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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT03383393
Other study ID # Alexandrovska UH
Secondary ID
Status Recruiting
Phase N/A
First received December 4, 2017
Last updated December 19, 2017
Start date January 3, 2018
Est. completion date December 5, 2019

Study information

Verified date December 2017
Source Alexandrovska University Hospital
Contact n/a
Is FDA regulated No
Health authority
Study type Observational [Patient Registry]

Clinical Trial Summary

After PCI searching for target lesion ischemia with intracoronary ECG will be performed and if found it will be treated pharmacologically


Description:

The study will include patients with coronary lesions and PCI. It will include patients with stable or unstable angina, without elevated hs-TnT. PCI will be performed and monitoring of intracoronary ST elevation. Any dissection or acute vessel closure will be promptly treated with balloon or stenting.

Although there could be good angiographic result sometimes ischemia could be detected in the treated region by means of intracoronary ECG ST elevation above 1mm.

This study aims to tackle this issue with randomization of the patients into three possible treatments - intracoronary adenosine, IIb/IIIa inhibitors or nitroglycerine alone - intracoronary ST segment will be searched for reverse or residual ischemia after the pharmacologic bolus.

The intracoronary electrocardiography (i.c. ECG) is a very sensitive method for ischemia detection. The i.c. ECG reacts earlier on ischemia; the changes are much more prominent and easy to register. The wire tip could be positioned directly in different regions and thus to "map" regional ischemia. In most of the studies and from our own observations became evident that when surface ECG do not react the i.c. ECG demonstrates significant changes in ST-segment and QRS complex. Moreover, the registration of i.c. ECG is very cheap and needs only an adapter connecting coronary wire end and ECG. An i.c. ECG also can differentiate residual ischemic changes in distal main vessel and side branch as sources of prolonged ischemia, respectively - source of periprocedural myonecrosis.

Once good angiographic result is obtained after stenting there could be different reasons for ischemia in the treated region - microembolic debris or coronary microvascular spasm.


Recruitment information / eligibility

Status Recruiting
Enrollment 60
Est. completion date December 5, 2019
Est. primary completion date December 5, 2019
Accepts healthy volunteers No
Gender All
Age group 18 Years to 100 Years
Eligibility Inclusion Criteria:

- Subject at least 18 years of age.

- Target lesion(s) located in a native coronary artery with diameter of = 2.5 mm and = 4.5 mm. If there is side branch lesion(s) located in a native coronary artery with diameter of = 2.0 mm.

- Target lesion(s) amenable for PCI with balloon angioplasty of the side branch.

Exclusion Criteria:

- Subjects with significant ST-T change (= 1mm).

- Non-cardiac co-morbid conditions are present with life expectancy <1 year or that may result in protocol non-compliance (per site investigator's medical judgment).

- Subjects who refuse to give informed consent.

- Subjects with the following angiographic characteristics: left main coronary artery stenosis, total occlusion target lesion, lesion of interest located at infarct-related artery.

- Subjects with LVEF < 30%.

- Subjects with moderate or severe degree valvular heart disease or primary cardiomyopathy.

- LBBB, RBBB, atrial fibrillation/flutter with no identifiable isoelectric line.

Study Design


Intervention

Drug:
Intracoronary bolus of adenosine (adenocor), Integrilin (eptifibatide) or nitroglyzerin (nitronal)
intracoronary drugs

Locations

Country Name City State
Bulgaria Alexandrovska University Hospital Sofia

Sponsors (1)

Lead Sponsor Collaborator
Alexandrovska University Hospital

Country where clinical trial is conducted

Bulgaria, 

Outcome

Type Measure Description Time frame Safety issue
Primary Intracoronary ischemia change after intracoronary drug bolus Look for ischemia change after intracoronary drugs 12 months
Secondary Target lesion revascularization Any revascularization at the territory of previously implanted stent. 12 months
Secondary Number of patients not alive death 12 months
Secondary Myocardial infarction MI after discharge 12 months
Secondary New onset angina or heart failure symptoms New onset angina symptoms of at least CCS class II; New onset dyspnea at exertion or at rest 12 months
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