Acute Myocardial InfarctionPhase 4SWEDESNCT00806403
Comparison Between Thrombolysis and Primary Percutaneous Coronary Intervention (PCI) to Treat ST-Segment Elevation Myocardial Infarction
A Phase 4 study testing reteplase 10+10 U and primary PCI in people with Acute Myocardial Infarction, run by Sahlgrenska University Hospital at 5 sites in Sweden.
Trial summary
The main objective is to compare a fibrinolytic strategy with an interventional strategy initiated as early as possible, preferably in the pre-hospital phase, with respect to resolution of ST-segment elevation at 120 minutes after inclusion and Thrombolysis In Myocardial Infarction (TIMI) flow grade evaluated at a… Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Acute Myocardial Infarction
- What is being tested?
- reteplase 10+10 U and primary PCI
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 205 participants
- Where
- 5 sitesSweden
- Study dates
- Nov 2001to Jun 2004
- Phase
- Phase 4
- 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 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients presenting within 6 h after onset of chest pain lasting for more than 30 min and with significant ST-segment elevation on ECG.
Who cannot join
- BP >180/110
- Known bleeding disorder
- Cardiogenic shock
- CPR>10 min
- Ongoing anticoagulant therapy
- Renal insufficiency
- Weight >120 kg
Trial locations and contacts
5 sites in 1 country.
5 sites in 1 country
Sweden5 sites
Sahlgrenska University Hospital
Gothenburg
Orebro University Hospital
Örebro
Sodersjukhuset
Stockholm
Norra Alvsborgs lans Hospital
Trollhättan
Varberg Hospital
Varberg
About this study
Official title: Very Early Initiation of Treatment With Thrombolysis and Low Molecular Weight Heparin, Versus Abciximab and Low Molecular Weight Heparin Followed by Percutaneous Coronary Intervention, for Acute ST-Elevation Myocardial Infarction
The main objective is to compare a fibrinolytic strategy with an interventional strategy initiated as early as possible, preferably in the pre-hospital phase, with respect to resolution of ST-segment elevation at 120 minutes after inclusion and Thrombolysis In Myocardial Infarction (TIMI) flow grade evaluated at a mandated coronary angiography 5 to 7 days after inclusion.
Read the detailed description
Patients in the fibrinolytic group received an intravenous injection of 30 mg enoxaparin followed by subcutaneous injections of 1 mg/kg body weight every 12 hours during hospital stay.
Patients in the invasive group were given an intravenous injection of enoxaparin of (0.75 mg/kg body weight) and abciximab as a intravenous bolus (0.25 mg/kg body weight) followed by a 12 hour infusion (10 microg/minute).
Secondary outcome measures were death, myocardial infarction and stroke alone or as a composite at 30 days.
Data on use of health care resources, loss of production and health-related quality of life were collected during one year. Cost-effectiveness was determined by comparing costs and quality-adjusted survival.
- Conditions
- Acute Myocardial Infarction
- Being tested
- reteplase 10+10 U, primary PCI
- Keywords
- thrombolysis, primary PCI, abciximab, ST-segment resolution, TIMI flow
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
reteplase 10+10 UDrug
Also called Rapilysin
comparison to primary PCI
primary PCIProcedure or surgery
Also called primary percutaneous coronary intervention
comparison to thrombolysis
| Study group | Role | What they receive |
|---|---|---|
| thrombolysis | Active comparator | Not described Receives: Drug: reteplase 10+10 U |
| invasive | Active comparator | Not described Receives: Procedure: primary PCI |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Patients With ST-segment Elevation Resolution Equal or More Than 50%
ST-segment elevation resolution was measured in the lead with most prominent ST elevation at time of inclusion
Measured: 120 minutes after inclusion
Number of Patients With Thrombolysis In Myocardial Infarction (TIMI) Flow Grade 3
Thrombolysis In Myocardial Infarction (TIMI) flow grade in the infarct related artery 5-7 days after inclusion.
Measured: 5-7 days after inclusion
Secondary outcomes (3)
Death
Measured: 30 days
Reinfarction
Measured: 30 days
Stroke
Measured: 30 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Dec 2008 (estimated)
- Study startNov 2001
- Primary completionJun 2003
- Study completionJun 2004
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Acute Myocardial InfarctionStudies of the same condition, open and under way.
