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Infarction, MyocardialPhase 3NCT00426751

Efficacy Of Eptifibatide Compared To Abciximab In Primary Percutaneous Coronary Intervention (PCI) For Acute ST Elevation Myocardial Infarction (STEMI)

A Phase 3 study testing Abciximab and Eptifibatide in people with Infarction, Myocardial, run by GlaxoSmithKline at 24 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Multinational, multicentre, randomised, prospective, open, parallel group study directly comparing two glycoprotein-IIb/IIIa inhibitors, abciximab and eptifibatide, added early to standard treatment before primary PCI of STEMI patients with respect to effect on sum-ST-resolution after 60 minutes post-procedure and… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Infarction, Myocardial
What is being tested?
Abciximab and Eptifibatide
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
429 participants
Where
24 sitesin 2 countries
Study dates
Oct 2006to Dec 2007
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Women must be postmenopausal (i.e.12 months without menstrual period), or surgically sterile, i.e. women of child bearing potential are not allowed to be included into the study. In cases of doubt a pregnancy test should be performed. (NB -post menopausal women currently receiving hormone replacement are permissible)
  • Acute myocardial infarction < 12 h defined as:
  • Angina or equivalent symptoms > 20 min and
  • ST elevation in 2 contiguous ECG leads (= 2 mm precordial lead, = 1 mm limb lead). This ECG recording serves as baseline ECG, i.e. ECG I.
  • Planned primary percutaneous coronary intervention
  • The subject has given written informed, dated consent to participate in the study

Who cannot join

  • Subjects not able to give informed consent
  • Left Bundle Branch Block
  • Thrombolytic therapy within 24 hours before randomization
  • Oral anticoagulation with International Normalized Ratio (INR) > 2
  • Known platelets < 100.000/µl or known hemorrhagic diathesis
  • Stroke or Transient Ischemic Attack (TIA) within the past 6 months or any permanent residual neurological defect
Show all 14Show fewer
  • Evidence of an active gastrointestinal or urogenital bleeding
  • Major surgery within 6 weeks
  • History of allergic reaction to abciximab or eptifibatide or any component used in the study (including contrast media)
  • Known severe renal (creatinine clearance <30ml/min) or hepatic insufficiency as well as Alanine transaminase (ALT)/aspartate transaminase (AST) elevations = 3xUpper limit normal (ULN); isolated AST-elevation is not considered an exclusion criteria from study participation
  • Severe concomitant disease with life expectation < 1 year
  • Subject has participated in any study using an investigational drug or device within 30 days or within 5 half-lives of the investigational drug (whichever is longer) of entry into this study.
  • Subjects who will be inaccessible due to geographic or social factors during treatment or follow-up
  • In France, a subject is neither affiliated with nor a beneficiary of a social security category.

Trial locations and contacts

24 sites in 2 countries.

