Current partner codePEPTIDESDE
NCT01913483·Phase 3·INTERVENTIONAL

ENDOvascular Interventions With AngioMAX: The ENDOMAX Trial

Status

Terminated

Phase

Phase 3

Enrollment

732

Locations

39

Results

Posted

Publications

0

Study summary

What the protocol is testing.

The primary objective of the study is to test whether anticoagulation with bivalirudin results in fewer major bleeding complications compared with unfractionated heparin (UFH) in participants undergoing peripheral endovascular interventions (PEI). The secondary objective is to test whether there were potential benefits from bivalirudin therapy on other clinically important events such as death, myocardial infarction (MI), stroke and/or transient ischemic attack (TIA), amputation, unplanned repeat revascularization (URV), and minor bleeding, as well as potential economic benefits that may result from improved clinical outcomes.

Interventions

Treatment arms and agents.

DRUG

Bivalirudin

Bivalirudin is an anticoagulant that binds directly to thrombin in a bivalent and reversible fashion.

DRUG

Unfractionated Heparin

Unfractionated heparin is an anticoagulant.

Timeline

From registration to results.

  1. First posted

    Aug 1, 2013

  2. Study start

    Sep 24, 2013

  3. Primary completion

    Mar 16, 2016

  4. Study completion

    Mar 16, 2016

  5. Results posted

    May 30, 2017

  6. Registry updated

    May 30, 2017

Outcomes

What the study measures.

Primary outcomes

Participants With Bleeding Academic Research Consortium Type 3 or Greater (BARC ≥3) Events Up to 48 h or at Hospital Discharge, As Adjudicated by the Independent Clinical Events Committee (CEC)

Time frame · Study drug administration (Day 1) up to 48 h post study drug initiation or at hospital discharge, whichever occurs first

BARC ≥3 includes: Type 3a-3c: clinical, laboratory, and/or imaging evidence of bleeding, which includes any transfusion with overt bleeding, bleeds that result in surgical intervention or administration of IV vasoactive drugs, overt bleeds with a hemoglobin drop greater than or equal to 3 grams (g)/deciliters (dL) to greater than or equal to 5 g/dL, cardiac tamponade caused by bleeding, intracranial hemorrhage, and intraocular bleeds that compromise vision. Type 4: (Coronary Artery Bypass Grafting-related Bleeding) includes perioperative intracranial bleeding within 48 h, bleeds that result in reoperation following closure of sternotomy for the purpose of controlling bleeding, bleeds that result in treatment with transfusion of ≥5 U of whole blood or packed red blood cells within a 48-h period; and chest tube output ≥2 liters within a 24-h period. Type 5: fatal bleeding that directly results in death that is either clinically suspicious or is confirmed as the cause of death.

Secondary outcomes

Participants With Myocardial Infarction (MI), Stroke/Transient Ischemic Attack (TIA), Unplanned Repeat Revascularization (URV), Death, and Minor Bleeding Up to 48 h Post Study Drug Administration

Time frame · Study drug administration (Day 1) up to 48 h post study drug initiation or at hospital discharge, whichever occurs first

Outcome assessments at 48 h post study drug initiation include bleeding events defined as BARC Type 2 or greater (BARC ≥2), bleeding events defined as thrombolysis in myocardial infarction (TIMI) major and TIMI minor, and net adverse clinical events (NACE) as adjudicated by the CEC (NACE=death, MI, stroke/TIA, amputations, URV, or bleeding events defined as BARC ≥3). In addition to Type 3(a-c), 4, and 5, BARC ≥2 also includes Type 2 bleeding, which is any overt, actionable sign of hemorrhage (more bleeding than would be expected for a clinical circumstance, including bleeding found by imaging alone) that does not fit the criteria for Type 3, 4, or 5, but does meet at least one of the following criteria of: requiring nonsurgical, medical intervention by a health-care professional; leading to hospitalization or increased level of care; prompting evaluation.

Participants With MI, Stroke/TIA, URV, Death, or Minor Bleeding Up to Day 30

Time frame · Study drug initiation (Day 1) up to 30 days

Outcome assessments at Day 30 include NACE, Major Adverse Clinical Events (MACE=death, MI, stroke/TIA, amputation, or URV), and bleeding defined as BARC ≥2, as adjudicated by the CEC. In addition to Type 3(a-c), 4, and 5, BARC ≥2 also includes Type 2 bleeding, which is any overt, actionable sign of hemorrhage (more bleeding than would be expected for a clinical circumstance, including bleeding found by imaging alone) that does not fit the criteria for Type 3, 4, or 5, but does meet at least one of the following criteria of: requiring nonsurgical, medical intervention by a health-care professional; leading to hospitalization or increased level of care; prompting evaluation.

