AzTrials
AzTrials

Myocardial InfarctionPhase 4CONTRASTNCT02590653

Assessment of the Effects of Atorvastatin Therapy on Myocardial Deformation Characteristics, in Patients With STEMI

A Phase 4 study testing Atorvastatin in people with Myocardial Infarction, run by Penza State University at 1 site in Russia.

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

The primary goal To assess the effect of atorvastatin in patients treated since the first 24-96 hours of the disease on the parameters of global and regional myocardial deformation in the infarcted area and the structural and functional properties of arteries at day 7, at 12, 24, 36 and 48 weeks of treatment; The… Read more about this study

Who is it for?
Ages 35 to 65 years
Conditions the study is for
Myocardial Infarction
What is being tested?
Atorvastatin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
200 participants
Where
1 siteRussia
Study dates
Oct 2014to Feb 2020
Phase
Phase 4
Are there results?
None posted in the registry

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 35 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Signed Informed Consent Form
  • Patients having physical and mental ability to participate in the study
  • Patients of both sexes aged 35 to 65 years
  • Presence of documented ST-elevation myocardial infarction confirmed by ECG, as well as troponin I and CK-MB levels.
  • Presence of hemodynamically relevant stenosis of one artery (i.e., the infarct-related artery) confirmed by coronary angiography (CAG), with the occlusion of other arteries not exceeding 30%.

Who cannot join

  • A history of repeat or recurrent myocardial infarction;
  • A history of chronic heart failure (CHF) III-IV by New-York Heart Association (NYHA);
  • Presence of left ventricular hypertrophy confirmed by echocardiography;
  • QRS complex exceeding 1.0;
  • Ejection fraction less than 40%;
  • Presence of hemodynamically relevant stenosis exceeding 30% in several coronary arteries confirmed by CAG;
Show all 22Show fewer
  • Type 1 diabetes mellitus;
  • Type 2 diabetes mellitus requiring pharmacotherapeutic correction with insulin;
  • Any severe concurrent disease;
  • A history of acute cerebrovascular accident (ACVA) within the 6 month period preceding the study;
  • Active hepatic disease or liver enzyme elevation of unclear etiology more than 3 times higher than the upper limit of normal;
  • Hepatic failure or bilirubin elevation more than 1.5 times higher than the upper limit of normal;
  • Uncontrolled arterial hypertension (AH), with systolic blood pressure (SBP) exceeding 180 mm Hg and diastolic blood pressure (DBP) exceeding 110 mm Hg;
  • A history of heart rhythm and/or cardiac conduction disorder;
  • Inborn and/or acquired heart defects;
  • A history of aortic aneurysm;
  • Current existence of severe anemia (Hb < 100 g/L);
  • Chronic renal disease (creatinine clearance < 30 mL/min);
  • Uncorrected thyroid dysfunction, with hyper- or hypothyroidism;
  • Intolerance of statins;
  • Alcohol abuse and drug use;
  • Participation in other clinical studies within the last two months.

Trial locations and contacts

1 site in 1 country.

Russia1 site
  • Valentin Oleynikov

    Penza, 440026

Other trials in Russia

About this study

Official title: Assessment of the Effects of Aggressive Atorvastatin Therapy on Myocardial Deformation Characteristics, Vascular Rigidity, 24 Hour ECG Monitoring Parameters and Quality of Life in Patients With STEMI

The primary goal

  • To assess the effect of atorvastatin in patients treated since the first 24-96 hours of the disease on the parameters of global and regional myocardial deformation in the infarcted area and the structural and functional properties of arteries at day 7, at 12, 24, 36 and 48 weeks of treatment;
Read more

The secondary goals. To evaluate the effect of treatment:

  • on the parameters of the global and regional myocardial deformation in the intact area on day 7, on 12, 24, 36 and 48 weeks of treatment;
  • on the parameters of the global and regional myocardial deformation depending on the degree of coronary blood flow restoration by thrombolysis in myocardial infarction (TIMI)
  • on systolic and diastolic left ventricular function in the presence of initial impairments, or absence of the negative dynamics of these parameters in case of normal baseline values;
  • on the clinical diagnostic criteria for the development or progression of heart failure;
  • the dynamics of the duration and extent of myocardial ischemia according to the daily ECG monitoring on day 7, at 12, 24, 36 and 48 weeks of treatment;
  • the appearance of new prognostically significant cardiac arrhythmias
  • on the pulse wave velocity
  • the thickness of the intima-media complex (IMT); 200 patients are planned to be include in a randomized, single-center, open, prospective, controlled clinical trial, the enrollment will be held at the Department of "Therapy" of Medical Institute of Penza State University.

