Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Trial Review
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Download to PDF
Trial registered on ANZCTR
Registration number
ACTRN12610000203055
Ethics application status
Approved
Date submitted
9/03/2010
Date registered
10/03/2010
Date last updated
10/03/2010
Type of registration
Retrospectively registered
Titles & IDs
Public title
Randomized Controlled Study of L-Arginine Blood Cardioplegia Administration in Patients with Reduced Left Ventricular Function Undergoing Coronary Artery Bypass Graft Surgery
Query!
Scientific title
Randomized Controlled Study of L-Arginine Blood Cardioplegia and its effects upon cardiac troponin release following Coronary Artery Bypass Graft Surgery in Patients with Reduced Left Ventricular Function
Query!
Secondary ID [1]
1473
0
None
Query!
Universal Trial Number (UTN)
Query!
Trial acronym
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Ischaemic cardiomyopathy requiring coronary artery surgery
256928
0
Query!
Condition category
Condition code
Cardiovascular
257075
257075
0
0
Query!
Coronary heart disease
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
Patients are randomized to receive either blood cardiplegaia, (which is the drug which is used to create myocardial standstill and myocardial protection during cardiac surgery) or to receive blood cardioplegia with teh addition of L-arginine 15 g/l. It is administered directly into the coronary circulation (400 ml) about every 10 -20 mins from the heart lung machine for the duration of aortic cross clamping which averages about 90 min. The heart lung machine is responsible for the function of the heart and the lung while a patient is on cardiopulmonary bypass. It oxygenates the blood and pumps it around the body.
Query!
Intervention code [1]
256118
0
Treatment: Drugs
Query!
Comparator / control treatment
Standard blood cardioplegia, is a combination of blood and a crystalooid electrolyte solution high in potassium which is used to create myocardial standstill and myocardial protection during cardiac surgery). It is normally administered directly into the coronary circulation (400 ml) from the heart lung machine about every 10 -20 mins for the duration of aortic cross clamping which averages about 90 min.
Query!
Control group
Active
Query!
Outcomes
Primary outcome [1]
257968
0
Whole blood cardiac troponin I concentration measured by immunoassay, sampled from arterial blood at 15 min, 12 and 24 hr post aortic cross clamp removal
Query!
Assessment method [1]
257968
0
Query!
Timepoint [1]
257968
0
15 min, 12 and 24 hrs post aortic cross clamp removal
Query!
Secondary outcome [1]
263502
0
1. Markers of myocardial oxidative stress - Coronary sinus concentrations of malondialdehyde, superoxide dismutase, xanthine oxidase
Query!
Assessment method [1]
263502
0
Query!
Timepoint [1]
263502
0
5 and 15 min post aortic cross clamp removal
Query!
Secondary outcome [2]
263505
0
2. Myocardial lactic acid flux. - this is determined by measuring lactic acid levels by sampling 2 ml of arterial and coronary sinus blood on an ABL 700 series blood gas analyser (Radiometer, Copenhagen, Denmark). Lactate flux is then calculated by subtracting coronary sinus from arterial lactate concentration.
Query!
Assessment method [2]
263505
0
Query!
Timepoint [2]
263505
0
1, 5 and 15 min post aortic cross clamp removal
Query!
Secondary outcome [3]
263506
0
3. Cardiac function measured by transoesophageal echocardiography
Query!
Assessment method [3]
263506
0
Query!
Timepoint [3]
263506
0
Pre and post cardiopulmonary bypass
Query!
Eligibility
Key inclusion criteria
Adult male and female patients aged between 18-80 years of age scheduled for elective coronary artery bypass graft surgery requiring cardiopulmonary bypass and with left ventricular ejection fraction less than 30% as determined by preoperative transthoracic or transoesophageal echocardiography
Query!
Minimum age
18
Years
Query!
Query!
Maximum age
80
Years
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
patient refusal, renal impairment (creatinine >150 micromol/l), abnormal liver enzymes, allergy to L-arginine, a pre-operative requirement for other than coronary artery surgery, urgent coronary surgery for evolving myocardial infarction or a contraindication to transoesophageal echocardiography
Query!
Study design
Purpose of the study
Treatment
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Query!
Masking / blinding
Blinded (masking used)
Query!
Who is / are masked / blinded?
Query!
Query!
Query!
Query!
Intervention assignment
Parallel
Query!
Other design features
Query!
Phase
Phase 2 / Phase 3
Query!
Type of endpoint/s
Efficacy
Query!
Statistical methods / analysis
Query!
Recruitment
Recruitment status
Completed
Query!
Date of first participant enrolment
Anticipated
1/09/2005
Query!
Actual
Query!
Date of last participant enrolment
Anticipated
Query!
Actual
Query!
Date of last data collection
Anticipated
Query!
