A Study of the Efficacy of Preventive Dosing of Fondaparinux Sodium Versus Placebo for the Prevention of Venous Thromboembolism (VTE) in Patients Undergoing Coronary Bypass Surgery Receiving Routine Mechanical Prophylaxis
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Purpose
This trial is a prospective, single-center Phase II randomized study to demonstrate the superior efficacy of Fondaparinux Sodium subcutaneous injections in patients undergoing CABG surgery (isolated and redo isolated) versus treatment with placebo. All consecutive patients scheduled for CABG surgery that meet the general inclusion and none of the exclusion criteria will be considered for enrollment in the study.
Consecutive patients will be randomized on the day of admission prior to their CABG surgery into one of two groups. One group will be randomized to the placebo while the second group will receive 2.5 mg Fondaparinux Sodium injections. Both groups will receive routine mechanical prophylaxis as determined by the treating physicians. Group randomized to receive Fondaparinux Sodium will receive a 2.5 mg SQ daily drug dose starting 12 +/- 2 hours post-wound closure or the following day in the morning (at the discretion of the cardiothoracic surgeon). The second dose would be administered 24 hours later and the dosing will then be once a day. The group randomized to placebo will receive subcutaneous equivolume isotonic saline at the same time points described above.
Patients randomized will receive a 2.5 mg dose of Fondaparinux Sodium or placebo subcutaneously for a total of 3-9 days post CABG with day 1 being the day of surgery. The drug will be discontinued if the patient is discharged before day 9. If the patient stays for more than 9 days inside hospital, a duplex would be obtained per protocol and further DVT prevention measures would be instituted per the discretion of treating physician.
Patients will be assessed daily while hospitalized for any symptoms and adverse reactions and will undergo laboratory testing (CBC, PT/INR, PTT and UA) as specified in the protocol. Post-op day 3-9(no later than 2 days after the last preventive drug dose) patients will undergo the protocol specific lower limb venous duplex scan and earlier if symptomatic. Patients will also be contacted (phone/office visit) for follow-up 25-35 days post CABG to assess for signs or symptoms of deep venous thrombosis or thromboembolism and for any potential complications.
| Condition | Intervention |
|---|---|
|
Deep Vein Thrombosis Coronary Artery Bypass Surgery Venous Thromboembolism |
Drug: Fondaparinux Other: Placebo |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Investigator) Primary Purpose: Treatment |
| Official Title: | A Study of the Efficacy of Preventive Dosing of Fondaparinux Sodium Versus Placebo for the Prevention of Venous Thromboembolism (VTE) in Patients Undergoing Coronary Bypass Surgery Receiving Routine Mechanical Prophylaxis |
- Rate of asymptomatic proximal DVT [ Time Frame: 7 days ] [ Designated as safety issue: Yes ]
- Asymptomatic Distal DVT [ Time Frame: 7 days ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 630 |
| Study Start Date: | October 2009 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | July 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Fondaparinux
Patients will receive a 2.5 mg dose of Fondaparinux subcutaneously for a total of 7 days post CABG
|
Drug: Fondaparinux
Patients will receive a 2.5 mg dose of Fondaparinux subcutaneously for a total of 7 days post CABG
Other Names:
|
| Placebo Comparator: Placebo |
Other: Placebo
subcutaneous equivolume isotonic saline
Other Names:
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 90 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Subject Inclusion Criteria In order to be enrolled in the study, subjects must meet all of the inclusion criteria as listed below.
- Consecutive patients undergoing isolated or redo isolated CABG
- Patients must provide written informed consent
- Patients must agree to comply with study procedures for the entire length of the study.
- Must be 18 years old or greater.
Subject Exclusion Criteria Any subject that meets any of the exclusion criteria listed below at baseline will be excluded from study participation.
- Patients with medical history that requires chronic anticoagulation with unfractionated heparin or coumadin or LMWH or heparinoids (i.e. previous DVT, pulmonary embolism, atrial fibrillation, heart valve replacement)
- Patients with contraindications to anticoagulation (coagulopathy e.g, INR>/=1.5, generalized bleeding disorders, peptic ulcer disease, hemorrhagic or ischemic stroke, etc within last 3 months)
- Patients who are unable to undergo a doppler ultrasound of the lower extremities
- Renal insufficiency (creatinine clearance < 30 mL/min)
- Patients who have a body weight < 50 kg
- Patients receiving continuous (indwelling) epidural
- Physician diagnosed acute or chronic hepatic failure
- Pregnancy
- Patients with life expectancy < 6 months
- Platelet count below 100,000/ mm-3
- History of documented VTE within last 3 months.
- Acute bacterial endocarditis
- Cerebral metastasis or abscess
- Inability to consent
- Refusal by treating physician
Contacts and Locations| United States, Illinois | |
| Prairie Education and Research Cooperative | |
| Springfield, Illinois, United States, 62701 | |
| Principal Investigator: | Raghu Kolluri, MD | Prairie Edcuation and Research Cooperative |
More Information
No publications provided
| Responsible Party: | Raghu Kolluri, MD, Prairie Education and Research Cooperative |
| ClinicalTrials.gov Identifier: | NCT00789399 History of Changes |
| Other Study ID Numbers: | 00508826 |
| Study First Received: | November 7, 2008 |
| Last Updated: | January 24, 2013 |
| Health Authority: | United States: Institutional Review Board United States: Food and Drug Administration |
Keywords provided by Prairie Education and Research Cooperative:
|
deep vein thrombosis coronary artery bypass surgery Venous thromboembolism |
Additional relevant MeSH terms:
|
Thromboembolism Thrombosis Venous Thrombosis Venous Thromboembolism Embolism and Thrombosis Vascular Diseases Cardiovascular Diseases Fondaparinux PENTA |
Anticoagulants Hematologic Agents Therapeutic Uses Pharmacologic Actions Fibrinolytic Agents Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action Cardiovascular Agents |
ClinicalTrials.gov processed this record on May 16, 2013