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Trial to Compare the Efficacy and Safety of a Single Bolus of TNK-tPA (Tenecteplase, Metalyse®) With Accelerated Infusion of Rt-PA (Alteplase, Actilyse®) in Asian Patients With Acute Myocardial Infarction

Sponsor
Boehringer Ingelheim (Industry)
Overall Status
Completed
CT.gov ID
NCT00148460
Collaborator
(none)
270
Enrollment
18
Locations
59.1
Duration (Months)
15
Patients Per Site
0.3
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The objective of this trial was to compare the efficacy and safety of a single bolus of TNK-tPA (tenecteplase, Metalyse®) compared with rt-PA (alteplase, Actilyse®) in Asian patients.

Condition or Disease Intervention/Treatment Phase
Phase 3

Detailed Description

This was a randomized (1:1), open-label, multi-center, active-control, parallel-group study to compare the efficacy and safety of TNK-tPA (tenecteplase, Metalyse®) with that of accelerated rt-PA (alteplase, Actilyse®) in Asian patients with AMI. The primary endpoint (TIMI 3 Flow) and the secondary endpoint (TIMI frame count) were evaluated in a blinded manner in the core laboratory.

Patients eligible for the trial who met all inclusion and exclusion criteria and who gave their informed consent were randomized to one of two treatment groups (i.e. TNK-tPA or accelerated rt-PA).

The study period totaled 30-37 days and included baseline, randomisation, study drug administration, in-hospital follow-up and thirty-day follow-up.

Coronary angiography was performed at 90 minutes after the start of study drug administration. 12-lead electrocardiograms (ECGs) were obtained before randomization, between 60 to 75 minutes and 180 ± 15 minutes after the start of study drug administration, and at hospital discharge.

If the patient showed rapid and progressive hemodynamic deterioration before 90 minutes, rescue PTCA or other appropriate interventions should be performed at the discretion of the treating physician.

Following the analysis of TIMI flow and frame count at each study center, the results were carefully recorded on the CRFs. This data was stored on a compact disk or a film and labeled with the subject's study I.D. number. It was then sent with the summary worksheets and ECGs to the Angiographic Core Laboratory located at the Leuven Coordinating Center (LCC) of the University Hospital Gasthuisberg (Leuven, Belgium) for central evaluations.

Study Hypothesis:
The null hypothesis tested was that there was no difference between the two treatment groups:

TNK-tPA (Tenecteplase, Metalyse®) and accelerated rt-PA (Actilyse®), against the alternative that there was a difference.

Comparison(s):

The primary endpoint of the study was TIMI 3 flow at 90 minutes after start of thrombolytic therapy, angiograms were evaluated in a blinded manner in a core laboratory.

Study Design

Study Type:
Interventional
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Randomised, Open-label, Multi-center, Angiographic Trial to Compare the Efficacy and Safety of Single Bolus of Tenecteplase (Metalyse®) With Accelerated Infusion of Alteplase in Asian Patients With Acute Myocardial Infarction
Study Start Date :
Mar 1, 2001
Study Completion Date :
Feb 1, 2006

Outcome Measures

Primary Outcome Measures

  1. The percentage of patients with thrombolysis in myocardial infarction (TIMI) grade 3 flow in the infarct-related artery (IRA) [at 90 minutes after the start of thrombolytic treatment]

Secondary Outcome Measures

  1. Infarct-related artery patency [at 90 minutes]

  2. The percentage of subjects with ST-segment resolution [at 60 and 180 minutes]

  3. Mortality [30-days]

  4. Safety []

  5. The effects of TNK-tPA on coagulation and fibrinogenolysis (at selected clinical sites) []

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 75 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:

  1. Age >= 18 and <= 75 years.

  2. Asian origin.

  3. Ischemic discomfort >= 30 minutes in duration.

  4. Onset of acute myocardial infarction (AMI) symptoms within 6 hours prior to randomization.

  5. A twelve lead electrocardiogram (ECG) with one of the following:

  • ST segment elevation >= 0.1 mV in two or more limb leads; or

  • = 0.2 mV in two or more contiguous precordial leads indicative of AMI.

  1. Ability to give informed consent.
Exclusion Criteria:

  1. Previous coronary artery bypass grafting (CABG) surgery.

  2. Cardiogenic shock (e.g. systolic blood pressure [SBP] < 90 mmHg).

  3. Systolic blood pressure (SBP) >= 180 mmHg and/or diastolic blood pressure (DBP) >= 110 mmHg during current admission on one reliable measurement prior to randomization.

  4. Inability to undergo cardiac catheterization.

  5. Significant bleeding disorder either at present or within the past 6 months.

  6. Major surgery, biopsy of a parenchymal organ, or significant trauma within 3 months.

  7. Any minor head trauma and/or any other trauma that occurred after onset of current myocardial infarction.

  8. Use of heparin, GPIIb/IIIa antagonists or other anticoagulants within the last 2 weeks.

  9. Any known history of stroke or transient ischemic attack or central nervous system structural damage (i.e. neoplasm, aneurysm, intracranial surgery).

  10. Prolonged cardiopulmonary resuscitation (> 10 minutes) within 2 weeks.

  11. Pregnancy, lactation or parturition within the previous 30 days. Women of childbearing potential must have had a negative pregnancy test and must have used a medically accepted method of birth control (i.e. uterine device, surgical sterilisation, progestogens alone).

  12. Previous treatment with TNK-tPA (tenecteplase).

  13. Inability to follow protocol and comply with follow-up.

  14. Drug abuse within the last year.

  15. Participation in another clinical trial within the previous 30 days.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Beijing An Zhen Hospital Beijing China 100029
2 Beijing University Beijing China 100044
3 Beijing Friendship Hospital Beijing China 100050
4 Beijing Xuan Wu Hospital Beijing China 100050
5 Bejing Tongren Hospital Beijing China 100730
6 Center Hospital of Dalian Dalian China 116033
7 Center Hospital of Jinan Jinan China 250013
8 Fudan University Shanghai China 200032
9 People's Hospital of Liaoning Province Shenyang China 110015
10 The University of Hong Kong, Cardiology Division Hong Kong Hong Kong
11 Dongsan Medical Center Jung-Ku Korea, Republic of 700711
12 Chunnam University Hospital Kwang-Ju Korea, Republic of 501757
13 Dong-A University Hospital Pusan Korea, Republic of 602715
14 Seoul National University Hospital Seoul Korea, Republic of 100744
15 Yonsei University Severance Hospital Seoul Korea, Republic of 120752
16 Seoul Joongang Hospital Seoul Korea, Republic of 138736
17 A-Jou University Hospital Suwon Korea, Republic of 443721
18 Wonju Christian Hospital (Yonsei University Hosp) Wonju Korea, Republic of

Sponsors and Collaborators

  • Boehringer Ingelheim

Investigators

  • Study Chair: Boehringer Ingelheim Study Coordinator, Boehringer Ingelheim Shanghai

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
, ,
ClinicalTrials.gov Identifier:
NCT00148460
Other Study ID Numbers:
  • 1123.8
First Posted:
Sep 8, 2005
Last Update Posted:
Oct 29, 2013
Last Verified:
Oct 1, 2013
Additional relevant MeSH terms:
Myocardial Infarction
Infarction
Tenecteplase

Study Results

No Results Posted as of Oct 29, 2013