RANOLAZINE for ST-elevation myocardial infarction | Acute myocardial infarction

Inclusion criteria

• {"criterion_text":"- Age ≥ 18 years and < 80 years on day of signing informed consent\n- Ability to provide written informed consent in a time window 0 to 1 day after successful pPCI.\n- ST-Elevation Myocardial Infarction at the time of the index hospitalization.\n- Successful pPCI (Thrombolysis In Myocardial Infarction [TIMI] flow 3 and residual coronary stenosis <30%).\n- Presence of at least one remaining angiographically significant (% diameter stenosis > 50%) non-culprit stenosis treatable with PCI.\n- Evidence of post-menopausal status or negative urinary or serum pregnancy test for child-bearing potential patients (definitions reported in section 10.9)..\n- Agreement for child-bearing potential patients who are sexually active to use contraception (definitions reported in section 10.10).."}

Exclusion criteria

• {"criterion_text":"- Hemodynamically unstable patients\n- Previous participation in a clinical trial in which an investigational drug was administered within 30 days of screening or within the 5 half-lives of the study drug, whichever is longer.\n- Previous myocardial infarction\n- Previous coronary artery by-pass graft (CABG)\n- Female patients with a positive pregnancy test at enrollment or prior to administration of study medication\n- Female patients who are pregnant or breastfeeding or reproductive potential who are not willing to employ effective birth control from screening to 90 days after the last dose of Ranolazine\n- Known hypersensitivity to the active principle (Ranolazine) or any of the excipients\n- Chronic Kidney Disease Stage 4 or 5 (eGFR < 30 mL/min/1.73 m 2)\n- Moderate to severe liver failure (Child Pugh B – C)\n- Simultaneous intake of the following classes of drugs: strong CYP3A4 inhibitors (i.e. clarithromycin, erythromycin, diltiazem, itraconazole, ketoconazole); HIV protease inhibitors (i.e. saquinavir, indinavir, ritonavir); class Ia antiarrhythmic drugs (i.e. ajmaline, disopyramide, procainamide, quinidine ) and class III antiarrhythmic drugs except amiodarone (i.e. dofetilide, sotalol)"}

Primary endpoints

• {"endpoint_text":"- The relative difference in terms of IMR and/or angioIMR will be evaluated. IMR and/or angioIMR will be assessed both at the baseline (after successful coronary revascularization) and at the time of staged revascularization of the non-culprit stenosis (either at 5+/-2 days or within 6+/-2 weeks after pPCI).","definition_or_measurement_approach":"IMR and/or angioIMR measured at baseline (after successful coronary revascularization) and at staged revascularization of the non-culprit stenosis (either at 5±2 days or within 6±2 weeks after pPCI); outcome is the relative difference between assessments."}

Secondary endpoints

• {"endpoint_text":"- The prevalence of residual CMD downstream to the culprit vessel in the two group of patients. Residual CMD will be defined as the finding of an IMRculprit or angioIMRculprit value > 25\n- The extent of the Infarct Size, as assessed by the CMR, in terms of grams (g) and percentage as compared with control group.\n- The prevalence of CMD downstream to the non-culprit vessel in the two group of patients (CMDnon-culprit). CMDnon-culprit will be defined as the finding of an IMRnon-culprit or angioIMRnon-culprit value > 25\n- The incidence of peri-procedural CMD after staged PCI of the non-culprit stenoses, defined as a 20% increase of IMRnon-culprit or angioIMRnon-culprit values assessed before and after elective PCI of the non-culprit vessel.\n- The difference between the two groups of patients, in terms of incidence of periprocedural Myocardial Infarction (PMI), eventually occurring during the staged procedure. PMI require to satisfy all the criteria of the fourth Universal Definition of Myocardial Infarction\n- The effects of INa current inhibition on endothelial function will be assessed at follow up as compared with control group. Endothelial function will be evaluated with the EndoPAT, measuring both the Endoscore and RHI\n- The incidence of MACE, defined as composite of death, myocardial infarction, or target-vessel revascularization at short (42+/-7 days) term follow-up.\n- Angina symptoms and quality of life will be assessed with SAQ7 and EuroQoL questionnaires and results compared between the two groups","definition_or_measurement_approach":"- Residual CMD (culprit): IMRculprit or angioIMRculprit > 25 defines CMD.\n- Infarct size measured by cardiac magnetic resonance (CMR) reported in grams and percentage versus control.\n- CMD (non-culprit): IMRnon-culprit or angioIMRnon-culprit > 25 defines CMDnon-culprit.\n- Peri-procedural CMD: a 20% increase in IMRnon-culprit or angioIMRnon-culprit values measured before and after elective PCI.\n- Periprocedural MI (PMI): events must satisfy all criteria of the fourth Universal Definition of Myocardial Infarction.\n- Endothelial function: assessed with EndoPAT measuring Endoscore and RHI.\n- MACE: composite of death, myocardial infarction, or target-vessel revascularization at short (42±7 days) follow-up.\n- Angina symptoms and QoL: assessed with SAQ7 and EuroQoL questionnaires."}

Italy

Earliest CTIS Part Ii Submission Date

08-08-2025

Latest Decision Or Authorization Date

25-11-2025

Processing Time Days

109

Number Of Sites

3

Number Of Participants

100

Primary sponsor

Full Name

Universita' Degli Studi Di Napoli Federico II

Organisation Type

Educational Institution

Country Of Registered Address

Italy

Third parties

• {"country":"Italy","full_name":"Fullcro S.r.l.","duties_or_roles":"codes: 12, 8","organisation_type":"Pharmaceutical company"}
• {"country":"Italy","full_name":"University Magna Graecia Of Catanzaro","duties_or_roles":"code: 4","organisation_type":"Educational Institution"}