A Trial of Routine Aspiration Thrombectomy With Percutaneous Coronary Intervention (PCI) Versus PCI Alone in Patients With ST-Segment Elevation Myocardial Infarction (STEMI) Undergoing Primary PCI (TOTAL)

This study is currently recruiting participants.
Verified May 2013 by Population Health Research Institute
Sponsor:
Information provided by (Responsible Party):
Dr. Sanjit S. Jolly, Population Health Research Institute
ClinicalTrials.gov Identifier:
NCT01149044
First received: June 22, 2010
Last updated: May 1, 2013
Last verified: May 2013
  Purpose

This is an international, randomized, controlled, parallel group study in which patients with ST-Segment Elevation Myocardial Infarction (STEMI) will be allocated to one of the following: Manual aspiration thrombectomy with Percutaneous Coronary Intervention (PCI) or PCI alone.


Condition Intervention
Acute Coronary Syndrome
ST Elevation Myocardial Infarction
Percutaneous Coronary Intervention
Procedure: Percutaneous Coronary Intervention with or without manual aspiration thrombectomy

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: TOTAL Trial: A Randomized Trial of Routine Aspiration ThrOmbecTomy With PCI Versus PCI ALone in Patients With STEMI Undergoing Primary PCI

Resource links provided by NLM:


Further study details as provided by Population Health Research Institute:

Primary Outcome Measures:
  • The first occurrence of cardiovascular death, recurrent myocardial infarction, cardiogenic shock, or new or worsening NYHA Class IV heart failure [ Time Frame: up to 180 days ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Stroke [ Time Frame: up to 30 days ] [ Designated as safety issue: Yes ]
  • Key Net Benefit Outcome: CV death, MI, stroke, cardiogenic shock or new or worsening NHYA Class IV heart failure [ Time Frame: up to 1 year ] [ Designated as safety issue: Yes ]
  • Cardiovascular Mortality [ Time Frame: up to 180 days ] [ Designated as safety issue: No ]

Other Outcome Measures:
  • Primary outcome at 30 days and 1 year [ Time Frame: up to 1 year ] [ Designated as safety issue: No ]
  • Components of primary outcome [ Time Frame: up to 1 year ] [ Designated as safety issue: No ]
    CV death, MI, cardiogenic shock or new or worsening class IV heart failure assessed separately at 30 days, 180 days and one year

  • All-cause mortality [ Time Frame: up to 1 year ] [ Designated as safety issue: No ]
    All-cause mortality at 30 days, 180 days and 1 year

  • Composite of CV death, MI, cardiogenic shock, or new or worsening NYHA class IV heart failure at 30 days, 180 days [ Time Frame: up to 180 days ] [ Designated as safety issue: No ]
    Composite of cardiovascular death, myocardial infarction, cardiogenic shock, or new or worsening NYHA class IV heart failure at 30 days, 180 days

  • TIMI flow rates, no reflow [ Time Frame: up to 1 year ] [ Designated as safety issue: No ]
  • Stent thrombosis [ Time Frame: up to 1 year ] [ Designated as safety issue: No ]
  • Distal embolization [ Time Frame: up to 1 year ] [ Designated as safety issue: No ]
  • Left main thrombus as a complication of the PCI procedure [ Time Frame: up to 1 year ] [ Designated as safety issue: No ]
  • Target Vessel dissection [ Time Frame: up to 1 year ] [ Designated as safety issue: No ]
  • Left main dissection [ Time Frame: up to 1 year ] [ Designated as safety issue: No ]
  • Major Bleeding [ Time Frame: up to 1 year ] [ Designated as safety issue: No ]

Estimated Enrollment: 6000
Study Start Date: August 2010
Estimated Primary Completion Date: June 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Upfront Thrombectomy followed by PCI
Upfront manual aspiration thrombectomy followed by PCI
Procedure: Percutaneous Coronary Intervention with or without manual aspiration thrombectomy
Active Comparator: PCI Alone
PCI without upfront manual aspiration thrombectomy
Procedure: Percutaneous Coronary Intervention with or without manual aspiration thrombectomy

Detailed Description:

The hypothesis for TOTAL is that the routine use of manual aspiration thrombectomy with an aspiration catheter (Export®) with PCI compared to PCI alone will reduce the incidence of cardiovascular death, recurrent myocardial infarction, cardiogenic shock, or new or worsening NYHA Class IV heart failure (HF) at 180 days in patients with STEMI undergoing primary PCI.

