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Effects of Nitric Oxide for Inhalation in Myocardial Infarction Size (NOMI)

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ClinicalTrials.gov Identifier: NCT01398384
Recruitment Status : Completed
First Posted : July 20, 2011
Last Update Posted : May 21, 2014
Sponsor:
Information provided by (Responsible Party):
Universitaire Ziekenhuizen Leuven

Study Description
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Brief Summary:
The purpose of this study is to determine the effects of Nitric Oxide for Inhalation on Myocardial Infarction Size.

Condition or disease Intervention/treatment Phase
Acute Myocardial Infarction Drug: Nitric Oxide Drug: MI size at 48-72 hours Phase 2

Detailed Description:
The primary objective of the trial is to assess whether or not inhaled nitric oxide can decrease myocardial infarction (MI) size as a fraction of left ventricular size at 48-72 hours in patients presenting with an ST segment elevation MI who undergo successful percutaneous coronary intervention.

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 250 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: The Effects of Nitric Oxide for Inhalation on Myocardial Infarction Size
Study Start Date : October 2010
Actual Primary Completion Date : May 2014
Actual Study Completion Date : May 2014

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Attack

Arms and Interventions
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Arm Intervention/treatment
Active Comparator: Nitric Oxide
nitric oxide for inhalation
 Drug: Nitric Oxide
MI size at 48-72 hours
Other Name: vasoKINOX 450
Placebo Comparator: Placebo
inhalation gas
 Drug: MI size at 48-72 hours
Placebo gas


Outcome Measures
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Primary Outcome Measures :
  1. Myocardial infarction size as a fraction of left ventricular size [ Time Frame: 48-72 hours ]
    Myocardial infarction size as a fraction of left ventricular size at 48-72 hours in patients presenting with an ST segment elevation MI who undergo successful percutaneous coronary intervention.


Secondary Outcome Measures :
  1. MI size, extent and transmurality of microvascular obstruction [ Time Frame: 48-72 hours ]
    MI size, extent and transmurality of microvascular obstruction measured by MRI

  2. MI size normalized to area at risk [ Time Frame: 48-72 hours ]
  3. Myocardial perfusion at coronary angiography at the completion of PCI (corrected TIMI frame count and myocardial blush grade). [ Time Frame: at completion of PCI, as expected 1 day ]
  4. Transmurality of infarct (as average percent wall thickness in all segments showing delayed enhancement). [ Time Frame: at 48 - 72 hours and 4 months ]
  5. Myocardial perfusion(MRI). [ Time Frame: at 48-72 hours and 4 months ]
  6. Global and regional left ventricular function and left ventricular mass at 48 - 72hours and 4 months after MI and the change in global LV function and mass between 48-72 hours and 4 months. MI size as a fraction of LV size at 4 months after MI. [ Time Frame: 48-72 hours and 4 months ]
  7. Resolution of ST segment elevation (serial ECGs) as indicated by the decrease in the total ST elevation (in mV) at 4 hours compared with that observed at enrollment. [ Time Frame: at 4 hours ]
  8. Troponin T levels and CPK-MB area under the curve at 48 hours. [ Time Frame: 48 hours ]
  9. Change in adverse remodeling parameters (compared with 48-72 hours):changes in LV end-diastolic volume, end-systolic volume, end-diastolic myocardial wall thickness in infarct, peri-infarct and remote areas and in sphericity index. [ Time Frame: 4 months ]
    Change in adverse remodeling parameters (compared with 48-72 hours):changes in LV end-diastolic volume, end-systolic volume, end-diastolic myocardial wall thickness in infarct, peri-infarct and remote areas and in sphericity index at end-diastole and end-systole.

