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| ID | Type | Description | Link |
|---|---|---|---|
| GUSU18003 | Other Identifier | GUSU Group |
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| Name | Class |
|---|---|
| Peking University First Hospital | OTHER |
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The current study aims to evaluate different doses of PC-SOD injections for efficacy and safety in comparison to placebo, in order to provide a basis for future clinical trials in terms of experimental design and dose selection.
The study is a randomized, single-blind, multi-center, placebo-controlled trial to preliminarily evaluate the efficacy and safety of PC-SOD, and to provide a basis for dose selection in the next stage of study.
For each participant, the trial will be divided into the screening/treatment (screening and treatment conducted during the first visit, 0 d) and safety follow-up (1 - 30 d) stages.
The study will screen 120 eligible subjects. After successful screening, the subjects will be randomly assigned into four groups of equal size, including the 40 mg PC-SOD, 80 mg PC-SOD, 160 mg PC-SOD and placebo control groups. Subjects in each group will be administered the corresponding intervention, followed by PCI treatment. During the safety follow-up stage, the subjects will receive basic treatment based on Guidelines for Management of Patients with ST-segment elevation myocardial infarction. Treatments will include dual anti-platelet therapy, beta-blockers, ACEI/ARB (angiotensin-converting enzyme inhibitor/ angiotensin receptor blocker), statins, anticoagulants, and so on.
By comparing the efficacy and safety endpoints of patients in the experimental and placebo control groups, the study aims to preliminarily evaluate the efficacy and safety of different doses of PC-SOD in reducing myocardial reperfusion injury.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 40 mg treatment group | Experimental | PC-SOD 40 mg dissolved in 10 mL of 5% glucose injection and intravenously administrated before recanalization. |
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| 80 mg treatment group | Experimental | PC-SOD 80 mg dissolved in 10 mL of 5% glucose injection and intravenously administrated before recanalization. |
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| 160 mg treatment group | Experimental | PC-SOD 160 mg dissolved in 10 mL of 5% glucose injection and intravenously administrated before recanalization. |
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| placebo control group | Placebo Comparator | placebo dissolved in 10 mL of 5% glucose injection and intravenously administrated before recanalization. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PC-SOD | Drug | PC-SOD will be dissolved in 10 mL of 5% glucose injection and intravenously administrated before recanalization. |
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| Measure | Description | Time Frame |
|---|---|---|
| The myocardial salvage index at 7 d after PCI | The myocardial salvage index is defined as (area of myocardial edema - area of myocardial infarction)/area of myocardial edema. | 7 days |
| The area of myocardial infarction at 7 d after PCI (detected by delayed-enhanced MRI [Magnetic Resonance Imaging] ) | The area of myocardial infarction is defined as the percentage of left ventricular myocardium occupied by delayed enhancement. | 7 days |
| Area of microvascular occlusion at 7 d after PCI | Microvascular occlusion is defined as the area with no enhancement in the infarcted regions where delayed enhancement can be observed on MRI scans. | 7 days |
| The area of infarction determined by the AUC (area under curve) for CK-MB (creatine kinase-muscle/brain) at 72h after PCI. | The area of infarction at 72h after surgery will be roughly estimated by calculating the AUC for CK-MB (before operation, and at 6, 12, 24, 48 and 72h after operation, respectively). | 72 hours |
| Cardiac function at 7 d after PCI | Cardiac function is assessed by assessing the left ventricular ejection fraction (percentage of stroke output to end-diastolic volume). | 7 days |
| The TIMI (thrombolysis in myocardial infarction) grade of coronary blood flow after PCI. | Coronary artery reperfusion will be assessed by the TIMI grading system, whose grades include: Grade 0: no contrast filling at the occlusion site and distal end; Grade 1: the contrast passes some of the occluded sites, but cannot fill the distal vessels; Grade 2: the contrast can fill the distal end of coronary artery completely, but the filling and clearing of contrast is slower than that of normal coronary artery; Grade 3: the contrast can fill the distal end rapidly and completely, and can be removed quickly. The TIMI flow grades will be determined by two physicians separately. In case of disagreement, a lead physician will help make the final call. |
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Inclusion Criteria:
Exclusion Criteria:
General exclusion criteria
Exclusion criteria for angiography
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Huo Yong, master | Contact | 13901333060 | drhuoyong@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Wuhan Asia Heart Hospital | Not yet recruiting | Wuhan | Hubei | 430022 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17855673 | Background | Yellon DM, Hausenloy DJ. Myocardial reperfusion injury. N Engl J Med. 2007 Sep 13;357(11):1121-35. doi: 10.1056/NEJMra071667. No abstract available. | |
| 2826476 | Background | Zweier JL. Measurement of superoxide-derived free radicals in the reperfused heart. Evidence for a free radical mechanism of reperfusion injury. J Biol Chem. 1988 Jan 25;263(3):1353-7. |
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| ID | Term |
|---|---|
| D015428 | Myocardial Reperfusion Injury |
| ID | Term |
|---|---|
| D009202 | Cardiomyopathies |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D017202 | Myocardial Ischemia |
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Since the appearance of PC-SOD preparations cannot be identical to that of placebo, and treatment groups have different administration doses, the study will be conducted in a single-blind manner, where only subjects (and families) are blinded and do not know whether they are treated by PC-SOD or placebo before unblinding.
Interpretation of cardiac MRI and ECG will also be conducted in a blinding manner. Images of all subjects will be evaluated blindly by researchers not directly involved in the study.
| placebo | Drug | Placebo will be dissolved in 10 mL of 5% glucose injection and intravenously administrated before recanalization. |
|
| within 24 hours |
| The corrected TIMI frame count (cTFC) after PCI. | The left anterior descending (LAD) artery will be analyzed in a 30º right anterior oblique view with 30º cranial angulation. The left circumflex (LCX) will be analyzed in a 30º right anterior oblique view with 30º caudal angulation. The right coronary artery (RCA) will be analyzed in a 45º left anterior oblique view. | within 24 hours |
| TIMI myocardial perfusion grade (TMPG) after PCI | Grade 0: no contrast entering the myocardium; Grade 1: the contrast enters myocardium slowly, with myocardial staining not disappearing or lasting for more than 30 s in the targeted vessels; Grade 2: delayed entering and disappearing of contrast in the myocardium, exceeding 3 cardiac cycles; Grade 3: normal entering and disappearing of contrast in the myocardium, occurring within 3 cardiac cycles. | within 24 hours |
| Percentage of ST-segment resolution on ECG (electrocardiogram) at 90 min after PCI | ST-resolution is defined as more than 50% of resolution. | 90 minutes |
| Number of cardiovascular events within 30 d after PCI | Cardiovascular events included all-cause death, cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization due to heart failure. | 30 days |
| SOD (Superoxide Dismutase) activity | Change from Baseline SOD activity at 6h, 12h, 24h, 48h, 72h and 7 d after surgery. | 0 hours, 6 hours, 12 hours, 24 hours, 48 hours, 72 hours and 7 days after surgery |
| Occurence of adverse events | Occurence of adverse events | During patient hospitalization, up to 30 days |
| Cardiac function at 30 d after PCI | Cardiac function is assessed by assessing the left ventricular ejection fraction (percentage of stroke output to end-diastolic volume). | 30 days |
| Zhongshan Hospital | Recruiting | Shanghai | Shanghai Municipality | 200032 | China |
|
| 2185587 | Background | Werns SW, Lucchesi BR. Free radicals and ischemic tissue injury. Trends Pharmacol Sci. 1990 Apr;11(4):161-6. doi: 10.1016/0165-6147(90)90068-J. |
| 2553296 | Background | Kloner RA, Przyklenk K, Whittaker P. Deleterious effects of oxygen radicals in ischemia/reperfusion. Resolved and unresolved issues. Circulation. 1989 Nov;80(5):1115-27. doi: 10.1161/01.cir.80.5.1115. |
| 3943152 | Background | Przyklenk K, Kloner RA. Superoxide dismutase plus catalase improve contractile function in the canine model of the "stunned myocardium". Circ Res. 1986 Jan;58(1):148-56. doi: 10.1161/01.res.58.1.148. |
| 2653661 | Background | Engler R, Gilpin E. Can superoxide dismutase alter myocardial infarct size? Circulation. 1989 May;79(5):1137-42. doi: 10.1161/01.cir.79.5.1137. No abstract available. |
| 7996483 | Background | Igarashi R, Hoshino J, Ochiai A, Morizawa Y, Mizushima Y. Lecithinized superoxide dismutase enhances its pharmacologic potency by increasing its cell membrane affinity. J Pharmacol Exp Ther. 1994 Dec;271(3):1672-7. |
| 18070953 | Background | Wu E, Ortiz JT, Tejedor P, Lee DC, Bucciarelli-Ducci C, Kansal P, Carr JC, Holly TA, Lloyd-Jones D, Klocke FJ, Bonow RO. Infarct size by contrast enhanced cardiac magnetic resonance is a stronger predictor of outcomes than left ventricular ejection fraction or end-systolic volume index: prospective cohort study. Heart. 2008 Jun;94(6):730-6. doi: 10.1136/hrt.2007.122622. Epub 2007 Dec 10. |
| D014652 |
| Vascular Diseases |
| D015427 | Reperfusion Injury |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |