Unique ID issued by UMIN | UMIN000010091 |
---|---|
Receipt number | R000011818 |
Scientific Title | A prospective randomized clinical trial, the effect of long acting CCBs in post-acute myocardial infarction patients |
Date of disclosure of the study information | 2013/02/21 |
Last modified on | 2022/09/24 14:54:28 |
A prospective randomized clinical trial, the effect of long acting CCBs in post-acute myocardial infarction patients
ACROSS-AMI (ACh-induced Coronary Spasm Study - Nifedipine and Benidipine After Acute Myocardial Infarction)
A prospective randomized clinical trial, the effect of long acting CCBs in post-acute myocardial infarction patients
ACROSS-AMI (ACh-induced Coronary Spasm Study - Nifedipine and Benidipine After Acute Myocardial Infarction)
Japan |
ST-segment elevation myocardial infarction(STEMI) or non-ST elevation myocardial infarction(NSTEMI)
Medicine in general | Cardiology |
Others
NO
To investigate the inhibitory effect of CCBs (Nifedipine / Adalat CR or Benidipine / Coniel) on coronary spasm and coronary endothelial dysfunction.
Safety,Efficacy
Exploratory
Pragmatic
Phase IV
A rate of changes in ACh-provoked coronary constrictive response and degree of coronary vascular tone at the follow up CAG, 6-12 months after onset.
(1)Incidence of coronary spasm at the 2nd ACh-provocation test
(2)Change in biomarkers
(3)Cardiovascular events(cardiovascular death, non-fatal MI, UAP, rehospitalization for heart failure, re-PCI etc)
(4)Adverse effects
(5)Coronary lesion finding by OCT(if possible)
Interventional
Parallel
Randomized
Individual
Open -no one is blinded
Active
YES
YES
Institution is considered as a block.
YES
Central registration
5
Treatment
Medicine |
ACh-provocation test positive / Nifedipine arm
ACh-provocation test positive / Benidipine arm
ACh-provocation test negative / Control arm
ACh-provocation test negative / Nifedipine arm
ACh-provocation test negative / Benidipine arm
20 | years-old | <= |
85 | years-old | > |
Male and Female
1) Patients that ACh-provocation test was performed within 2 weeks after hospitalization and no PCI-needed residual lesions were observed at discharge
2) Age: 20-85 years old
3) Patients that written informed consents were obtained
Patients with
1) Unstable angina (UAP)
2) Triple vessel disease
3) Left ventricular ejection fraction <40%
4) Chronic atrial fibrillation
5) Severe hepatic dysfunction
6) Low tolerability of DHP-CCB
7) A history of DES implantation
8) Patients who were recognized by the chief physician to be inappropriate for study participation
160
1st name | Hisao |
Middle name | |
Last name | Ogawa |
Graduate School of Medical Sciences, Kumamoto University
Department of Cardiovascular Medicine
860-8556
1-1-1, Honjo, Chuo-ku, Kumamoto
096-373-5175
ogawah@kumamoto-u.ac.jp
1st name | Koichi |
Middle name | |
Last name | Kaikita |
Graduate School of Medical Sciences, Kumamoto University
Department of Cardiovascular Medicine
860-8556
1-1-1, Honjo, Chuo-ku, Kumamoto
096-373-5175
kaikitak@kumamoto-u.ac.jp
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
Bayer Yakuhin Ltd.
Profit organization
Institutional Review Board
1-1-1, Honjo, Chuo-ku, Kumamoto
096-373-5657
iyg-igaku@jimu.kumamoto-u.ac.jp
NO
熊本大学医学部附属病院(熊本県)
済生会熊本病院(熊本県)
横浜市立大学市民総合医療センター(神奈川県)
愛媛県立新居浜病院(愛媛県)
国立循環器病研究センター(大阪府)
日本医科大学千葉北総病院(千葉県)
昭和大学藤が丘病院(神奈川県)
広島鉄道病院(広島県)
東京女子医大八千代医療センター(千葉県)
心臓血管研究所付属病院(東京都)
2013 | Year | 02 | Month | 21 | Day |
None
Unpublished
None
97
There were no significant differences in the baseline clinical characteristics except younger age in nifedipine compared with benidipine groups.
In age-adjusted model, the difference of dilator response to ISDN between initial and follow-up ACh tests was almost identical between 2 groups. However, the difference of constrictor response to ACh was significantly improved in the nifedipine rather than benidipine groups.
2022 | Year | 09 | Month | 24 | Day |
There were no significant differences in baseline clinical characteristics except younger age in nifedipine compared with benidipine groups.
ACROSS-AMI study is an open label, multicenter study of 97 consecutive AMI patients who underwent percutaneous coronary intervention (PCI) and had no residual stenosis in major left coronary artery (LCA). The 84 AMI patients who were positive for initial acetylcholine (ACh) provocation test in LCA (LACh) 1-2 weeks post-MI were randomized into 2 groups treated with nifedipine (N=43) and benidipine (N=41). After exclusion of 14 patients, data of 70 AMI patients [nifedipine (N=35) and benidipine (N=35)] were eligible for the present analysis.
In studies 1 and 2, the nifedipine group (studies 1 + 2: 48 subjects) had hypotension (1 patient, 2.1%), headache (1 patient, 2.1%), edema (1 patient, 2.1%), A dull headache (1 patient, 2.1%) was observed, and an adverse event of skin eruption (1 patient, 2.3%) was observed in the benidipine group (Study 1: 43 patient).
The primary end point is the changes in coronary vasodilator response to ISDN and vasoconstrictor response to ACh by using QCA between ACh provocation test 2 weeks and 6-9 months after AMI. Coronary vasodilator response to ISDN and Coronary vasoconstrictor response to ACh were calculated by the following formula.
Completed
2013 | Year | 01 | Month | 16 | Day |
2013 | Year | 12 | Month | 03 | Day |
2013 | Year | 08 | Month | 07 | Day |
2017 | Year | 05 | Month | 31 | Day |
2013 | Year | 02 | Month | 21 | Day |
2022 | Year | 09 | Month | 24 | Day |
Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000011818