  10. Death, nonfatal recurrent MI, recurrent ischemia necessitating re-hospitalization, PCI, or surgical revascularization, and stroke (i.e. combined CV endpoint) at 4 months. Enzyme leak during subsequent scheduled PCI will not be considered new ischemia/MI. [ Time Frame: 4 months ]
  11. Assess the safety of inhaled NO for this use as determined by reported adverse events (including bleeding and laboratory changes). [ Time Frame: during treatment gas period, an average of 6 hours ]

Eligibility Criteria
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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:

  1. Acute myocardial infarction (defined as an episode of chest pain or related symptom lasting greater than 2 hours but less than 12 hours and electrocardiographic evidence of ST elevation (measured as 0.08 seconds after the J point; sum greater or equal to 0.6 mV in leads I, II, III, AVL, AVF, V1-V6).
  2. No evidence of congestive heart failure (no S3 or evidence of pulmonary edema) and normal oxygen saturation on ≤ 2L oxygen by NC.
  3. All patients must undergo successful percutaneous coronary intervention for TIMI 0 or 1 coronary flow with resulting TIMI 2 or 3 (residual stenosis less than 30% if stented and less than 50% if opened by balloon angioplasty).
  4. Age > 18 years.
  5. Signed EC approved informed consent.

Exclusion Criteria:

  1. Prior myocardial infarction (as determined by patient history and/or ECG), cardiac surgery, or severe pericardial, congenital, cardiomyopathic or valvular heart disease.
  2. Requirement for urgent cardiac surgery.
  3. Previous CABG or PCI.
  4. Left bundle branch block.
  5. Unable to tolerate magnetic resonance imaging (including disallowed metallic implants or BMI > 35) or unable to tolerate gadolinium contrast media, including patients with calculated creatinine clearance less than 60 ml/min/1.73 m2 BSA.
  6. Active or recent hemorrhage requiring an invasive procedure for evaluation or transfusion within 6 weeks prior to presentation or hemorrhagic stroke within the 6 weeks prior to presentation.
  7. Known or suspected aortic dissection.
  8. Prior history of pulmonary disease requiring chronic oxygen therapy.
  9. Pregnancy, lactating and woman of childbearing potential.
  10. Use of investigational drugs or device within the 30 days prior to enrollment to the study. Investigational uses of approved therapies will be allowed.
  11. Medical problem likely to preclude completion of the study.
Contacts and Locations
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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): NCT01398384


Locations
Belgium
Jessa Hospital
Hasselt, Belgium
UZ Leuven
Leuven, Belgium, 3000
Hungary
Semmelweis University Heart Center
Budapest, Hungary, 1122
Poland
John Paul II Hospital
Krakow, Poland, 31-202
Sponsors and Collaborators
Universitaire Ziekenhuizen Leuven
Investigators
Principal Investigator: Stefan Janssens, Prof Dr UZ Leuven
Principal Investigator: Frans Van de Werf, Prof Dr UZ Leuven
More Information
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Additional Information:
NOMI: Final Statistical Analysis Plan 19 May 2014  This link exits the ClinicalTrials.gov site

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Responsible Party: Universitaire Ziekenhuizen Leuven
ClinicalTrials.gov Identifier: NCT01398384     History of Changes
Other Study ID Numbers: LCC2010.01
First Posted: July 20, 2011    Key Record Dates
Last Update Posted: May 21, 2014
Last Verified: May 2014

Keywords provided by Universitaire Ziekenhuizen Leuven:
ST Elevation MI
STEMI

Additional relevant MeSH terms:
Infarction
Myocardial Infarction
Ischemia
Pathologic Processes
Necrosis
Myocardial Ischemia
Heart Diseases
Cardiovascular Diseases
Vascular Diseases
Nitric Oxide
Bronchodilator Agents
Autonomic Agents
 Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Asthmatic Agents
Respiratory System Agents
Free Radical Scavengers
Antioxidants
Molecular Mechanisms of Pharmacological Action
Neurotransmitter Agents
Endothelium-Dependent Relaxing Factors
Vasodilator Agents
Gasotransmitters
Protective Agents