- More trials run by Sahlgrenska University HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 205 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sahlgrenska University Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Stockholm South General Hospital, Region Örebro County, Norra Alvsborgs Lans Hospital, Trollhattan, Varberg Hospital, Sweden
- Investigators
- Lars Grip, M.D. PhD, Principal investigator, Sahlgren's University Hospital/SLeif Svensson, M.D. PhD, Study chair, Stockholm South General HospitalJohan Herlitz, M.D. PhD, Study chair, Sahlgren's University Hospital/SMikael Dellborg, M.D. PhD, Study chair, Sahlgren's University Hospital/OAke Ohlsson, M.D. PhD, Study chair, Stockholm South General HospitalMikael Aasa, M.D., Study chair, Stockholm South General Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00806403
- Sponsor's protocol ID
- SWEDES 23/09/01
- Acronym
- SWEDES
- Status last verified
- Nov 2008
- First submitted
- 7 Nov 2008
- Last updated
- 10 Dec 2008
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Svensson L, Aasa M, Dellborg M, Gibson CM, Kirtane A, Herlitz J, Ohlsson A, Karlsson T, Grip L. Comparison of very early treatment with either fibrinolysis or percutaneous coronary intervention facilitated with abciximab with respect to ST recovery and infarct-related artery epicardial flow in patients with acute ST-segment elevation myocardial infarction: the Swedish Early Decision (SWEDES) reperfusion trial. Am Heart J. 2006 Apr;151(4):798.e1-7. doi: 10.1016/j.ahj.2005.09.013.
PubMed 16569536Aasa M, Kirtane AJ, Dellborg M, Gibson MC, Prahl-Abrahamsson U, Svensson L, Grip L. Temporal changes in TIMI myocardial perfusion grade in relation to epicardial flow, ST-resolution and left ventricular function after primary percutaneous coronary intervention. Coron Artery Dis. 2007 Nov;18(7):513-8. doi: 10.1097/MCA.0b013e3282c1fdb6.
PubMed 17925603Aasa M, Henriksson M, Dellborg M, Grip L, Herlitz J, Levin LA, Svensson L, Janzon M. Cost and health outcome of primary percutaneous coronary intervention versus thrombolysis in acute ST-segment elevation myocardial infarction-Results of the Swedish Early Decision reperfusion Study (SWEDES) trial. Am Heart J. 2010 Aug;160(2):322-8. doi: 10.1016/j.ahj.2010.05.008.
PubMed 20691839
Study at a glance
From the registry record, last updated by the sponsor on 10 Dec 2008. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Very Early Initiation of Treatment With Thrombolysis and Low Molecular Weight Heparin, Versus Abciximab and Low Molecular Weight Heparin Followed by Percutaneous Coronary Intervention, for Acute ST-Elevation Myocardial Infarction
- ClinicalTrials.gov ID
- NCT00806403
- Acronym / sponsor ID
- SWEDES / SWEDES 23/09/01
- Conditions
- Acute Myocardial Infarction
- Keywords
- thrombolysis, primary PCI, abciximab, ST-segment resolution, TIMI flow
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 205 participants (actual)
- Lead sponsor
- Sahlgrenska University HospitalUniversity, hospital or other
- Collaborators
- Stockholm South General Hospital, Region Örebro County, Norra Alvsborgs Lans Hospital, Trollhattan, Varberg Hospital, Sweden
- Study start
- Nov 2001
- Primary completion
- Jun 2003 (actual)
- Study completion
- Jun 2004 (actual)
- First posted
- 10 Dec 2008 (estimated)
- Results
- Posted 10 Dec 2008
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The main objective is to compare a fibrinolytic strategy with an interventional strategy initiated as early as possible, preferably in the pre-hospital phase, with respect to resolution of ST-segment elevation at 120 minutes after inclusion and Thrombolysis In Myocardial Infarction (TIMI) flow grade evaluated at a mandated coronary angiography 5 to 7 days after inclusion.