Eligibility

Who can take part.

Minimum age
18 Years
Maximum age
Not reported
Sex
ALL
Healthy volunteers
No

Inclusion Criteria: * Participants ≥ 18 years of age * Must be undergoing one of the following PEI procedures: * Carotid artery stenting * Lower Extremity Interventions (LEI) for Critical Limb Ischemia * LEI for claudication * Provide written informed consent prior to any study-specific procedure being performed Exclusion Criteria: * Any known contra-indication to the use of bivalirudin or UFH * Acute limb ischemia * Planned amputation regardless of the outcome of the PEI * Dialysis dependent * Weight less than 38 kg or more than 202 kg * History of any bleeding diathesis or severe hematological disease * History of intra-cranial: mass, aneurysm, arteriovenous malformation or hemorrhage * Gastrointestinal or genitourinary bleeding within the 30 days prior to randomization * Any surgery (excluding punch or shave skin biopsy) within the 30 days prior to randomization * Concomitant percutaneous coronary intervention * Any percutaneous coronary, endovascular, or structural heart disease procedure within 30 days prior to randomization * International normalized ratio \>1.7 within 24 h prior to the index procedure * Administration of therapeutic doses of UFH within 30 min prior to the index procedure (a low dose \[≤2000 U\] of heparin is permitted during the diagnostic angiogram prior to the intervention) * Administration of enoxaparin within 8 h; other low molecular weight heparins or fondaparinux within 24 h; any oral anti-Xa or antithrombin agent within 48 h; or thrombolytics, glycoprotein inhibitors, or warfarin within 72 h prior to the index procedure * Severe contrast allergy that cannot be pre-medicated * Procedures performed by radial access when they are intended as the primary access site for the index procedure * Known or suspected pregnant women or nursing mothers * Previous enrollment in this study (MDCO-BIV-12-03) * Participation in other investigational drug or device trials within 30 days prior to randomization * Participants who, for any reason, are deemed by the investigator to be inappropriate for this study

Study locations

39 registered sites.

United States. Showing up to 24 locations stored in the fast local snapshot.

Tri-Lakes Research

Hot Springs, Arkansas, United States

Stanford Hospital and Clinics

Stanford, California, United States

Clearwater Cardiovascular and Interventional Consultants

Clearwater, Florida, United States

Florida Research Network

Gainesville, Florida, United States

The Cardiac and Vascular Institute

Gainesville, Florida, United States

Baptist Cardiac & Vascular Institute

Miami, Florida, United States

Florida Hospital

Orlando, Florida, United States

Peoria Radiology Research & Education Foundation

Peoria, Illinois, United States

Midwest Cardiovascular Research Foundation

Davenport, Iowa, United States

Kentucky Heart Foundation - King's Daughters Medical Center

Ashland, Kentucky, United States

Tufts Medical Center

Boston, Massachusetts, United States

VA Boston Healthcare System

Boston, Massachusetts, United States

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Cape Cod Research Institute

Hyannis, Massachusetts, United States

Michigan Heart

Ypsilanti, Michigan, United States

Mayo Clinic

Rochester, Minnesota, United States

Deborah Heart and Lung Center

Browns Mills, New Jersey, United States

Holy Name Medical Center

Teaneck, New Jersey, United States

New Mexico Heart Institute

Albuquerque, New Mexico, United States

Weill Cornell Medical College

New York, New York, United States

Icahn School of Medicine at Mount Sinai

New York, New York, United States

Columbia University Medical Center

New York, New York, United States

Stony Brook Medicine

Stony Brook, New York, United States

Novant Health Heart and Vascular Institute

Charlotte, North Carolina, United States

Publications

Results and literature.

No PMID-linked publications were present in this registry snapshot.

Primary links

Continue at the source.

Related trials

More studies on Bivalirudin.

Related PeptideStat pages

Put the record in context.

Research pages describe evidence. Vendor pages, where available, describe independently tracked research-product listings and are not clinical recommendations.