Myocardial InfarctionPhase 4RESTORENCT04493840
Randomized Evaluation of Shenfu Injection to Reduce Myocardial Injury
A Phase 4 study testing Shenfu Injection and 5% Glucose Injection in people with Myocardial Infarction, run by Beijing Anzhen Hospital at 1 site in China.
Trial summary
This study aims to evaluate whether perioperative use of Shenfu Injection, as compared to placebo, could reduce infarct size assessed by cardiac magnetic resonance (CMR) in patients with acute anterior ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Myocardial Infarction
- What is being tested?
- Shenfu Injection and 5% Glucose Injection
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 326 participants
- Where
- 1 siteChina
- Study dates
- 30 Jul 2020to 31 Aug 2022
- 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 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age ≥18 and <75 years.
- First-time acute anterior STEMI scheduled for primary PCI.
- ST segment elevation in at least two contiguous precordial leads according to electrocardiogram (>30 min).
- Symptoms onset ≤12 hours.
- The presence of proximal or middle left anterior descending branch (LAD) occlusion with pre-PCI TIMI flow 0 or 1 according to baseline coronary angiogram.
- Written informed consent.
Who cannot join
- Cardiogenic shock, serious heart failure (Killip class III or above), malignant ventricular arrhythmia, or mechanical complications.
- Post cardiopulmonary resuscitation (CPR) (including cardioversion).
- Patients who have received thrombolytic therapy or upstream GPIIb/IIIa inhibitors (GPI).
- Uncontrolled hypertension (systolic BP ≥180 mm Hg or a diastolic BP ≥110 mmHg).
- Prior myocardial infarction, PCI or coronary artery bypass graft.
- Known severe hepatic insufficiency (AST/ALT >3-fold the upper limit of normal value) or known renal insufficiency.
Show all 16Show fewer
- Malignant tumor, lymphoma, HIV-positive, or cirrhosis with life expectancy <1 year.
- Patients with active bleeding, intracranial hemorrhage, major surgery or trauma within 1 months, or ischemic stroke or transient ischemic attack (TIA) within 6 months.
- History of anemia (hemoglobin<90g/L) or thrombocytopenia (thrombocyte<100×109/L).
- Patients who require simultaneous intervention of left main disease during primary PCI or those with multi-vessel disease who plan to intervene in non-culprit vessels within 7 days (simultaneous or staged).
- Scheduled for CABG within one month after randomization.
- Pregnancy, lactation, or potentially fertile women.
- Patients who have known to be allergic to Shenfu Injection or its components or patients with serious adverse effect.
- Patients with contraindication to CMR (metal foreign body in the body, claustrophobia, etc.).
- Participation in other clinical trial in recent 3 months.
- Patients who cannot complete this trial or comply with the protocol.
Trial locations and contacts
1 site in 1 country.
China1 site, 1 recruiting
- Recruiting
Beijing Anzhen Hospital, Capital Medical University
Beijing
Shao-Ping Nie, MD, PhD, 86-10-84005256, spnie@ccmu.edu.cn
Xiao Wang, MD, 86-10-84005255, spaceeye123@126.com
About this study
Official title: Effect of Shenfu Injection on Myocardial Injury in Patients With Acute ST Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention: A Multicenter, Randomized, Double-Blinded, Parallel-Group, Placebo-Controlled Clinical Trial
This study aims to evaluate whether perioperative use of Shenfu Injection, as compared to placebo, could reduce infarct size assessed by cardiac magnetic resonance (CMR) in patients with acute anterior ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
Read the detailed description
Shenfu injection is a traditional Chinese medicine formulation containing ginseng (Panax; family: Araliaceae) and aconite (Radix aconiti lateralis preparata, Aconitum carmichaeli Debx; family: Ranunculaceae) with Ginsenosides and aconite alkaloids as the main active ingredients. Its quality is strictly controlled in compliance with the standard of the China Ministry of Public Health (official approval code: certification number Z20043117; No. 110804, Ya'an, China). Animal studies have shown that Shenfu injection has protective effects against reperfusion injury through multiple pharmacologic effects, including scavenging free radicals, inhibiting inflammatory mediators, suppressing cell apoptosis, and inhibiting calcium overload. However, few data are available regarding its efficacy in humans. We aimed to determine whether perioperative use of Shenfu injection, as compared to placebo, might reduce infarct size in patients with STEMI undergoing primary PCI.
- Conditions
- Myocardial Infarction
- Being tested
- Shenfu Injection, 5% Glucose Injection
- Medical subject headings
- Myocardial Infarction
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Shenfu InjectionDrug
80ml Shenfu Injection + 70ml 5% glucose injection, ivdrip, within 30 minutes before PCI and 1 to 5 days (once a day) after PCI (6 times in total). Drug titration time should be no less than 30 minutes.
5% Glucose InjectionDrug
150 ml 5% glucose injection, ivdrip, within 30 minutes before PCI and 1 to 5 days (once a day) after PCI (6 times in total). Drug titration time should be no less than 30 minutes.
| Study group | Role | What they receive |
|---|---|---|
| Shenfu Injection | Experimental | Not described Receives: Drug: Shenfu Injection |
| 5% Glucose Injection | Placebo comparator | Not described Receives: Drug: 5% Glucose Injection |
What is being measured
The primary outcome is the main question the study is designed to answer.
Infarct size (% of left ventricular mass)
Infarct size was assessed by performing CMR imaging at 5±2 days after PCI
Measured: 5±2 days after PCI
Secondary outcomes (16)
Microvascular obstruction (% of left ventricular mass)
Measured: 5±2 days after PCI
Intramyocardial hemorrhage (% of left ventricular mass)
Measured: 5±2 days after PCI
Area under the curve (AUC) of creatine kinase isoenzyme (CK-MB)
Measured: Immediately after admission (0 hour), and 6, 12, 18, 24, 48, and 72 hours after PCI
AUC of cardiac troponin I
Measured: Immediately after admission (0 hour), and 6, 12, 18, 24, 48, and 72 hours after PCI
Peak value of CK-MB and cTnI
Measured: 72 hours after PCI
ST segment resolution (%) according to ECG
Measured: 24 hours after PCI
TIMI flow grade
Measured: Immediately after PCI
Corrected TIMI frame count (CTFC)
Measured: Immediately after PCI
TIMI myocardial perfusion grade (TMPG)
Measured: Immediately after PCI
Myocardial salvage index
Measured: 5±2 days after PCI
Area at risk (myocardial edema, % of left ventricular mass)
Measured: 5±2 days after PCI
Left ventricular end-diastolic volume (LVEDV)
Measured: 5±2 days after PCI
Left ventricular end-systolic volume (LVESV)
Measured: 5±2 days after PCI
Left ventricular ejection fraction (LVEF)
Measured: 5±2 days after PCI
Major adverse cardiovascular and cerebrovascular events (MACCE, including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, emergency revascularization)
Measured: 30 days after PCI
Individual events (including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, emergency revascularization, re-hospitalization for heart failure)
Measured: 30 days after PCI
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Jul 2020
- Study start30 Jul 2020
- Primary completion31 Jul 2022 (estimated)
- Study completion31 Aug 2022 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Myocardial InfarctionStudies of the same condition, open and under way.
- More trials run by Beijing Anzhen 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
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 326 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Beijing Anzhen Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Shao-Ping Nie, Beijing Anzhen Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04493840
- Sponsor's protocol ID
- 2019013
- Acronym
- RESTORE
- Status last verified
- Sep 2021
- First submitted
- 23 Jul 2020
- Last updated
- 10 Sep 2021
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Wang X, Guo R, Guo Y, Guo Q, Yan Y, Gong W, Zheng W, Wang H, Xu L, Ai H, Que B, Yan X, Ma X, Nie S. Rationale and design of the RESTORE trial: A multicenter, randomized, double-blinded, parallel-group, placebo-controlled trial to evaluate the effect of Shenfu injection on myocardial injury in STEMI patients after primary PCI. Am Heart J. 2023 Jun;260:9-17. doi: 10.1016/j.ahj.2023.02.005. Epub 2023 Feb 22.
