Japan-Working Groups of Acute Myocardial Infarction for the Reduction of Necrotic Damage by a K-ATP
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Purpose
To evaluate whether nicorandil as an adjunctive therapy for AMI reduces myocardial infarct size and improves regional wall motion
| Condition | Intervention |
|---|---|
|
Acute Myocardial Infarction |
Drug: nicorandil Drug: placebo |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Japan-Working Groups of Acute Myocardial Infarction for the Reduction of Necrotic Damage by a K-ATP |
- estimated infarct size [ Time Frame: 72hrs ]
- left ventricular function (left ventricular ejection fraction and end-diastolic volume) and regional wall motion [ Time Frame: 2-8weeks and 6-12months ]
- survival rate [ Time Frame: 2.7years (median follow-up) ]
- cardiovascular events (ie, cardiac death, nonfatal re-infarction, re-hospitalization because of cardiac disease, revascularization) [ Time Frame: 2.7years (median follow-up) ]
- reperfusion injury (ie, malignant ventricular arrhythmia during reperfusion periods, re-elevation of ST-segment, worsening of chest pain) [ Time Frame: 24hrs ]
- the association of SNPs of ANP-related genes with response to ANP treatment [ Time Frame: 2.7years (median follow-up) ]
| Estimated Enrollment: | 600 |
| Study Start Date: | October 2001 |
| Study Completion Date: | December 2005 |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: 1 |
Drug: nicorandil
(0∙067 mg/kg as a bolus, followed by 1∙67 μg/kg per min as a 24-h continuous intravenous infusion
|
| Placebo Comparator: 2 |
Drug: placebo
Control
|
Detailed Description:
The benefits of percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) are limited by reperfusion injury. In animal models, nicorandil, a hybrid of an ATP-sensitive K+ (KATP) channel opener and nitrates, reduces infarct size, so the Japan-Working groups of acute myocardial Infarction for the reduction of Necrotic Damage by a K-ATP channel opener (J-WIND-KATP) designed a prospective, randomized, multicenter study to evaluate whether nicorandil reduces myocardial infarct size and improves regional wall motion when used as an adjunctive therapy for AMI.
Twenty-six hospitals in Japan are participating in the J-WIND-KATP study. Patients with AMI who are candidates for PCI are randomly allocated to receive either intravenous nicorandil or placebo. The primary end-points are (1) estimated infarct size and (2) left ventricular function. Single nucleotide polymorphisms (SNPs) that may be associated with the function of KATP-channel and the susceptibility of AMI to the drug will be examined. Furthermore, a data mining method will be used to design the optimal combined therapy for post-myocardial infarction (MI) patients.
It is intended that J-WIND-KATP will provide important data on the effects of nicorandil as an adjunct to PCI for AMI and that the SNPs information that will open the field of tailor-made therapy. The optimal therapeutic drug combination will also be determined for post-MI patients.
Eligibility| Ages Eligible for Study: | 20 Years to 79 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age 20-79 years
- Chest pain of more than 30 min
- 0.1 mV ST-segment elevation in 2 contiguous ECG leads
- Admission to hospital within 12 h of symptom onset
- First episode of AMI
- Candidates for PCI
Exclusion Criteria:
- History of old myocardial infarction
- Left main coronary artery stenosis
- Severe liver and/or kidney dysfunction
- Suspected aortic dissection
- History of coronary artery bypass graft
- History of allergic response to drugs
- Severe hypovolemia
- Right ventricular infarction
Contacts and Locations| Japan | |
| National Cardiovascular Center | |
| Suita, Osaka, Japan, 565-8565 | |
| Study Chair: | Masafumi Kitakaze, MD, PhD | National Cerebral and Cardiovascular Center |
More Information
Publications:
| ClinicalTrials.gov Identifier: | NCT00212030 History of Changes |
| Other Study ID Numbers: | CSSCJ-2, UMIN_ID:C000000089 |
| Study First Received: | September 13, 2005 |
| Last Updated: | October 31, 2007 |
| Health Authority: | Japan: Ministry of Health, Labor and Welfare |
Keywords provided by National Cerebral and Cardiovascular Center:
|
Acute myocardial infarction Data mining Nicorandil Randomized clinical trial SNPs |
Additional relevant MeSH terms:
|
Infarction Myocardial Infarction Ischemia Pathologic Processes Necrosis Myocardial Ischemia Heart Diseases Cardiovascular Diseases Vascular Diseases Nicorandil Anti-Arrhythmia Agents |
Cardiovascular Agents Therapeutic Uses Pharmacologic Actions Antihypertensive Agents Vasodilator Agents Vitamin B Complex Vitamins Micronutrients Growth Substances Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 23, 2013