The Impact of Compound Danshen Dropping Pills (CDDP) on the Post-myocardial Infarction Ventricular Remodeling

Myocardial Infarction Clinical Trial

Official title:

The Impact of Traditional Chinese Medicine, Compound Danshen Dropping Pills (CDDP) on the Post-myocardial Infarction Ventricular Remodeling: A Multicentre, Randomized, Double-blind, Placebo-controlled, Pilot Study

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05000411
• Other study ID #: CDDP
• Status: Recruiting
• Phase: Phase 4
• Start date: August 25, 2021
• Est. completion date: March 1, 2024

Study information

• Verified date: April 2023
• Source: The First Affiliated Hospital with Nanjing Medical University
• Contact: Liansheng Wang
• Phone: +86 13390787111
• Email: drlswang[@]njmu.edu.cn
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study is designed to evaluate the efficacy and safety of compound Danshen dropping pills (CDDP) in improving ventricular remodeling and cardiac function after acute anterior wall ST-Elevation myocardial infarction(STEMI). 268 patients with acute anterior wall STEMI after primary Percutaneous Coronary Intervention (pPCI) are randomly assigned 1:1 to CDDP group(n=134) and control group(n=134) with follow-up of 24 weeks. Both groups are treated with standard therapy of STEMI, with the CDDP group administrating 20 tablets of CDDP before pPCI and 10 tablets three times a day after pPCI and the control group treated with placebo at the same time. The primary endpoint is 24-week echocardiographic including left ventricle ejection fraction (LVEF) , left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI).The secondary endpoint is the change in N terminal pro-B-type natriuretic peptide（NT-proBNP ）level, arrhythmia and cardiovascular events (death, cardiac arrest or cardiopulmonary resuscitation, hospitalization due to heart failure or angina pectoris).

Description:

Background: Progressive ventricular remodeling after acute anterior wall myocardial infarction（MI）is an important factor in the occurrence and death of heart failure. Angiotensin converting enzyme inhibitors and beta-blockers can ameliorate post-MI ventricular remodeling, but high-dose therapy can't be tolerable because of hemodynamic instability in the early stage of acute mycardial infarction（AMI）. It is known that traditional Chinese medicine, compound Danshen dropping pills (CDDP) exerts protective effect on microcirculatory disturbance caused by ischemia-reperfusion injury and improves energy metabolism after acute myocardial ischemia. Experimental studies have shown CDDP may attenuate ventricular remodeling after myocardial infarction.

Methods：This study is designed to evaluate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function after acute anterior wall ST-Elevation MI(STEMI). 268 patients with acute anterior wall STEMI after primary Percutaneous Coronary Intervention (pPCI) are randomly assigned 1:1 to CDDP group(n=134) and control group(n=134) with follow-up of 24 weeks. Both groups are treated with standard therapy of STEMI, with the CDDP group administrating 20 tablets of CDDP before pPCI and 10 tablets three times a day after pPCI and the control group treated with placebo at the same time. The primary endpoint is 24-week echocardiographic including left ventricle ejection fraction (LVEF) , left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI).The secondary endpoint is the change in N terminal pro-B-type natriuretic peptide（NT-proBNP） level, arrhythmia and cardiovascular events (death, cardiac arrest or cardiopulmonary resuscitation, hospitalization due to heart failure or angina pectoris).

Discussion：This is the first prospective study that will demonstrate the impact of CDDP on ventricular remodeling and cardiac function in patients treated with pPCI for a first acute anterior wall STEMI .This study may provide novel insights of Traditional Chinese Medicine , CDDP to improve ventricular remodeling.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 268
• Est. completion date: March 1, 2024
• Est. primary completion date: August 25, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

1. Aged 18-75 years, gender unlimited;

2. According to the guidelines for diagnosis and treatment of acute ST segment elevation myocardial infarction (2019), patients with acute anterior ST segment elevation myocardial infarction were diagnosed;

3. Patients with primary acute myocardial infarction;

4. Patients who completed PCI reperfusion treatment within 12 hours after the onset of the disease;

5. Patients categorized as Classes I, II or III according to Killip classification on admission;

6. Subjects participated in the study voluntarily and signed informed consent.

Exclusion Criteria:

1. Patients with previous cardiac insufficiency caused by other diseases (valvular heart disease, congenital heart disease, pericardial disease, arrhythmia, other non cardiac causes);

2. The patients underwent coronary artery bypass graft(CABG) within 12 weeks;

3. Patients undergoing cardiac resynchronization;

4. Patients with left ventricular outflow tract obstruction;

5. Patients with myocarditis;

6. Patients with uncontrolled severe arrhythmia;

7. Patients with aortic aneurysm;

8. Patients with serious liver, kidney, blood system, mental disease or systemic disease;

9. Significant liver and kidney dysfunction (ALT > 2.0 times the upper limit of normal value; creatinine > 1.5 times the upper limit of normal value);

10. Patients with serum potassium > 5.5mmol/l;

11. Uncontrolled hypertension (higher than 180 / 110mmhg);

12. Pregnant or lactating women;

13. Patients allergic to compound Danshen Dropping Pills; 1

14. Patients participating in clinical studies of other drugs.

Related Conditions & MeSH terms

• Infarction
• Myocardial Infarction
• Ventricular Remodeling

Intervention

Drug:
• Compound Danshen Dropping Pills (CDDP)
The patients in this group are treated with 20 tablets of Compound Danshen Dropping Pills (CDDP) before primary Percutaneous Coronary Intervention (pPCI) and 10 tablets three times a day after pPCI.
• Placebo
The patients in this group take 20 tablets of placebo before primary Percutaneous Coronary Intervention (pPCI) and 10 tablets three times a day after pPCI .

Locations

Country	Name	City	State
China	First Affiliated Hospital of Nanjing Medical University	Nanjing	Jiangsu

Sponsors (1)

Lead Sponsor	Collaborator
The First Affiliated Hospital with Nanjing Medical University

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	ultrasonic cardiogram:left ventricle ejection fraction (LVEF)	LVEF refers to the percentage of stroke output to left ventricular end-diastolic volume and it can be examined by ultrasonic cardiogram.	Week 24
Primary	ultrasonic cardiogram:left ventricular end-diastolic volume index (LVEDVI)	LVEDVI(ml/m2)=left ventricular end-diastolic volume(ml)/body surface area(m2). It can be examined by ultrasonic cardiogram.	Week 24
Primary	ultrasonic cardiogram:left ventricular end-systolic volume index (LVESVI)	LVESVI(ml/m2)=left ventricular end-systolic volume(ml)/body surface area(m2). It can be examined by ultrasonic cardiogram.	Week 24
Secondary	N terminal pro-B-type natriuretic peptide(NT-proBNP )decline level	N terminal pro-B-type natriuretic peptide(NT-proBNP )is obtained by blood test.	Day 0/ Day 3/ Day 7/ Week 4/ Week 24/ Week 48
Secondary	Adverse cardiovascular events		Day 0 to Week 48