24 sites in 2 countries

France14 sites
  • GSK Investigational Site

    Alençon, 61014

  • GSK Investigational Site

    Bordeaux, 33076

  • GSK Investigational Site

    Caen, 14033

  • GSK Investigational Site

    Créteil, 94010

  • GSK Investigational Site

    Lille, 59037

  • GSK Investigational Site

    Melun, 77000

  • GSK Investigational Site

    Melun, 77007

  • GSK Investigational Site

    Nancy, 54000

  • GSK Investigational Site

    Ollioules, 83190

  • GSK Investigational Site

    Pau, 64046

  • GSK Investigational Site

    Perpignan, 66000

  • GSK Investigational Site

    Pessac, 33604

  • GSK Investigational Site

    Toulon, 83056

  • GSK Investigational Site

    Vandœuvre-lès-Nancy, 54511

Other trials in France

Germany10 sites
  • GSK Investigational Site

    Aachen, North Rhine-Westphalia, 52074

  • GSK Investigational Site

    Dortmund, North Rhine-Westphalia, 44137

  • GSK Investigational Site

    Freiburg im Breisgau, Baden-Wurttemberg, 79106

  • GSK Investigational Site

    Heidelberg, Baden-Wurttemberg, 69120

  • GSK Investigational Site

    Homburg, Saarland, 66421

  • GSK Investigational Site

    Ludwigshafen am Rhein, Rhineland-Palatinate, 67063

  • GSK Investigational Site

    Mönchengladbach, North Rhine-Westphalia, 41063

  • GSK Investigational Site

    Neuss, North Rhine-Westphalia, 41464

  • GSK Investigational Site

    Offenbach, Hesse, 63069

  • GSK Investigational Site

    Würzburg, Bavaria, 97080

Other trials in Germany

About this study

Official title: Eptifibatide Versus Abciximab in Primary PCI for Acute ST Elevation Myocardial Infarction

Multinational, multicentre, randomised, prospective, open, parallel group study directly comparing two glycoprotein-IIb/IIIa inhibitors, abciximab and eptifibatide, added early to standard treatment before primary PCI of STEMI patients with respect to effect on sum-ST-resolution after 60 minutes post-procedure and other measures of myocardial reperfusion

Being tested
Abciximab, Eptifibatide
Keywords
Eptifibatide, ST-elevation Myocardial Infarction, STEMI, Abciximab
Medical subject headings
Myocardial Infarction, ST Elevation Myocardial Infarction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AbciximabDrug

    Intravenous bolus of 0.25 mg/kg followed by continuous intravenous infusion of 0.125 mcg/kg/min (max. 10 mcg/min) for 12 h after PCI.

  • EptifibatideDrug

    Also called Abciximab

    Intravenous bolus of 180 mcg/kg followed immediately by a continuous infusion of 2.0 mdg/kg/ min for 20-24 h after end of PCI, and a second bolus of 180 mcg/kg administered 10 min after the first bolus.

Study groups in NCT00426751
Study groupRoleWhat they receive
AbciximabActive comparatorIntravenous bolus of 0.25 mg/kg followed by continuous intravenous infusion of 0.125 mcg/kg/min (max. 10 mcg/min) for 12 h after PCI.
Receives: Drug: Abciximab
EptifibatideExperimentalIntravenous bolus of 180 mcg/kg followed immediately by a continuous infusion of 2.0 mcg/kg/ min for 20-24 h after end of PCI, and a second bolus of 180 mcg/kg administered 10 min after the first bolus.
Receives: Drug: Eptifibatide

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Complete Sum ST Resolution (STR) 60 Minutes (Min) After Percutaneous Coronary Intervention (PCI) (Per Protocol Population)

    Sum STR was calculated as the difference between baseline (ECG I) and ECG III. The sum STR is the segment elevation resolution from all ECG leads associated with the infarct location. ST resolution, a method used to evaluate myocardial reperfusion, was expressed as a percentage of the baseline value (Complete: ≥ 70% resolution).

    Measured: Baseline (ECG I) and 60 min +/- 15 min after PCI (ECG III)

  2. Number of Participants With Complete Sum ST Resolution (STR) 60 Min After Percutaneous Coronary Intervention (PCI) (Intent-to-Treat Population)

    Sum STR was calculated as the difference between baseline (ECG I) and ECG III. The sum STR is the segment elevation resolution from all ECG leads associated with the infarct location. ST resolution, a method used to evaluate myocardial reperfusion, was expressed as a percentage of the baseline value (Complete: ≥ 70% resolution).

    Measured: Baseline (ECG I) and 60 min +/- 15 min after PCI (ECG III)

Secondary outcomes (18)
  1. Number of Participants With Complete or Partial Sum ST Resolution (STR) 60 Min After PCI

    Sum STR was calculated as the difference between baseline (ECGI) and ECG III. The sum STR is the segment elevation resolution from all ECG leads associated with infarct location. ST resolution, a method used to evaluate myocardial reperfusion, was expressed as a percentage of the baseline (Complete: ≥ 70% resolution; Partial: ≥ 30% and < 70% resolution; None: < 30% resolution).