Actual
Query!
Sample size
Target
50
Query!
Accrual to date
Query!
Final
Query!
Recruitment in Australia
Recruitment state(s)
Query!
Funding & Sponsors
Funding source category [1]
256615
0
Other Collaborative groups
Query!
Name [1]
256615
0
Australian New Zealand College of Anaesthetists
Query!
Address [1]
256615
0
ANZCA House
630 St Kilda Road
Melbourne Vic 3004
Query!
Country [1]
256615
0
Australia
Query!
Primary sponsor type
Individual
Query!
Name
David Andrews
Query!
Address
Department of Anaesthesia and Pain Management
The Royal Melbourne Hospital
Grattan Street
Parkville, 3050
Victoria Australia
Query!
Country
Australia
Query!
Secondary sponsor category [1]
255905
0
None
Query!
Name [1]
255905
0
Query!
Address [1]
255905
0
Query!
Country [1]
255905
0
Query!
Ethics approval
Ethics application status
Approved
Query!
Ethics committee name [1]
258645
0
Human Research and Ethics Committee (HREC) The Royal Melbourne Hospital
Query!
Ethics committee address [1]
258645
0
Query!
Ethics committee country [1]
258645
0
Australia
Query!
Date submitted for ethics approval [1]
258645
0
Query!
Approval date [1]
258645
0
Query!
Ethics approval number [1]
258645
0
Query!
Summary
Brief summary
Aim We aim to detect any significant improvement in myocardial protection when L-arginine is added to standard blood cardioplegia. The study and control populations will consist of patients undergoing coronary artery graft surgery with pre-existing poor myocardial function. This group of individuals often have underlying ischaemia and frequently exhibit low output syndrome (LOS) post-cardiopulmonary bypass. Inadequate myocardial protection resulting in ischaemia-reperfusion injury may be a cause for LOS. As a consequence these patients require a high incidence of pharmacological and mechanical support and frequently experience a protracted stay in the intensive care unit (ICU). L-arginine has been shown to reduce reperfusion injury when added to cardioplegia. Our hypothesis is that effective prevention of ischaemia-reperfusion injury in the jeopardised myocardium leads to an improvement in myocardial preservation and a reduction in the complications that ensue. To prove this, we propose to conduct a randomised, double blind placebo control trial in which L-arginine is added to standard blood cardioplegia. Markers of reperfusion injury, myocyte damage, will be measured. Other markers will include cardiac function, inotrope use and length of ICU stay. Study design A prospective double blind randomised controlled trial of L-arginine cardioplegia administered to patients with known poor myocardial function undergoing coronary artery graft surgery. A minimum of fifty patients in total will be allocated into two groups according to a computer generated random sequence. Once randomization has occurred all participants in the patient’s management will remain blinded to group selection. The control group will receive standard blood cardioplegia technique; while the treatment group will receive L-arginine enriched blood cardioplegia. Endpoints 1. Indicators of cell death – systemic cardiac Troponin I levels pre-cardiopulmonary bypass at 15 min and 12 and 24hrs post aortic clamp removal. Serum Troponin I levels are a measure of myocardial cell death. 2. Markers of myocardial oxidative stress - coronary sinus concentrations of xanthine oxidase, superoxide dismutase and malondialdehyde pre-cardiopulmonary bypass at 5 and 15 minutes post removal of cross clamp. These are a measure of reperfusion injury. 3. Lactic Acid flux at 1 and 5 and 15 minutes post removal of cross clamp as a measure of myocardial aerobic reserve capacity. 3. Effect upon myocardial function - myocardial systolic and diastolic function as measured by intraoperative transoesophageal echocardiography.
Query!
Trial website
Query!
Trial related presentations / publications
Query!
Public notes
Query!
Contacts
Principal investigator
Name
30908
0
Query!
Address
30908
0
Query!
Country
30908
0
Query!
Phone
30908
0
Query!
Fax
30908
0
Query!
Email
30908
0
Query!
Contact person for public queries
Name
14155
0
Dr David Andrews
Query!
Address
14155
0
Department of Anaesthesia and Pain Management
The Royal Melbourne Hospital
Grattan Street
Parkville, 3050
Victoria Australia
Query!
Country
14155
0
Australia
Query!
Phone
14155
0
+613 9342 7540
Query!
Fax
14155
0
Query!
Email
14155
0
[email protected]
Query!
Contact person for scientific queries
Name
5083
0
Dr David Andrews
Query!
Address
5083
0
Department of Anaesthesia and Pain Management
The Royal Melbourne Hospital
Grattan Street
Parkville, 3050
Victoria Australia
Query!
Country
5083
0
Australia
Query!
Phone
5083
0
+613 9342 7540
Query!
Fax
5083
0
Query!
Email
5083
0
[email protected]
Query!
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF