Cardiovascular Disease Clinical Trial
Official title:
Clinical Study to Assess the Safety and Efficacy of ex-Vivo Vein Graft Exposure to AVI-5126 in Coronary Artery By-Pass Grafting to Reduce Clinical Graft Failure
For some people who have heart by-pass surgery, the vein that is used to by-pass a blockage will, after some time, become narrowed and possibly blocked. AVI-5126 blocks a gene that is believed to be responsible for the events in the blood vessel that cause this narrowing. Therefore, exposing the vein to AVI-5126 before it is attached to the coronary artery may result in less problems with these vein grafts later on. This study will determine if this procedure is both safe and effective.
Coronary artery bypass (CABG) is a common procedure employed for life-threatening
cardiovascular disease. While bypass surgery is effective in restoring blood flow in the
short-term, 30 to 50 percent of venous bypass grafts eventually become blocked or fail.
Within the first year after a CABG procedure, it is estimated that between 15 and 30% of
saphenous vein grafts fail (i.e., ≥ 75% reduction in flow within the graft), due to intimal
hyperplasia at the anastomosis sites. There is currently no approved treatment to prevent
venous graft failure. These patients may frequently undergo a second bypass surgery if the
extent of graft failure(s) is sufficiently severe to lead to uncontrolled angina pectoris.
It is clear that a second CABG procedure in a patient represents a higher operative
mortality rate than the first procedure. Venous graft failure in CABG is a major unmet
medical-surgical problem.
AVI has previously focused some of its Neugene® products in the area of preventing
cardiovascular stenosis. This application of antisense targeted to to inhibit the c-myc gene
has previously been demonstrated to prevent sequelae of intimal hyperplasia following
endovascular injury. The purpose of this study is to evaluate whether immersion of the
excised saphenous vein in a novel anti-c-myc antisense drug (AVI-5126) solution will prevent
subsequent graft failure at 1 year, compared to physiological saline (placebo) prior to
graft anastomosis.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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