Definition of the study group:

The patients with STEMI (myocardial infarction with ST-segment elevation) will be included in the study

  • Group 1 STEMI - 100 patients receiving atorvastatin 80 mg / day for 48 weeks;
  • Group 2 STEMI - 100 patients receiving atorvastatin 20 mg / day for 48 weeks Planned number of patients: Pre-Screening - 300 subjects; screening and randomization - 200 subjects.

Patients will be randomized by random number generation to include in the group 1 or 2. All included patients will be on the standard basis therapy of the coronary artery disease, according to the national recommendation.

Read the detailed description
  1. Hypotheses:
  2. Atorvastatin therapy directly results in improved deformation characteristics of hibernating myocardium due to its pleiotropic effects on endothelial dysfunction and atherosclerotic plaque stability, as well as stimulation of angiogenesis in ischemic zones of myocardium.
  3. Long-term atorvastatin therapy improves the morphofunctional properties of large arteries and decreases the severity of endothelial dysfunction in patients with a history of myocardial infarction.
  4. Atorvastatin causes an anti-ischemic effect, if used for a long time. 2.1. Primary objective To evaluate the effect of atorvastatin, when started between 24 and 96 hours after disease onset, on the parameters of global and regional myocardial deformation in the zone of infarction, as well as morphofunctional properties of arteries, on Day 7 and Weeks 12, 24, 36 and 48 of the treatment; 2.2. Secondary objectives. To evaluate:
  • the effect of treatment on the parameters of global and regional myocardial deformation in the zone of intact myocardium on Day 7 and Weeks 12, 24, 36 and 48 of the treatment;
  • the effect of treatment on the parameters of global and regional myocardial deformation depending on TIMI blood flow grade;
  • the effect of treatment on systolic and diastolic function of the left ventricle in patients with impaired left ventricular function at baseline, as well as the ability of this treatment to prevent deterioration of left ventricular function in patients with normal left ventricular function at baseline;
  • the effect of treatment on heart failure development and progression as assessed using the corresponding clinical diagnostic criteria;
  • the effect of treatment on duration and time course of myocardial ischemia using 24 hour ECG monitoring on Day 7 and Weeks 12, 24, 36 and 48 of treatment;
  • the effect of treatment on the appearance of new prognostically significant disorders of cardiac rhythm;
  • the effect of treatment on pulse wave velocity and cardio-ankle vascular index (CAVI);
  • the effect of treatment on intima-media thickness (IMT);
  • the effect of treatment on the results of automated quantitative vascular elasticity measurements, pulse wave and pulse pressure;
  • the effect of treatment on endothelial function using the reactive hyperemia test;
  • the effect of treatment on the time course of blood chemistry parameters (i.e., total cholesterol, HDL, LDL, triglycerides, creatinine, C-reactive protein (CRP), alanine transaminase (ALT), aspartate transaminase (AST) and creatinkinase (CK);
  • the safety of treatment;
  • the effect of treatment on patient's well-being and quality of life;
  • patient compliance with the therapy. 2.3. Scientific novelty of the study It is planned to study, for the first time, the effect of long-term aggressive statin therapy on the functional status of myocardium in the zone of ischemia, lesion and necrosis in patients with STEMI using the two-dimensional strain procedure.

It is planned, for the first time, to comprehensively study the effect of aggressive statin therapy on the status of vasculature, with measuring multiple parameters characterizing the morphofunctional status of elastic and muscular arteries in patients with documented coronary heart disease (CHD).

