E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
General anesthesia for on pump coronary artery bypass surgery |
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E.1.1.1 | Medical condition in easily understood language |
anaesthesia for bypass surgery |
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E.1.1.2 | Therapeutic area | Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Anesthesia and Analgesia [E03] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10006894 |
E.1.2 | Term | CABG |
E.1.2 | System Organ Class | 10042613 - Surgical and medical procedures |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess the effect of xenon anesthesia on the posteoperative blood level of cardiac troponin, a predictive marker of medium and long term clinical outcome after coronary artery bypass graft surgery 24 hours after the end of intervention, compared to sevoflurane anesthesia and total intravenous anesthesia. |
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E.2.2 | Secondary objectives of the trial |
- To assess the effect of xenon on other myocardial damage-related criteria and on short term consequences of myocardial damage
- To assess the feasbility of xenon for cornoary artery bypass graft surgery
- To assess the effect of xenon of the postoperative follow-up, during intensive care unit stay and hospital saty
- To assess the effect of xenon on the incidence of posteperative delirium
-To assess the effect of xenon on safety |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1)Male or female patients aged 18 years (or having reached majority if the legal age of majority is over 18) or more at the date of selection
2)Coronary heart disease requiring elective isolated coronary artery bypass graft surgery to be performed with cardiopulmonary bypass in mild hypothermia (central temperature between 32° and 34° Celsius) or normothermia with cardiac arrest and cold or warm cardioplegia
3)Normal or moderately impaired left ventricular systolic function (corresponding to a left ventricular ejection fraction above or equal to 35%, if available)
4)Written informed consent signed and dated by the patient after full explanation of the study has been given by the investigator prior to participation
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E.4 | Principal exclusion criteria |
-Legal incapacity or limited legal capacity
- Women who are pregnant, breast-feeding or women of childbearing potential not using adequate contraceptive methods
- Patient previously randomised in this study
- Recent acute myocardial infarction (within 7 days)
- Ongoing unstable angina
- Active endocarditis
- Ongoing treatment with nicorandil
- Ongoing treatment with a sulfonylurea medication if this treatment cannot be replaced 24 hours before surgery
- Participation in a drug or device trial within the previous 30 days
- Known contraindication to xenon, sevoflurane, propofol or sufentanil
- Recent or ongoing myocardial damage/infraction with cardiac troponin level assessed within 24 hours of surgery above the upper reference limite for the diagnosis of mycocardial infraction (local laboratory) or prolonged thoracic pain and ST-segement deviation at rest
- Severe renal dysfunction with preoperative value of serum creatinine level above 200 micromoles/litre(local laboratory)
- Severe haptic dysfunction with preoperative value of alanine amine-transferase or alkaline phosphatase three times above the upper normal value(loval laboratory)
- Severely depressed left ventricular function, corresponding to an ejection fraction below 35%,if available
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E.5 End points |
E.5.1 | Primary end point(s) |
Cardiac troponin blood level measured 24 hours after the end of intervention (central laboratory) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
This time point is the most frequently chosen time point reported in studies performed to investigate the correlation between troponin levels and clinical outcome. |
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E.5.2 | Secondary end point(s) |
Other myocardial damage ( blood cardiac troponin, CK-MB levels, MI type 5 , NT-proBNP levels, CRP levels),feasibility of xenon as anaesthetic during CABG, ICU parameters(blood loss, blood transfusion, length of stay) mechamical ventilation , incidence on post operative delirium (CAM test), safety (Adverse event)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
From the inclusion to the hospital discharge. During anaesthesia, 12 hours, 24hours, 48 hours, at the ICU discharge, at the hospital discharge. For CAM test, at inclusion then once a day as soon as trachea is extubated, at the ICU discharge and Hospital discharge
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | Yes |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Sevoflurane(PR2),Propofol(PR3) |
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E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 16 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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LAST VISIT OF THE LAST SUBJECT |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 2 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 2 |
E.8.9.2 | In all countries concerned by the trial days | 0 |