  Eligibility

Ages Eligible for Study:   19 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Patients presenting with:

    • Symptoms of myocardial ischemia lasting for ≥ 30 minutes AND
    • Definite ECG changes indicating STEMI: ST elevation of greater than 0.1 mV in two contiguous limb leads or 0.2 mV in two contiguous precordial leads
  2. Referred for primary PCI
  3. Randomized within 12 hours of symptoms onset and prior to diagnostic angiography
  4. Informed consent

Exclusion Criteria:

  1. Age ≤ 18 years
  2. Prior coronary artery bypass surgery (CABG)
  3. Life expectancy less than six months due to non-cardiac condition
  4. Treatment with fibrinolytic therapy for qualifying index STEMI event
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01149044

Contacts
Contact: Brandi L Meeks, M.Eng. 905 527 4322 ext 40442 total@phri.ca

  Hide Study Locations
Locations
United States, Georgia
Emory University Hospital Midtown Active, not recruiting
Atlanta, Georgia, United States
United States, New Mexico
University of New Mexico Health Sciences Center Active, not recruiting
Albuquerque, New Mexico, United States
United States, Ohio
Lindner Research Center at Christ Hospital Recruiting
Cincinnati, Ohio, United States
Contact: Dr. I. Sarembock         total@phri.ca    
United States, Pennsylvania
Geisinger Clinic Active, not recruiting
Danville, Pennsylvania, United States
WPAHS - Allegheny General Hospital Active, not recruiting
Pittsburgh, Pennsylvania, United States
Northeast Clinical Trials Group Recruiting
Scranton, Pennsylvania, United States
Contact: Dr. S. Pancholy         total@phri.ca    
Australia, New South Wales
Royal North Shore Hospital Recruiting
Sydney, New South Wales, Australia
Contact: Dr. R. Bhindi         total@phri.ca    
St. George Public Hospital Recruiting
Sydney, New South Wales, Australia
Contact: Dr. J. Weaver         total@phri.ca    
Brazil
Hospital Sao Lucas - PUCRS Recruiting
Porto Alegre, RS, Brazil
Contact: Dr. P. Caramori         total@phri.ca    
Irmandade da Santa Casa de Misericórdia de Porto Alegre Recruiting
Porto Alegre, RS, Brazil
Contact: Dr. V. Lima         total@phri.ca    
Hospital Santa Isabel Recruiting
Blumenau, Santa Catarina, Brazil
Contact: Dr. A. Kormann         total@phri.ca    
Santa Casa de Marilia Recruiting
Marilia, Sao Paulo, Brazil
Contact: Dr. M.A. Tebet         total@phri.ca    
Fundação Faculdade de Medicina de São José do Rio Preto Recruiting
Sao Jose do Rio Preto, Sao Paulo, Brazil
Contact: Dr. M.A. dos Santos         total@phri.ca    
Canada, Alberta
University of Alberta Recruiting
Edmonton, Alberta, Canada
Contact: Dr. R. Welsh         total@phri.ca    
Royal Alexandra Hospital Recruiting
Edmonton, Alberta, Canada
Contact: Dr. R. Leung         total@phri.ca    
Canada, British Columbia
Vancouver General Hospital Recruiting
Vancouver, British Columbia, Canada
Contact: Dr. A. Fung         total@phri.ca    
Victoria Heart Institute Recruiting
Victoria, British Columbia, Canada
Contact: Dr. A. Della Siega         total@phri.ca    
Royal Columbian Hospital Recruiting
Westminster, British Columbia, Canada
Contact: Dr. J. Charania         total@phri.ca    
Canada, Nova Scotia
Queen Elizabeth II Health Sciences Recruiting
Halifax, Nova Scotia, Canada
Contact: Dr. S.N. Nadeem         total@phri.ca    
Canada, Ontario
Hamilton General Hospital Recruiting
Hamilton, Ontario, Canada, L8L 2X2
Contact: Dr. S. Jolly         total@phri.ca    
London Health Sciences Centre Recruiting
London, Ontario, Canada
Contact: Dr. S. Lavi         total@phri.ca    
York PCI Group - Southlake Regional Recruiting
Newmarket, Ontario, Canada
Contact: Dr. W. Cantor         total@phri.ca    
Scarborough Cardiology Research Recruiting
Scarborough, Ontario, Canada
Contact: Dr. S. Kassam         total@phri.ca    
St. Michael's Hospital Recruiting
Toronto, Ontario, Canada
Contact: Dr. A. Cheema         total@phri.ca    
Toronto General Hospital Recruiting
Toronto, Ontario, Canada
Contact: Dr. V. Dzavik         total@phri.ca    
Canada, Quebec
CSSS de Chicoutimi Recruiting
Chicoutimi, Quebec, Canada
Contact: Dr. T. Cieza         total@phri.ca    
MUHC Royal Victoria Hospital Recruiting
Montreal, Quebec, Canada
Contact: Dr. L. Bilodeau         total@phri.ca    
Quebec Heart Lung Insitute Recruiting
Quebec City, Quebec, Canada
Contact: Dr. O. Bertrand         total@phri.ca    
China
The Tenth People's Hospital Tongji University Recruiting
Shanghai, China
Contact: Prof. Y. Xu         total@phri.ca    
Shanghai Gongli Hospital Recruiting
Shanghai, China
Contact: Dr. J. Qiu         total@phri.ca    
Yueyang Hospital Shanghai University of TCM Recruiting
Shanghai, China
Contact: Dr. H. Luo         total@phri.ca    