    Measured: Baseline (ECG I) and 60 min +/- 15 min after PCI (ECG III)

  2. Number of Participants With Complete Single Lead ST Resolution (STR) 60 Min After PCI

    Single lead STR is calculated as the difference (as a percentage) between baseline (ECG I) and ECG III of either the ST elevation on one of the leads (II, III, aVF, V5, and V6) or the ST depression of one of the precordial leads (V1- V4), whichever lead showed the largest deviation either at baseline or at ECG III, respectively (Complete: ≥ 70%; Partial: ≥ 30% and <70%).

    Measured: Baseline (ECG I) and 60 min +/- 15 min after PCI (ECG III)

  3. Mean Change From Baseline in the Sum ST Resolution 60 Min After PCI

    Sum STR was calculated as the difference between baseline (ECGI) and ECG III. The sum STR is the segment elevation resolution from all ECG leads associated with infarct location. ST resolution, a method used to evaluate myocardial reperfusion, was expressed as a percentage of the baseline.

    Measured: Baseline (ECG I) and 60 min +/- 15 min after PCI (ECG III)

  4. Mean Change From Baseline in Single Lead ST Resolution (STR) 60 Min After PCI

    Single lead STR is calculated as the difference between baseline (ECG I) and ECG III of either the ST elevation on one of the leads (II, III, aVF, V5, and V6) or the ST depression of one of the precordial leads (V1 -V4), whichever lead showed the largest deviation either at baseline or at follow-up, respectively. STR was expressed as a percentage from baseline.

    Measured: Baseline (ECG I) and 60 min +/- 15 min after PCI (ECG III)

  5. Mean Change From Baseline in the Sum ST Resolution (STR) Before PCI

    Mean sum STR was calculated as the difference between baseline (ECGI) and ECG II: the mean of the sum of ST elevation resolution from all ECG leads associated with infarct location. ST resolution was expressed as a percentage from baseline.

    Measured: Baseline (ECG I) and immediately prior to PCI (ECG II)

  6. Mean Maximum ST Deviation Existing (Max STE) 60 Min After PCI

    Max STE is measured similarly to single-lead STR, but was not compared with the ST deviation on the baseline ECG I. It was the existing ST deviation on the single ECG lead of maximum ST deviation present at 60 minutes after the PCI (ECG III).

    Measured: 60 min +/- 15 min after PCI (ECG III)

  7. Number of Participants With the Indicated Patency of Infarcted Vessels According to Thrombolysis in Myocardial Infarction (TIMI) Classification Before PCI

    Number of participants with the respective patency of the infarcted vessels was evaluated by TIMI (Thrombolysis In Myocardial Infarction) flow grades (Grade 0 = No perfusion, Grade 1 = Penetration with minimal perfusion, Grade 2 = Partial perfusion, Grade 3 = Complete perfusion), as assessed by core angiography lab.

    Measured: immediately before PCI

  8. Number of Participants With TIMI 3 Patency of Infarcted Vessels Following PCI

    The number of participants with TIMI grade 3 (complete perfusion) patency of the infarcted vessels following PCI, as assessed by core angiography lab, was measured.

    Measured: after PCI

  9. Mean Number of Corrected TIMI Frame Counts (cTIMI) Following PCI

    cTIMI frame counts (number of cineframes needed for dye to reach standardized distal landmarks in a coronary vessel; objective index of coronary blood flow) following PCI, as assessed by core angiography lab.

    Measured: after PCI

  10. Number of Participants With the Indicated Myocardial Blush Grade (TIMI Myocardial Perfusion Grade [TMPG]) After PCI

    The number of participants with the indicated myocardial blush grade (TMPG), used to assess the myocardial reperfusion in the infarcted myocardium following PCI (as assessed by the core angiography laboratory), was measured. Blush grades: 0 = failure of dye to enter the microvasculature; 1 = dye slowly enters but fails to exit the microvasculature; 2 = delayed entry and exit of dye from the microvasculature; 3: normal entry and exit of dye from the microvasculature. Blush that is of only mild intensity throughout the washout phase but fades minimally is also classified as grade 3.

    Measured: after PCI

  11. Combined Endpoint: Number of Participants With Events of Death, Re-myocardial Infarction (MI), and Urgent Target Vessel Revascularisation (UTVR)

    The number of participants who died, experienced re-MI, or experienced UTVR (necessity of re-PCI of the target vessel or coronary artery bypass graft [CABG] because of recurrent ischaemic angina within 30 days after PCI) within the specified timeframe was measured.

    Measured: Day 7 or hospital discharge; Day 30 after index-MI

  12. Number of Participants Who Died, and/or Experienced Re-MI and UTVR (Individually Counted)

    The number of participants who died, and/or experienced re-MI or UTVR (individually counted) within the specified timeframe was measured.

    Measured: Day 7 or hospital discharge; Day 30 after index-MI

  13. Number of Participants Who Experienced Stroke or Major Bleeding Complications

    Number of participants who experienced stroke (hemorrhagic, non-hemorrhagic) or major bleedings (TIMI class: intracranial haemorrhage, spontaneous bleeding, bleeding at any instrumented site, retroperitoneal bleeding, or clinically significant overt haemorrhage associated with a drop in haematocrit of ≥ 15% or a drop in haemoglobin of ≥ 5 g/dL).

    Measured: Day 7 or hospital discharge; Day 30 after index-MI

  14. Number of Participants Who Died and or Experienced Re-MI Until 6 Months After PCI

    The number of participants who died and/or experienced re-MI within 6 month after PCI was measured.

    Measured: until 6 Month (Day 180) after index-MI

  15. Number of Participants With Heart Failure Until 6 Months After PCI

    The number of participants with heart failure within 6 month after PCI was measured.

    Measured: until 6 Months (Day 180) after index-MI

  16. Number of Participants With Major Bleedings (TIMI Classification)

    Number of participants with major bleedings (according to TIMI classification: intracranial haemorrhage, spontaneous bleeding, bleeding at any instrumented site, retroperitoneal bleeding, or clinically significant overt haemorrhage associated with a drop in haematocrit of ≥ 15% or a drop in haemoglobin of ≥ 5 g/dL) within the specified timeframe was measured.

    Measured: Day 7 or hospital discharge; Day 30 after index-MI

  17. Number of Participants With Minor Bleedings (TIMI Classification)

    The number of participants with minor bleedings (according to TIMI classification: clinically overt bleeding [e.g., gross haematuria or haematemesis) associated with a drop in haematocrit of ≥ 9% or a drop in haemoglobin of ≥ 3 g/dL) within the specified timeframe was measured.

    Measured: Day 7 or hospital discharge; Day 30 after index-MI

  18. Mean Duration of Stay in the Ward

    Costs were measured as the duration of stay in the ward (outpatient, normal ward, and intensive care unit) within the specified timeframe was measured.

    Measured: until 6 months after index-MI

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jan 2007 (estimated)
  2. Study startOct 2006
  3. Primary completionDec 2007
  4. Study completionDec 2007

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
429 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00426751
Sponsor's protocol ID
106915
Status last verified
Nov 2012
First submitted
24 Jan 2007
Last updated
27 Nov 2012

Publications

  • Zeymer U, Margenet A, Haude M, Bode C, Lablanche JM, Heuer H, Schroder R, Kropff S, Bourkaib R, Banik N, Zahn R, Teiger E. Randomized comparison of eptifibatide versus abciximab in primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction: results of the EVA-AMI Trial. J Am Coll Cardiol. 2010 Aug 3;56(6):463-9. doi: 10.1016/j.jacc.2009.08.093.

    PubMed 20670755

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Abciximab and Eptifibatide in people with Infarction, Myocardial, run by GlaxoSmithKline at 24 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Nov 2012. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 24 sites in France, Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 26 Apr 2010). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Complete Sum ST Resolution (STR) 60 Minutes (Min) After Percutaneous Coronary Intervention (PCI) (Per Protocol Population) (time frame: Baseline (ECG I) and 60 min +/- 15 min after PCI (ECG III)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00426751, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Nov 2012.

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