Coronary Artery Disease Clinical Trial
— SAFE-PCIOfficial title:
SGLT-2 Inhibitors in Prevention of Post-procedural Renal and Cardiovascular Complications aFter PCI Among Patients With Diabetes Mellitus and Coronary Artery Disease: a Prospective, Randomized, Pilot Study (SAFE-PCI)
Patients with type 2 diabetes mellitus (DM) have higher risk of major cardiovascular events (MACE) and renal disfunction. The Sodium-glucose cotransporter-2 inhibitors (iSGLT2) reduces hyperglycemia in patients with type 2 DM and have multiple metabolic effects, lowering primary composite cardiovascular outcomes and progression to renal failure. 25% of patients with Stable Ischemic Heart Disease (SIHD) undergoing PCI are diabetics being one of the most prevalent and important risk factors for the development of contrast induced nephropathy (CIN). The occurence of CIN is associated with higher rates of death, loss of renal function, necessity of dialysis and increase of health care costs. In this pilot study we sought to evaluate if the iSGLT2 would prevent periprocedural complications - such as periprocedural CIN and MI - in type 2 DM patients undergoing PCI through the assessment of renal and myocardial biomarkers
Status | Recruiting |
Enrollment | 40 |
Est. completion date | December 2022 |
Est. primary completion date | July 2022 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Age = 18 years - Type II Diabetes mellitus - Finding of obstructive coronary artery disease (=50% stenosis in major epicardial vessel) and clinical indication of percutaneous coronary intervention.(PCI) - Participant is willing to comply with all aspects of the protocol, including adherence to the assigned strategy, medical therapy and follow-up visits - Participant is willing to give written informed consent Exclusion Criteria: - Estimated glomerular filtration rate (eGFR) < 30mL/min/1,73m2 or dialysis - Inability to comply with the protocol - Urgent need for PCI - Acute coronary syndrome within the previous 30 days - Use of iodinated contrast or other nephrotoxic agents < 7 days - Angina after coronary bypass surgery - Canadian Cardiovascular Society Class IV angina, including unprovoked rest angina - Life expectancy less than the duration of the trial due to non-cardiovascular comorbidity - Pregnancy |
Country | Name | City | State |
---|---|---|---|
Brazil | Instituto do Coracao - HCFMUSP | Sao Paulo |
Lead Sponsor | Collaborator |
---|---|
University of Sao Paulo General Hospital |
Brazil,
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* Note: There are 30 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Serum creatinine values in pre-specified periods | Delta and area under curve | Pre PCI | |
Primary | Serum creatinine values in pre-specified periods | Delta and area under curve | Day 1 | |
Primary | Serum creatinine values in pre-specified periods | Delta and area under curve | Day 2 | |
Primary | Serum creatinine values in pre-specified periods | Delta and area under curve | Day 30 | |
Primary | NGAL values in pre-specified periods | Delta and area under curve | Pre PCI | |
Primary | NGAL values in pre-specified periods | Delta and area under curve | Day 1 | |
Primary | NGAL values in pre-specified periods | Delta and area under curve | Day 2 | |
Primary | NGAL values in pre-specified periods | Delta and area under curve | Day 30 | |
Secondary | Increase in serum creatinine = 0.3 mg/dl or 50% from the baseline value, within 48 hours after the index procedure | CI-AKI will be defined as an increase in serum creatinine = 0.3 mg/dl or 50% from the baseline value, within 48 hours after the index procedure CI-AKI will be defined as an increase in serum creatinine = 0.3 mg/dl or 50% from the baseline value, within 48 hours after the index procedure | 48 hours after PCI | |
Secondary | Biomarkers elevation =10 upper reference limit (URL) for creatine kinase MB (CKMB) and/or =70 URL for troponin | Periprocedural MI will be defined as biomarkers elevation =10 upper reference limit (URL) for creatine kinase MB (CKMB) and/or =70 URL for troponin | 24 hours after PCI | |
Secondary | Occurrence of definite or probable stent thrombosis | Stent thrombosis will be defined as the occurrence of definite or probable stent thrombosis according to the Academic Research Consortium (ARC) criteria | Until 30 days | |
Secondary | Death From Cardiovascular Causes | Secondary Composite Outcome: Death From Cardiovascular Causes, Myocardial Infarction, or Hospitalization for Unstable Angina, definite or probable stent thrombosis, stroke, bleeding (BARC 3-5) or death | Until 30 days | |
Secondary | Myocardial Infarction | Secondary Composite Outcome: Death From Cardiovascular Causes, Myocardial Infarction, or Hospitalization for Unstable Angina, definite or probable stent thrombosis, stroke, bleeding (BARC 3-5) or death | Until 30 days | |
Secondary | Hospitalization for Unstable Angina | Secondary Composite Outcome: Death From Cardiovascular Causes, Myocardial Infarction, or Hospitalization for Unstable Angina, definite or probable stent thrombosis, stroke, bleeding (BARC 3-5) or death | Until 30 days | |
Secondary | Stroke | Secondary Composite Outcome: Death From Cardiovascular Causes, Myocardial Infarction, or Hospitalization for Unstable Angina, definite or probable stent thrombosis, stroke, bleeding (BARC 3-5) or death | Until 30 days | |
Secondary | Bleeding (BARC 3-5) | Secondary Composite Outcome: Death From Cardiovascular Causes, Myocardial Infarction, or Hospitalization for Unstable Angina, definite or probable stent thrombosis, stroke, bleeding (BARC 3-5) or death | Until 30 days | |
Secondary | Death | Secondary Composite Outcome: Death From Cardiovascular Causes, Myocardial Infarction, or Hospitalization for Unstable Angina, definite or probable stent thrombosis, stroke, bleeding (BARC 3-5) or death | Until 30 days |
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