Trust; the Clinical Research Office, Sheffield Teaching Hospitals NHS Foundation Trust; and the Research Ethics Committee. The study will be a single-centre study including use of a CE-marked medical device to obtain samples, conducted at Cardiology and Cardiothoracic Surgery Directorate, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust.

Patients with a diagnosis of NSTE-ACS, receiving DAPT with a combination of aspirin and ticagrelor or prasugrel, and listed either for coronary angiography with the intention of proceeding to PCI or for PCI following coronary angiography at a referring hospital, will be approached and their informed consent sought for this study. 18 patients found to have culprit significant proximal epicardial coronary artery stenosis suitable for PCI, meeting all the inclusion and exclusion criteria, will proceed to have platelet function testing and LBS measurements. Blood will be taken from the arterial sheath or guide catheter and baseline platelet function testing will be performed (VerifyNow P2Y12 assay; light transmittance aggregometry with ADP and arachidonic acid as agonists; and serum thromboxane B2 assay). Balloon predilatation prior to stent deployment will be a mandatory requirement for the study. Following balloon predilatation, the LBS will be deployed across the treated lesion and blood sampling will be performed proximal and distal to the lesion at approximately 5 minutes after predilatation. The following assays will be performed on the sampled blood:

  1. Plasma levels of soluble markers of thrombosis and inflammation including prothrombin fragments 1 and 2, fibrinopeptide A, soluble P-selectin and thromboxane B2.
  2. Platelet surface P-selectin expression
  3. Leukocyte surface CD11b expression Blood taken prior to PCI will also be sent to the local laboratory for measurement of the cardiac-specific marker high-sensitivity troponin T and a further venous blood sample will be collected at 6 hours after PCI to measure any rise in troponin in order to correlate this with thrombin generation. A rise of 5 times the upper limit of normal of troponin following PCI in the context of chest pain or diagnostic ECG changes will be used to define peri-procedural myocardial infarction per the Universal Definition of Myocardial Infarction (Thygesen, Alpert et al. 2012).

OCT of the culprit lesion, as well as the coronary artery proximal and distal to this, will be performed before and after the deployment of the LBS to assess any topographical changes to the vessel wall caused by the LBS and provide information on target lesion morphology.

Clinical outcomes will be reviewed and AEs (including MACE) will be recorded at 6 hours, 30 days and 6 months after the procedure. At the 6-hour visit, patients will be assessed by a medically-qualified investigator and have a blood sample collected for troponin T level and ECG performed. At the 30-day visit, patients will receive a full clinical assessment by a medically-qualified investigator, have DAPT compliance assessed, be asked about angina intensity, have any MACE or other AEs recorded and have an ECG. A telephone contact will be made at 6 months after PCI to assess any MACE or other AEs, angina intensity and DAPT compliance.

Being tested
The Liquid Biopsy System

What participants receive

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

  • The Liquid Biopsy SystemDevice

    The Liquid Biopsy System is a single use percutaneously-delivered coronary blood sampling device designed to collect blood samples from within a target coronary artery so that the blood can be analysed.

Study groups in NCT03300167
Study groupRoleWhat they receive
CE-marked coronary artery catheterExperimentaluse of a novel CE-marked coronary artery catheter to obtain spatially-separated intravascular samples for laboratory measurement.
Receives: Device: The Liquid Biopsy System

What is being measured

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

  1. Plasma prothrombin fragments

    Plasma prothrombin fragments 1+2 compared within-patients between samples from distal, mid and proximal ports

    Measured: during the percutaneous coronary intervention procedure

Secondary outcomes (5)
  1. Fibrinopeptide A

    Compared with 0-6 hour serum hsTnT rise

    Measured: during the percutaneous coronary intervention procedure and 6 hours later [peri-procedural MI only]

  2. Soluble platelet P-selectin

    Compared with 0-6 hour serum hsTnT rise

    Measured: during the percutaneous coronary intervention procedure and 6 hours later [peri-procedural MI only]

  3. TXB2

    Compared with 0-6 hour serum hsTnT rise

    Measured: during the percutaneous coronary intervention procedure and 6 hours later [peri-procedural MI only]

  4. platelet surface P-selectin expression

    Compared with 0-6 hour serum hsTnT rise

    Measured: during the percutaneous coronary intervention procedure and 6 hours later [peri-procedural MI only]

  5. Leukocyte surface CD11b expression

    Compared with 0-6 hour serum hsTnT rise

    Measured: during the percutaneous coronary intervention procedure and 6 hours later [peri-procedural MI only]

Timeline

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

  1. First posted3 Oct 2017
  2. Study start30 Nov 2017
  3. Primary completion30 Jun 2020 (estimated)
  4. Study completion30 Jun 2020 (estimated)

Why it stopped: Delivery of equipment. PI not had any further interaction with the company so closed study.

