Angioplasty to Blunt the Rise of Troponin in Acute Coronary Syndrome (ACS) (ABOARD)
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| ClinicalTrials.gov Identifier: NCT00442949 |
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Recruitment Status :
Completed
First Posted : March 5, 2007
Last Update Posted : February 12, 2009
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Sponsor:
Assistance Publique - Hôpitaux de Paris
Information provided by:
Assistance Publique - Hôpitaux de Paris
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Brief Summary:
Release of troponin evaluated by the peak of troponin during the hospital phase.Because of its sensitivity and specificity as well as its widespread use in routine practice, rise in troponin levels is the main assessment criteria of this study. We plan to demonstrate a significantly altered distribution of the troponin release as evaluated by the peak of troponin for each patient during the hospitalization period (from randomization to cardiologic unit discharge), in the two arms of the trial.
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Acute Coronary Syndrome | Procedure: Catheterization immediate PCI Procedure: delayed PCI | Not Applicable |
We propose to evaluate the optimal moment for catheterization in patients presenting with acute coronary syndromes by comparing rapid catheterization on the day of admission (within 8 hours of admission, with an average time close to 3 hours, as in the rapid strategy arm of the ISAR-COOL trial) with a slower approach where the examination is scheduled for the next working day (8 to 60 hours post admission, with an average close to 24 hours). Patients included will present with severe unstable angina defined as a TIMI score > 3 All patients must present with an indication for catheterization and they will receive the same optimal pharmacological treatment including abciximab (ReoPro*) when undergoing PCI and started just before the procedure as indicated in the label of the drug (substitution by another drug of the class, eptifibatide or tirofiban, is not possible in the catheterization laboratory according to the labels of these two other drugs). Randomization will evaluate only time to catheterization: rapidly, as soon as possible following admission (within 8 hours of admission) versus a delayed approach (8 to 60 hours following admission). The goal of randomization is to determine the ideal time to catheterization while indications for catheterization, pharmacological treatment, and patient care remain constant. This is a pragmatic study aiming to compare 2 different strategies in the management of ACS.
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 400 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | None (Open Label) |
| Primary Purpose: | Treatment |
| Official Title: | Angioplasty to Blunt the Rise of Troponin in Acute Coronary Syndromes Randomized for an Immediate or Delayed Intervention (The ABOARD Study) |
| Study Start Date : | August 2006 |
| Actual Primary Completion Date : | December 2008 |
| Actual Study Completion Date : | January 2009 |
| Arm | Intervention/treatment |
|---|---|
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Active Comparator: 2
Catheterization immediate PCI
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Procedure: Catheterization immediate PCI
Catheterization immediate PCI |
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Experimental: 1
delayed PCI
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Procedure: delayed PCI
delayed PCI |
Primary Outcome Measures :
- Release of troponin evaluated by the peak of troponin during the hospital phase [ Time Frame: during the hospital phase ]
Secondary Outcome Measures :
- Death, MIs and urgent revascularizations will be recorded as ischemic events during 1month following randomization. [ Time Frame: during 1month following randomization ]
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| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- Man over 18 or non-pregnant woman over 18.
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Patient hospitalized for severe acute coronary syndrome. To be selected patients will need to have at least 2 criteria for acute coronary syndrome AND a TIMI score > 3 for severity of ACS.
ACS is defined by at least two of the following diagnostic criteria :
- ischemic symptom
- electrocardiographic abnormalities in the ST segment (depression or transitory elevation of at least 0.1 mV), or in the T waves, at least in two contiguous leads positive troponin (as defined locally).
Severity of ACS is defined by a TIMI score > 3
- indication for catheterization agreed and possible within the following 8 hours.
- signed consent form
Exclusion Criteria:
- Patients that would require immediate catheterization for ongoing refractory ischemia, major arrhythmias, or hemodynamic instability are not eligible for the study.
- Anticoagulant therapy with antivitamin K within 5 days preceding randomization
- Thrombolytic therapy during the preceding 24 hours
- Upstream treatment by a GPIIb/IIIa inhibitor
- ReoPro should not be administered to patients with known sensitivity to abciximab, to any component of the product or to murine monoclonal antibodies. Because inhibition of platelet aggregation increases the risk of bleeding, ReoPro is contra-indicated in the following clinical situations: active internal bleeding; history of cerebrovascular accident within two years; recent (within two months) intracranial or intraspinal surgery or trauma; recent (within two months) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled hypertension; pre-existing thrombocytopenia; vasculitis; hypertensive or diabetic retinopathy; severe hepatic or severe renal failure.
- Woman nursing
Information from the National Library of Medicine
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): NCT00442949
Locations
| France | |
| Institut de Cardiologie - Hôpital Pitié-Salpétrière | |
| Paris, France, 75013 | |
Sponsors and Collaborators
Assistance Publique - Hôpitaux de Paris
Investigators
| Principal Investigator: | Gilles MONTALESCOT, Professor | Assistance Publique - Hôpitaux de Paris |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Myriem CARRIER, Department Clinical Research of Developpement |
| ClinicalTrials.gov Identifier: | NCT00442949 History of Changes |
| Other Study ID Numbers: |
P050705 |
| First Posted: | March 5, 2007 Key Record Dates |
| Last Update Posted: | February 12, 2009 |
| Last Verified: | April 2008 |
Keywords provided by Assistance Publique - Hôpitaux de Paris:
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Acute coronary syndrome Angioplasty Abciximab Troponin release |
Additional relevant MeSH terms:
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Syndrome Acute Coronary Syndrome Disease Pathologic Processes |
Myocardial Ischemia Heart Diseases Cardiovascular Diseases Vascular Diseases |