Balloon Catheters and Stents to Prevent Heart Rhythm Irregularities in Individuals Post-Heart Attack
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|ClinicalTrials.gov Identifier: NCT00119847|
Recruitment Status : Unknown
Verified February 2006 by National Heart, Lung, and Blood Institute (NHLBI).
Recruitment status was: Active, not recruiting
First Posted : July 14, 2005
Last Update Posted : February 23, 2006
|Condition or disease||Intervention/treatment||Phase|
|Cardiovascular Diseases Heart Diseases Myocardial Infarction Coronary Disease Arrhythmia Ventricular Fibrillation||Drug: Beta Adrenergic Blockers Drug: Platelet Inhibitors Drug: ACE Inhibitors Procedure: PTCA and/or Stents||Not Applicable|
There is now unequivocal evidence that early coronary reperfusion using either thrombolytics or primary angioplasty results in a long-term mortality reduction among individuals who have had a heart attack. The benefit of early reperfusion (less than 6 hours after the heart attack) was initially attributed to myocardial salvage and the resultant preservation of left ventricular function. However, it is now known that the survival benefit associated with thrombolytic therapy is not consistently associated with a major improvement in left ventricular ejection fraction (LVEF). These observations led to the formulation of the "late open artery hypothesis," which suggests that clinical outcomes can potentially be improved by late reperfusion after a heart attack. Observational clinical studies have suggested that late patency of the infarct-related artery (IRA) after thrombolysis is associated with a survival benefit that is independent of LVEF and therefore cannot be solely explained by salvage of myocardium. Definitive proof of the late open artery hypothesis is currently lacking, however, because previous studies that have evaluated late percutaneous transluminal coronary angioplasty (PTCA) of occluded IRAs after a heart attack have produced conflicting results.
These findings led to the organization of the Occluded Artery Trial (OAT), an international, NHLBI-funded, randomized trial of 2,200 participants. OAT is testing the hypothesis that mechanical reperfusion of an occluded IRA with PTCA and percutaneous coronary intervention (PCI) 3 to 28 days after a heart attack in high-risk individuals will reduce mortality, recurrent heart attacks, and hospitalization for class IV congestive heart failure. Enhancement of electrical stability is one of the major mechanisms that has been proposed to explain the association of an open IRA with an improved prognosis independent of myocardial salvage.
This study is an ancillary study of OAT. It will characterize the effects of late PCI of occluded IRAs on the most important and clinically relevant noninvasive markers of vulnerability to malignant ventricular arrhythmias: heart rate variability, T wave variability, and signal-averaged electrocardiography. These analyses will be performed in 300 participants at baseline, 30 days, and 1 year following a heart attack in order to determine the effects of late PCI on the autonomic nervous system, ventricular repolarization, and ventricular conduction abnormalities.
|Study Type :||Interventional (Clinical Trial)|
|Enrollment :||300 participants|
|Official Title:||Electrophysiologic Effects of Late PCI (OAT-EP)|
|Study Start Date :||September 2002|
- Short-termed fractal scaling exponent (alpha 1) (measured at Year 1)
- Temporal variability in time
- Temporal variability in amplitude
- Filtered QRS duration
- Composite OAT clinical outcome of death, heart attack, and development of class IV congestive heart failure (measured at Year 1)
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00119847
|United States, Maryland|
|University of Maryland Baltimore Professional Schools|
|Baltimore, Maryland, United States, 21201|
|Study Chair:||Eric J. Rashba, MD||University of Maryland Baltimore Professional Schools|