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Device feasibility
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03300167
Sponsor's protocol ID
STH19267
Acronym
IN HEART
Status last verified
Nov 2020
First submitted
13 Jun 2017
Last updated
17 Mar 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kavanagh TG, Griffiths NJ, Todd I. Psoas abscess and Crohn's disease. J R Soc Med. 1979 Aug;72(8):612-3. doi: 10.1177/014107687907200813. No abstract available.

    PubMed 552561
  • Caine ED, Polinsky RJ. Haloperidol-induced dysphoria in patients with Tourette syndrome. Am J Psychiatry. 1979 Sep;136(9):1216-7. doi: 10.1176/ajp.136.9.1216. No abstract available.

    PubMed 289300
  • Timmermans PJ, Vossen JM. Prey catching in the archer fish: does the fish use a learned correction for refraction? Behav Processes. 2000 Oct 26;52(1):21-34. doi: 10.1016/s0376-6357(00)00107-8.

    PubMed 11011106
  • Suzuki N, Kato M, Dohmori R. [Synthesis of antimicrobial agents. II. Synthesis of 1,8-naphthyridine derivatives and their activities against Trichomonas vaginalis (author's transl)]. Yakugaku Zasshi. 1979 Feb;99(2):155-64. doi: 10.1248/yakushi1947.99.2_155. No abstract available. Japanese.

    PubMed 312317
  • Lai Y, Xu DP. [Study on the chemical structure from the roots of Actinidia deliciosa]. Zhong Yao Cai. 2007 Feb;30(2):166-8. Chinese.

    PubMed 17571763
  • [Animal husbandry (the main trends)]. Veterinariia. 1977 Jun;(6):LL'*23. No abstract available. Russian.

    PubMed 929940
  • May A. The Confidential Enquiries into Maternal Deaths 1997-1999: what can we learn? Int J Obstet Anesth. 2002 Jul;11(3):153-5. doi: 10.1054/ijoa.2002.0957. No abstract available.

    PubMed 15321539
  • Falgoust DL. Hospital security over the years: keeping up with the changes. J Healthc Prot Manage. 2002 Summer;18(2):115-22.

    PubMed 12371242
  • da Costa MC. [Correlation between serum DDT levels and the diphtheria antibody titer in girls]. Rev Saude Publica. 1979 Mar;13(1):32-42. doi: 10.1590/s0034-89101979000100005. No abstract available. Portuguese.

    PubMed 223229
  • Courtney LD. Respiratory distress syndrome. Br Med J. 1977 Mar 5;1(6061):639. doi: 10.1136/bmj.1.6061.639-a. No abstract available.

    PubMed 843850
  • Farng E, Hunt SA, Rose DJ, Sherman OH. Anterior cruciate ligament radiofrequency thermal shrinkage: a short-term follow-up. Arthroscopy. 2005 Sep;21(9):1027-33. doi: 10.1016/j.arthro.2005.05.015.

    PubMed 16171626
  • Costa M, Pecci L, Pensa B, Cannella C. Hydrogen peroxide involvement in the rhodanese inactivation by dithiothreitol. Biochem Biophys Res Commun. 1977 Sep 23;78(2):596-603. doi: 10.1016/0006-291x(77)90221-2. No abstract available.

    PubMed 410413
  • Mertz D, Johnstone J, Loeb M. Does duration of perioperative antibiotic prophylaxis matter in cardiac surgery? A systematic review and meta-analysis. Ann Surg. 2011 Jul;254(1):48-54. doi: 10.1097/SLA.0b013e318214b7e4.

    PubMed 21412147
  • Zagury D, Chaouat G, Morgan DA, Voisin GA. [Identification of cytotoxic cells responsible for lysis of target cells pretreated with concanavalin A in spleen populations of pregnant mice with suppressive activity]. C R Seances Acad Sci D. 1979 May 7;288(17):1343-6. French.

    PubMed 113118
  • Donnelly N, Hadwin JA, Cave K, Stevenage S. Perceptual dominance of oriented faces mirrors the distribution of orientation tunings in inferotemporal neurons. Brain Res Cogn Brain Res. 2003 Oct;17(3):771-80. doi: 10.1016/s0926-6410(03)00201-5.

    PubMed 14561462

Questions about this trial

What is this clinical trial studying?

A study testing The Liquid Biopsy System in people with Non ST Segment Elevation Acute Coronary Syndrome, run by Sheffield Teaching Hospitals NHS Foundation Trust at 1 site in United Kingdom.

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 4 inclusion and 25 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: withdrawn, as of the sponsor's last update on 17 Mar 2021. 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 United Kingdom. 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?

The study was withdrawn before enrolling participants, so there are no results.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Plasma prothrombin fragments (time frame: during the percutaneous coronary intervention procedure). 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 NCT03300167, which also lists 19 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 17 Mar 2021.

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