Detailed description
Patients in the fibrinolytic group received an intravenous injection of 30 mg enoxaparin followed by subcutaneous injections of 1 mg/kg body weight every 12 hours during hospital stay.
Patients in the invasive group were given an intravenous injection of enoxaparin of (0.75 mg/kg body weight) and abciximab as a intravenous bolus (0.25 mg/kg body weight) followed by a 12 hour infusion (10 microg/minute).
Secondary outcome measures were death, myocardial infarction and stroke alone or as a composite at 30 days.
Data on use of health care resources, loss of production and health-related quality of life were collected during one year. Cost-effectiveness was determined by comparing costs and quality-adjusted survival.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| thrombolysis | Active comparator | Drug: reteplase 10+10 U |
| invasive | Active comparator | Procedure: primary PCI |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Patients presenting within 6 h after onset of chest pain lasting for more than 30 min and with significant ST-segment elevation on ECG.
Key exclusion criteria (7 listed)
- BP >180/110
- Known bleeding disorder
- Cardiogenic shock
- CPR>10 min
- Ongoing anticoagulant therapy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| reteplase 10+10 UAlso: Rapilysincomparison to primary PCI | Drug | thrombolysis |
| primary PCIAlso: primary percutaneous coronary interventioncomparison to thrombolysis | Procedure or surgery | invasive |
Primary outcome
Number of Patients With ST-segment Elevation Resolution Equal or More Than 50%
Time frame: 120 minutes after inclusion
ST-segment elevation resolution was measured in the lead with most prominent ST elevation at time of inclusion
Number of Patients With Thrombolysis In Myocardial Infarction (TIMI) Flow Grade 3
Time frame: 5-7 days after inclusion
Thrombolysis In Myocardial Infarction (TIMI) flow grade in the infarct related artery 5-7 days after inclusion.
3 secondary outcomes
Death
Time frame: 30 days
Reinfarction
Time frame: 30 days
Stroke
Time frame: 30 days
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Dec 2008.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 16569536Svensson L, Aasa M, Dellborg M, Gibson CM, Kirtane A, Herlitz J, Ohlsson A, Karlsson T, Grip L. Comparison of very early treatment with either fibrinolysis or percutaneous coronary intervention facilitated with abciximab with respect to ST recovery and infarct-related artery epicardial flow in patients with acute ST-segment elevation myocardial infarction: the Swedish Early Decision (SWEDES) reperfusion trial. Am Heart J. 2006 Apr;151(4):798.e1-7. doi: 10.1016/j.ahj.2005.09.013.
- Results publication: PubMed 17925603Aasa M, Kirtane AJ, Dellborg M, Gibson MC, Prahl-Abrahamsson U, Svensson L, Grip L. Temporal changes in TIMI myocardial perfusion grade in relation to epicardial flow, ST-resolution and left ventricular function after primary percutaneous coronary intervention. Coron Artery Dis. 2007 Nov;18(7):513-8. doi: 10.1097/MCA.0b013e3282c1fdb6.
- Derived from this study: PubMed 20691839Aasa M, Henriksson M, Dellborg M, Grip L, Herlitz J, Levin LA, Svensson L, Janzon M. Cost and health outcome of primary percutaneous coronary intervention versus thrombolysis in acute ST-segment elevation myocardial infarction-Results of the Swedish Early Decision reperfusion Study (SWEDES) trial. Am Heart J. 2010 Aug;160(2):322-8. doi: 10.1016/j.ahj.2010.05.008.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Lars Grip, M.D. PhD principal investigator
Sahlgren's University Hospital/S
Leif Svensson, M.D. PhD study chair
Stockholm South General Hospital
Johan Herlitz, M.D. PhD study chair
Sahlgren's University Hospital/S
5 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing reteplase 10+10 U and primary PCI in people with Acute Myocardial Infarction, run by Sahlgrenska University Hospital at 5 sites in Sweden.
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 1 inclusion and 7 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 10 Dec 2008. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 5 sites in Sweden. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
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 10 Dec 2008). 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 Patients With ST-segment Elevation Resolution Equal or More Than 50% (time frame: 120 minutes after inclusion). 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 NCT00806403, which also lists 3 linked publications.
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 10 Dec 2008.