The First People's Hospital, Jiatong University Recruiting
Shanghai, China
Contact: Dr. S. Liu         total@phri.ca    
Czech Republic
Krasjska Nemocnice Liberec Recruiting
Liberec, Czech Republic
Contact: Dr. D. Horak         total@phri.ca    
University Hospital Pilsen Recruiting
Pilsen, Czech Republic
Contact: Dr. I. Bernat         total@phri.ca    
University Hospital Motol Recruiting
Prague, Czech Republic
Contact: Dr. P. Hajek         total@phri.ca    
University Hospital Kralovske Vinohrady Recruiting
Praha, Czech Republic
Contact: Dr. V. Kocka         total@phri.ca    
Masaryk Hospital Active, not recruiting
Usti nad Labem, Czech Republic
Finland
Kuopio University Hospital Recruiting
Kuopio, Finland
Contact: Dr. H. Romppanen         total@phri.ca    
Heart Center, Tampere University Hospital Recruiting
Tampere, Finland
Contact: Prof. K. Niemela         total@phri.ca    
France
CHU Albert Michallon Recruiting
Grenoble, France
Contact: Dr. S. Marliere         total@phri.ca    
Hopital Universitaire Nord Marseille Recruiting
Marseille, France
Contact: Dr. L. Bonello         total@phri.ca    
Hopital Lariboisiere Ap-HP Recruiting
Paris, France
Contact: Dr. G. Sideris         total@phri.ca    
Hopital Bichat Recruiting
Paris, France
Contact: Prof. P.G. Steg         total@phri.ca    
Centre Hospitalier de Pau Recruiting
Pau, France
Contact: Dr. N. Delarche         total@phri.ca    
Germany
Elisabeth-Krankenhaus Essen Recruiting
Essen, Germany
Contact: Dr. C. Naber         total@phri.ca    
Clinical Association Oberallgaeu-Kempten Recruiting
Immenstadt, Germany
Contact: Prof. J. Torzewski         total@phri.ca    
Greece
Patras University Hospital Recruiting
Patras, Greece
Contact: Prof. D. Alexopoulos         total@phri.ca    
Ahepa University Hospital Recruiting
Thessaloniki, Greece
Contact: Dr. A. Ziakas         total@phri.ca    
Hungary
Semmelweis University Heart and Vascular Center Recruiting
Budapest, Hungary
Contact: Prof. B. Merkely            
University of Szeged Recruiting
Szeged, Hungary
Contact: Prof. I. Ungi         total@phri.ca    
Korea, Republic of
Soonchunhyang University Cheonan Hospital Recruiting
Cheonan, Korea, Republic of
Contact: Dr. Seung Jin Lee         total@phri.ca    
Chonnam National University Hospital Recruiting
Gwangju, Korea, Republic of
Contact: Dr. Myung-Ho Jeong         total@phri.ca    
Kyung-Hee University Hospital Recruiting
Seoul, Korea, Republic of
Contact: Prof. Weon Kim         total@phri.ca    
Macedonia, The Former Yugoslav Republic of
Medical University Skopje Recruiting
Skopje, Macedonia, The Former Yugoslav Republic of
Contact: Prof. S. Kedev         total@phri.ca    
Netherlands
St. Antonius Ziekenhuis Recruiting
Nieuwegein, Netherlands
Contact: Prof. J.M. ten Berg         total@phri.ca    
Serbia
Clinical Center of Serbia Recruiting
Belgrade, Serbia
Contact: Prof. G. Stankovic         total@phri.ca    
Spain
Hospital Universitari Germans Trias I Pujol Recruiting
Baldona, Spain
Contact: Dr. J. Mauri         total@phri.ca    
Hospital Universitari de Bellvitge Recruiting
Barcelona, Spain
Contact: Prof. A. Cequier         total@phri.ca    
Complexo Hospitalario A Coruna Recruiting
Barcelona, Spain
Contact: Dr. N. Vazquez         total@phri.ca    
Hospital Vall d'Hebron Recruiting
Barcelona, Spain
Contact: Dr. B. Garcia del Blanco         total@phri.ca    
University Hospital La Paz Recruiting
Madrid, Spain
Contact: Dr. R. Moreno Gomez         total@phri.ca    
Hospital Universitario Virgen de la Victoria Recruiting
Malaga, Spain
Contact: Dr. J.M. Hernandez         total@phri.ca    
Hospital Son Espases Recruiting
Palma de Mallorca, Spain
Contact: Dr. A. Bethencourt         total@phri.ca    
Hospital Clinico Universitario de Vigo Recruiting
Vigo, Spain
Contact: Dr. A. Iniguez Romo         total@phri.ca    
United Kingdom
Hull and East Yorkshire Hospitals Recruiting
Hull, United Kingdom
Contact: Dr. S. Thackray         total@phri.ca    
Glenfield General Hospital Recruiting
Leicester, United Kingdom
Contact: Prof. A. Gershlick         total@phri.ca    
Manchester Royal Infirmary Recruiting
Manchester, United Kingdom
Contact: Dr. M. El-Omar         total@phri.ca    
Sheffield Teaching Hospitals Recruiting
Sheffield, United Kingdom
Contact: Dr. J. Gunn         total@phri.ca    
Musgrove Park Hospital Recruiting
Taunton, United Kingdom
Contact: Dr. M. Seddon         total@phri.ca    
Sponsors and Collaborators
Population Health Research Institute
Investigators
Principal Investigator: Sanjit S. Jolly, MD, MSc, FRCP Hamilton Health Sciences Corporation
Principal Investigator: Vladimir Džavík, MD, FRCPC Peter Munk Cardiac Centre, University Health Network
  More Information

