This is a prospective, multicenter, randomized, double-blind, placebo-controlled study. The purpose of this study is to determine the safety and effectiveness of human-derived antithrombin III (AT-III \[Human\]) supplementation prior to high-risk, non-emergency, cardiac surgery with cardiopulmonary bypass (CPB). A total of 404 adult subjects undergoing CPB who meet the study eligibility criteria were planned to be randomized to receive either AT-III (Human) or placebo.
The primary objective of this clinical study was to compare the percentage of subjects with any component of a 7 item major morbidity composite (postoperative mortality, stroke, acute kidney injury (\[AKI\]), surgical re-exploration, arterial or venous thromboembolic event, prolonged mechanical ventilation, or infection) between 2 groups of subjects randomly allocated to receive preoperative supplementation of AT-III (Human) (Antithrombin-III (\[Human \]) or Placebo. The secondary objectives of this clinical study were the following: * To compare postoperative antithrombin III (AT) levels at the Intensive Care Unit (ICU) admission between the AT-III (Human) treatment group and Placebo control group * To compare the following perioperative outcomes between the AT-III (Human) treatment group and Placebo control group: * Postoperative chest-drain blood loss in the first 12 and 24 hours after surgery * Transfusion requirements * Need for surgical re-exploration * Low cardiac output syndrome * Myocardial Infarction (MI) * Stroke * AKI * Arterial or venous thromboembolic events * Infections * Prolonged mechanical ventilation (\>24 hours) * All-cause postoperative mortality * ICU stay duration * Prolonged ICU stay (\>6 days) * Length of hospital stay Additionally, safety objectives included the evaluation of AT III (Human) for clinical safety including adverse events (AEs), risks for bleeding, clinical laboratory testing, physical exam, and vital signs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
425
AT-III (Human) is an antithrombin concentrate prepared from pooled human plasma. AT-III (Human) is provided as a freeze-dried preparation for intravenous use. The AT-III (Human) preparation is reconstituted in 10 or 20 mL of sterile water for injection prior to intravenous administration.
0.9% Sodium Chloride for Injection, United States Pharmacopeia
UC Irvine
Orange, California, United States
VA Medical Center - San Francisco
San Francisco, California, United States
Stanford University Hospital and Clinics
Stanford, California, United States
University of Colorado
Aurora, Colorado, United States
Yale University School of Medicine
New Haven, Connecticut, United States
Percentage of Subjects With Any Component of a Major Morbidity Composite
Major morbidity composite defined as a composite of any one or more of the following: 1. Postoperative mortality (deaths occurring within 30 days of the operation or occurring during the primary hospitalization). 2. Stroke (clinical diagnosis of focal or global neurological deficit of abrupt onset caused by disturbance in cerebral blood supply). 3. Acute kidney injury (increase of serum creatinine levels to \>2.0 mg/dL and twice the baseline level or a new requirement for dialysis postoperatively). 4. Surgical reexploration (return to operating room because of bleeding, tamponade, graft occlusion or other cardiac reason). 5. Arterial or venous thromboembolic event (perioperative myocardial or mesenteric infarction, peripheral thromboembolism, acute coronary graft thrombosis, intracardiac thrombosis, deep vein thrombosis, pulmonary embolism). 6. Prolonged mechanical ventilation (\>24 hours). 7. Infection (deep sternal-wound infection and/or bloodstream infections).
Time frame: Up to Day 30 +/- 4 days
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
University of Florida College of Medicine
Gainesville, Florida, United States
Jackson Memorial Hospital at University of Miami
Miami, Florida, United States
Emory University Hospital
Atlanta, Georgia, United States
Georgia Regents University
Augusta, Georgia, United States
Memorial Medical Center
Springfield, Illinois, United States
...and 31 more locations