2.4. Clinical significance of study results. If the proposed hypotheses are confirmed after the primary endpoints described in Section 3 have been reached, new convincing evidence supporting the use of long-term aggressive treatment with Atorvastatin starting from the early stages of myocardial infarction will be obtained. Obviously, the clinical benefits will include the improved prognosis and decreased risk of repeated vascular events. Favorable effects of this therapy on the morphofunctional status of arterial vasculature will play an important role in the treatment of these patients. Positive results of this study can form the basis for planning and conducting larger studies on pleiotropic effects of Atorvastatin in patients with a history of myocardial infarction.

  1. Primary endpoints
  2. Statistically significant differences in spatial and velocity parameters of myocardial deformation in the zone of previous STEMI as compared to controls.
  3. Statistically significant differences in spatial and velocity parameters of myocardial deformation in the intact zone after STEMI as compared to controls.
  4. Statistically significant differences in intima-media thickness (IMT) according to echo tracking data as compared to controls.
  5. Statistically significant differences in carotid-femoral pulse wave velocity and CAVI as compared to controls.
  6. Planning and conducting the study. It is planned to include 200 patients in this randomized, open-label, single-center, prospective, controlled clinical study; these patients will be recruited at the Department of Therapy of the Penza State University Medical Institute.

4.1. Allocation to study groups:

Patients with STEMI will be included in this study:

Group 1: 100 patients with STEMI to receive atorvastatin at a dose of 80 mg per day for 48 weeks; Group 2: 100 patients with STEMI to receive atorvastatin at a dose of 20 mg per day for 48 weeks.

4.2. Planned number of patients: Prescreening - 300 patients; screening and randomization - 200 patients.

4.3. Study design. Patients will be randomized using sealed envelopes numbered with increasing serial numbers from 1 to 200; each envelope will contain information about patient inclusion into Group 1 or Group 2. Information about treatment schedule and dosing regimen will be provided separately.

4.3.1. Treatment regimen, dose titration strategy and combination treatment principles Patients meeting the inclusion criteria and not meeting the exclusion criteria will be included in the study.

Group A patients will start the treatment between 24 and 96 hours after the onset of STEMI:

  • Atorvastatin at a dose of 80 mg per day.

Group K patients will start the treatment between 24 and 96 hours after the onset of STEMI:

  • Atorvastatin at a dose of 20 mg per day.
Being tested
Atorvastatin
Keywords
STEMI, myocardial strain, atorvastatin
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.

Study groups in NCT02590653
Study groupRoleWhat they receive
Group AExperimentalGroup A patients will start atorvastatin at a dose of 80 mg/day between 24 and 96 hours after the onset of STEMI
Receives: Drug: Atorvastatin
Group KActive comparatorGroup K patients will start atorvastatin at a dose of 20 mg/day between 24 and 96 hours after the onset of STEMI
Receives: Drug: Atorvastatin

What is being measured

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

  1. Cardiovascular events

    Myocardial infarction, Unstable angina, Cardiac death

    Measured: 2 years

Secondary outcomes (5)
  1. Global myocardial strain in the zone of previous STEMI and in the intact zone after STEMI

    two-dimensional strain

    Measured: 2 years

  2. Global myocardial strain rate in the zone of previous STEMI and in the intact zone after STEMI

    two-dimensional strain

    Measured: 2 years

  3. Intima-media thickness of carotid artery

    echo-tracking

    Measured: 2 years

  4. Carotid-femoral pulse wave velocity

    Applanation tonometry

    Measured: 2 years

  5. Cardiac-ankle vascular index

    Volume sphygmography

    Measured: 2 years

Timeline

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

  1. First posted29 Oct 2015 (estimated)
  2. Study startOct 2014
  3. Primary completionDec 2019
  4. Study completionFeb 2020

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
200 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02590653
Sponsor's protocol ID
PSU/T-253
Acronym
CONTRAST
Status last verified
Mar 2020
First submitted
22 Oct 2015
Last updated
24 Mar 2020
Results posted
No
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Atorvastatin in people with Myocardial Infarction, run by Penza State University at 1 site in Russia.

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 5 inclusion and 22 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 24 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Russia. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Cardiovascular events (time frame: 2 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 24 Mar 2020.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in