A Phase 4 interventional study of Dipyridamole and placebo in Cardiovascular Disease and Ischemic Heart Disease, sponsored by Radboud University Medical Center. Completed at 1 site in Netherlands. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2013-01-10.
Sponsored by Radboud University Medical Center · Phase 4, Interventional, and Prevention
Rationale:
Due to western lifestyle human coronary arteries are prone to develop atherosclerotic plaques. Hence the heart is an important target organ for atherothrombotic complications: myocardial ischemia, arrhythmias, myocardial infarction and heart failure. To alleviate symptoms and decrease mortality in these patients, myocardial revascularisation is recommended. Coronary artery bypass grafting (CABG) is indicated in patients with severe atherosclerotic disease of all three coronary arteries or the left main stem coronary artery. Cardiac ischemia and reperfusion injury during CABG is inevitable and jointly accountable for complications that occur after CABG (e.g. death, myocardial infarction, arrhythmias, stroke, or renal complications). Dipyridamole has been shown to reduce ischemia reperfusion injury in healthy volunteers using an intermediate endpoint and may prevent cardiovascular death or event in secondary prevention after cerebrovascular disease. The investigators hypothesise that oral pre-treatment with dipyridamole can increase cardiac tissue tolerance against ischemia and reperfusion injury due to CABG. The investigators expect lower troponin-I release in patients who were pretreated with dipyridamole.
Objective: To study the effect of oral pretreatment with dipyridamole on high sensitivity (HS)-troponin-I release after CABG. Secondary objectives are whether oral pretreatment with dipyridamole reduces postoperative CABG arrhythmias, prolonged inotropic support, and duration of Intensive Care-stay. Further secondary endpoints are the effects of dipyridamole pretreatment on renal injury and post-ischemic recovery of contractile function (measured ex-vivo).
Hypothesis:
The investigators hypothesize that oral pre-treatment with dipyridamole can increase cardiac tissue tolerance against ischemia and reperfusion injury. The investigators expect lower HS-troponin-I release in patients who were pretreated with dipyridamole. Additionally the investigators expect the incidence of arrhythmias, need for prolonged inotropic support (longer than 24 hours postoperative) to be decreased in pretreated patients.
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This study's enrollment of 95 is close to the median of 100 across 2,738 interventional studies indexed under Cardiovascular Diseases.
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Exclusion Criteria:
Drug: placebo
Drug: Dipyridamole
prior to CABG surgery 3 day treatment with dipyridamole 200mg SR twice daily
Also known as: persantin
prior to CABG surgery 3 day treatment with placebo capsules twice daily
HS-troponin-I
high sensitivity cardiac troponin-I
Time frame: within 72 hours after CABG.
duration of inotropic support
Time frame: within three days after CABG
duration of IC stay
Time frame: within three days after CABG
drain production
thoracic drain production after CABG
Time frame: 24 hours after surgery and total drain production within three days after surgery
post-ischemic recovery of contractile function
The right atrial appendage is harvested during cardiac surgery before the introduction of the extracorporal circulation. Two atrial trabeculae are dissected, suspended in an organ bath, and linked to a force transducer. after equilibration and baseline measurement, simulated ischemia and reperfusion influences contractile force recovery
Time frame: until 4 hours after harvesting
Renal damage
biomarkers for renal failure will be detemined in blood and urine before and after CABG
Time frame: Within three days after CABG
This study is completed, as verified in Jan 2013. You cannot join it, but the record below documents what was studied.
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Radboud University Medical Center