PubMed 36822255
Study at a glance
From the registry record, last updated by the sponsor on 10 Sep 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Shenfu Injection on Myocardial Injury in Patients With Acute ST Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention: A Multicenter, Randomized, Double-Blinded, Parallel-Group, Placebo-Controlled Clinical Trial
- ClinicalTrials.gov ID
- NCT04493840
- Acronym / sponsor ID
- RESTORE / 2019013
- Conditions
- Myocardial Infarction
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 326 participants (estimated)
- Lead sponsor
- Beijing Anzhen HospitalUniversity, hospital or other
- Study start
- 30 Jul 2020 (actual)
- Primary completion
- 31 Jul 2022 (estimated)
- Study completion
- 31 Aug 2022 (estimated)
- First posted
- 30 Jul 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to evaluate whether perioperative use of Shenfu Injection, as compared to placebo, could reduce infarct size assessed by cardiac magnetic resonance (CMR) in patients with acute anterior ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
Detailed description
Shenfu injection is a traditional Chinese medicine formulation containing ginseng (Panax; family: Araliaceae) and aconite (Radix aconiti lateralis preparata, Aconitum carmichaeli Debx; family: Ranunculaceae) with Ginsenosides and aconite alkaloids as the main active ingredients. Its quality is strictly controlled in compliance with the standard of the China Ministry of Public Health (official approval code: certification number Z20043117; No. 110804, Ya'an, China). Animal studies have shown that Shenfu injection has protective effects against reperfusion injury through multiple pharmacologic effects, including scavenging free radicals, inhibiting inflammatory mediators, suppressing cell apoptosis, and inhibiting calcium overload. However, few data are available regarding its efficacy in humans. We aimed to determine whether perioperative use of Shenfu injection, as compared to placebo, might reduce infarct size in patients with STEMI undergoing primary PCI.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Shenfu Injection | Experimental | Drug: Shenfu Injection |
| 5% Glucose Injection | Placebo comparator | Drug: 5% Glucose Injection |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Age ≥18 and <75 years.
- First-time acute anterior STEMI scheduled for primary PCI.
- ST segment elevation in at least two contiguous precordial leads according to electrocardiogram (>30 min).
- Symptoms onset ≤12 hours.
- The presence of proximal or middle left anterior descending branch (LAD) occlusion with pre-PCI TIMI flow 0 or 1 according to baseline coronary angiogram.
Key exclusion criteria (16 listed)
- Cardiogenic shock, serious heart failure (Killip class III or above), malignant ventricular arrhythmia, or mechanical complications.
- Post cardiopulmonary resuscitation (CPR) (including cardioversion).
- Patients who have received thrombolytic therapy or upstream GPIIb/IIIa inhibitors (GPI).
- Uncontrolled hypertension (systolic BP ≥180 mm Hg or a diastolic BP ≥110 mmHg).
- Prior myocardial infarction, PCI or coronary artery bypass graft.
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 |
|---|---|---|
| Shenfu Injection80ml Shenfu Injection + 70ml 5% glucose injection, ivdrip, within 30 minutes before PCI and 1 to 5 days (once a day) after PCI (6 times in total). Drug titration time should be no less than 30 minutes. | Drug | Shenfu Injection |
| 5% Glucose Injection150 ml 5% glucose injection, ivdrip, within 30 minutes before PCI and 1 to 5 days (once a day) after PCI (6 times in total). Drug titration time should be no less than 30 minutes. | Drug | 5% Glucose Injection |
Primary outcome
Infarct size (% of left ventricular mass)
Time frame: 5±2 days after PCI
Infarct size was assessed by performing CMR imaging at 5±2 days after PCI
16 secondary outcomes
Microvascular obstruction (% of left ventricular mass)
Time frame: 5±2 days after PCI
Intramyocardial hemorrhage (% of left ventricular mass)
Time frame: 5±2 days after PCI
Area under the curve (AUC) of creatine kinase isoenzyme (CK-MB)
Time frame: Immediately after admission (0 hour), and 6, 12, 18, 24, 48, and 72 hours after PCI
AUC of cardiac troponin I
Time frame: Immediately after admission (0 hour), and 6, 12, 18, 24, 48, and 72 hours after PCI
Peak value of CK-MB and cTnI
Time frame: 72 hours after PCI
ST segment resolution (%) according to ECG
Time frame: 24 hours after PCI
TIMI flow grade
Time frame: Immediately after PCI
Corrected TIMI frame count (CTFC)
Time frame: Immediately after PCI
TIMI myocardial perfusion grade (TMPG)
Time frame: Immediately after PCI
Myocardial salvage index
Time frame: 5±2 days after PCI
Area at risk (myocardial edema, % of left ventricular mass)
Time frame: 5±2 days after PCI
Left ventricular end-diastolic volume (LVEDV)
Time frame: 5±2 days after PCI
Left ventricular end-systolic volume (LVESV)
Time frame: 5±2 days after PCI
Left ventricular ejection fraction (LVEF)
Time frame: 5±2 days after PCI
Major adverse cardiovascular and cerebrovascular events (MACCE, including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, emergency revascularization)
Time frame: 30 days after PCI
Individual events (including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, emergency revascularization, re-hospitalization for heart failure)
Time frame: 30 days after PCI
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Sep 2021.
- Derived from this study: PubMed 36822255Wang X, Guo R, Guo Y, Guo Q, Yan Y, Gong W, Zheng W, Wang H, Xu L, Ai H, Que B, Yan X, Ma X, Nie S. Rationale and design of the RESTORE trial: A multicenter, randomized, double-blinded, parallel-group, placebo-controlled trial to evaluate the effect of Shenfu injection on myocardial injury in STEMI patients after primary PCI. Am Heart J. 2023 Jun;260:9-17. doi: 10.1016/j.ahj.2023.02.005. Epub 2023 Feb 22.
Related trials for Myocardial Infarction
Not yet recruitingPhase 4
Roxadustat and Myocardial Injury After Off-Pump Coronary Artery Bypass Surgery
Coronary Artery Disease, Coronary Artery Bypass Grafting
Active, not recruitingObservational study
A Longitudinal Cohort Study to Evaluate Cardiovascular Risk Factors and Disease in Haiti
Hypertension, Diabetes
Active, not recruitingPhase 3
A Study of Inclisiran to Prevent Cardiovascular Events in High-risk Primary Prevention Patients.
Primary Prevention of Atherosclerotic Cardiovascular Disease
Enrolling by invitation
The DANE-HEART Trial - Computed Tomography Coronary Angiography for Primary Prevention
Coronary Atherosclerosis and Other Heart Disease, Cardiovascular Diseases
Not yet recruitingObservational study
Elicit Drugs in Myocardial Infarction
Young Patients With Acute Myocardial Infarction
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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Shenfu Injection and 5% Glucose Injection in people with Myocardial Infarction, run by Beijing Anzhen Hospital at 1 site in China.
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 16 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: status not confirmed, as of the sponsor's last update on 10 Sep 2021. 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 China. 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. Some participants in this study may receive a placebo. 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?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Shao-Ping Nie, MD, PhD (86-10-84005256, spnie@ccmu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Infarct size (% of left ventricular mass) (time frame: 5±2 days after PCI). 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 NCT04493840, 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 10 Sep 2021.