Additional Information:
No publications provided by Population Health Research Institute

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Dr. Sanjit S. Jolly, MD MSc, FRCP(C), Interventional Cardiologist, Assistant Professor, Population Health Research Institute
ClinicalTrials.gov Identifier: NCT01149044     History of Changes
Other Study ID Numbers: TOTAL Trial
Study First Received: June 22, 2010
Last Updated: May 1, 2013
Health Authority: Canada: Research Ethics Board
United States: Institutional Review Board
Macedonia: Ethics Committee
Brazil: Ethics Committee
China: Ethics Committee
Czech Republic: Ethics Committee
Finland: Ethics Committee
Australia: Ethics Committee
Serbia: Ethics Committee
Greece: Ethics Committee
France: Ethics Committee
Germany: Ethics Committee
Hungary: Ethics Committee
Netherlands: Ethics Committee
South Korea: Ethics Committee
Spain: Ethics Committee
United Kingdom: Ethics Committee

Keywords provided by Population Health Research Institute:
Acute Coronary Syndrome
PCI
Percutaneous Coronary Intervention
STEMI
Thrombectomy

Additional relevant MeSH terms:
Infarction
Myocardial Infarction
Acute Coronary Syndrome
Ischemia
Pathologic Processes
Necrosis
Myocardial Ischemia
Heart Diseases
Cardiovascular Diseases
Vascular Diseases
Angina Pectoris
Chest Pain
Pain
Signs and Symptoms

ClinicalTrials.gov processed this record on May 19, 2013