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The Oral treatment of Colchicine in Argentina (ORCA) trial is a prospective, randomized, multicenter trial to included 450 patients with indication for myocardial revascularization with PCI between a group to be treated with BMS plus oral colchicine (OC) for three months, which should be administered at the time of PCI, these patients they would receive 0.5 mg twice a day per 3 months compared to the other group of patients who will be treated exclusively with last generation of DES.
In a previous randomized comparison oral colchicine plus bare metal stent (BMS) compared to BMS plus placebo in a diabetic High risk for re-stenosis population, OC demonstrate a significant reduction of angiographic and intravascular ultrasound parameters of in-stent restenosis (ISR) after BMS implantation at one year of follow up (Journal of the American College of Cardiology,2013,61,1678-1685), with a clinical indication of target lesion revascularization in 3.6%. In addition previous reported registries from our group with Drug Eluting Stents showed similar amount of reduction in clinical parameters (not angiographic) of restenosis (ERACI III trial, one year TVR in 8.8% with 1st DES design, Rodriguez A et al EuroIntervention 2006,2:53-60 and 4.0% with 2nd generation DES design ERACI IV Cardiac and cardiovascular interventions Journal, 2014 ). Taking in account those numbers the investigators sought to compare differences in overall cost with both revascularization strategies at 1, 2, 3 and 5 years of follow up assuming that safety and efficacy clinical end points would be similar. Cost included in hospital, procedural and resources fees, follow up cost including re-hospitalization driving by target vessel revascularization (TVR) and both spontaneous and TVR myocardial infarction (MI) and medication cost for each revascularization strategies Safety end point will be incidence of major adverse cardiac events (MACE) defined as the composite of death from any cause, MI (peri-procedural and spontaneous at follow up) and ischemic driving TVR.
The study will be considered complete after all subjects have completed the 12-month Primary safety and efficacy endpoint was incidence of target vessel failure (TVF) plus one year overall cost with both strategies.. Additional end points are clinical endpoints measured in-hospital at at follow up period. cardiac death, cardiac death plus MI. spontaneous MI beyond 30 day to 5 years, and stent thrombosis rate (ST) (definite or probable by Academic Research Consortium definitions).
A sub-study of changes in biological markers of inflammation in patients with acute coronary syndrome (ACS) including MI will be analyzed in both groups. For this reason, a measurement of interleukin 6, metalloproteases, adiponectin and Protein C reactive (PCR) will be performed at the time of enrolment and 4 days and a month after inclusion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Oral Colchicine +BMS implantation | Experimental | This group will receive after BMS and Colchicine, at the time of PCI, 0,5 mg twice a day during the first three months after stent implantation |
|
| Second generation Drug eluting stent (DES) | No Intervention | This group will receive DES at the moment of randomization and will be treated as standard of care. All second generation DES should be approved by ANMAT for clinical use. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Colchicine | Drug | At the moment of BMS implantation intervention will mean that this group will receive colchicine as described. |
|
| Measure | Description | Time Frame |
|---|---|---|
| MACE | MACE: Was defined as a composite of death, Myocardial infarction (MI) Stroke, stroke and ischemic target vessel revascularization (TVR) Death included cardiac, non- cardiac and non- determined. MI included STEMI with new q waves at the EKG and /or 5 times increase cardiac enzymes elevation for baseline levels. NSTEMI included 5 times enzymes elevation with non- new Q waves. TVR included repeat revascularization in the target vessel initially treated driving by new chest pain and / or perfusion ischemic changes at ergometric or perfusion test. | 365 days |
| Measure | Description | Time Frame |
|---|---|---|
| Target lesion failure | Target lesion failure (TLF): TLF was defined as cardiac death, MI and ischemic driving revascularization (TLR) of initially treated lesion. | 365 days |
| Measure | Description | Time Frame |
|---|---|---|
| Changes C-Reactive Protein (CRP) values | Normal values: 0 to 5 mg/L | baseline, 4 and 30 days |
| Changes in Adinopectine values μU/mL | Normal values in women 4,62±1,57 vs In men 3,93±1,86 μU/mL |
Inclusion Criteria:
Clinical and angiographic
6. Subject has a left ventricular ejection fraction (LVEF) > 40 % as measured within 60 days prior to enrollment.
7. Subject is willing to comply with all protocol-required follow-up evaluations.
8. Subject has one or more coronary artery stenosis of ≥ 70 % in a coronary artery with visually estimated reference vessel diameter (RVD) ≥2.50 mm.
Exclusion Criteria:
Clinical and angiographic
5. Subject is participating in another investigational drug or device clinical trial that has not reached its primary endpoint, or that, in the opinion of the investigator, may cause non-compliance with the protocol or confound data interpretation.
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| Name | Affiliation | Role |
|---|---|---|
| Alfredo E Rodriguez, MD, PhD | Centro de estudios en Cardiologia Intervencionista | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sanatorio Otamendi | Ciudad de Buenos Aires | Buenos Aires | 1126 | Argentina | ||
| Sanatorio Las Lomas |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33174761 | Result | Correa-Sadouet C, Rodriguez-Granillo AM, Gallardo C, Mieres J, Fontana L, Curotto MV, Wainer P, Allende NG, Fernandez-Pereira C, M Vetulli H, la Hoz RP, Kastrati A, Rodriguez AE; ORCA investigators. Randomized comparison between bare-metal stent plus colchicine versus drug-eluting stent alone in prevention of clinical adverse events after percutaneous coronary intervention. Future Cardiol. 2021 Jul;17(4):539-547. doi: 10.2217/fca-2020-0161. Epub 2020 Nov 11. | |
| 40363904 |
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All researchers that want to work with the database must sign a confidentiality form and all legal documents applicable for the time being.
From May 2020 to December 2022
Researcher with approved HIPPA compliant certificates. Accept to sign confidentiality form. Do not publish content without autorization of the Sponsor or Chair of the trial.
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| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| D050197 | Atherosclerosis |
| D054058 | Acute Coronary Syndrome |
| D007249 | Inflammation |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D003078 | Colchicine |
| ID | Term |
|---|---|
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
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| baseline and 30 days |
| Changes in Interleukin 6 values (pg/m) | Normal values IL-6 (5-15 pg/ml) | baseline and 30 days |
| San Isidro |
| Buenos Aires |
| 1111 |
| Argentina |
| Derived |
| Rodriguez-Granillo AM, Mieres J, Fernandez-Pereira C, Sadouet CC, Milei J, Swieszkowski SP, Stutzbach P, Santaera O, Wainer P, Rokos J, Gallardo C, Cristodulo-Cortez R, Perez de la Hoz R, Kastrati A, Rodriguez AE, On Behalf Of Orca Investigators. Randomized Clinical Trial Comparing Bare-Metal Stents Plus Colchicine Versus Drug-Eluting Stents for Preventing Adverse Cardiac Outcomes: Three-Year Follow-Up Results of the ORal Colchicine in Argentina (ORCA) Trial. J Clin Med. 2025 Apr 22;14(9):2871. doi: 10.3390/jcm14092871. |
| D001161 |
| Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |