Status:

NOT_YET_RECRUITING

Reversing Microvascular Dysfunction in Heart Failure With Preserved Ejection Fraction

Lead Sponsor:

Montreal Heart Institute

Conditions:

Heart Failure With Preserved Ejection Fraction

Microvascular Coronary Artery Disease

Eligibility:

All Genders

40+ years

Phase:

PHASE2

PHASE3

Brief Summary

This study will evaluate the impact of colchicine on the change in coronary flow reserve (CFR), a marker for coronary microvascular dysfunction (CMD), compared to placebo in patients with heart failur...

Detailed Description

This will be a pilot mechanistic study. Patients will be randomly assigned in a 1:1 ratio to receive colchicine 0.5 milligram (mg) daily or a matched placebo. Follow-up will occur six months after ran...

Eligibility Criteria

Inclusion

  • Subjects ≥ 40 years of age,
  • Chronic symptomatic HF and left ventricular ejection fraction (LVEF) \> 40% within 12 months prior to the screening visit (regardless of the imaging modality) documented by one of the following:
  • HF requiring hospitalization and IV diuretics within 12 months of study entry, or
  • NTproBNP \> or = 150pg/ml in sinus rhythm or NTproBNP \> or = 450pg/ml in chronic atrial fibrillation,
  • New York Heart Association Class, NYHA functional class II to (ambulatory) IV,
  • Evidence of pathological systemic inflammation: high C-reactive protein, hs-CRP levels (hs-CRP \> or = 5mg/L),
  • Subjects with the capacity to provide informed consent.

Exclusion

  • Patients with a diagnosis of infiltrative cardiomyopathy,
  • Presence of severe valvular heart disease,
  • Presence of active infection within the 3 months prior to enrollment needing antibiotics (excluding COVID (Coronavirus disease)-19),
  • Acute decompensated HF, acute coronary syndrome (including MI), cardiac surgery, other major cardiovascular surgery, or urgent percutaneous coronary intervention (PCI) within the 3 months prior to enrollment,
  • Known or clinically judged significant (i.e., angina with CCS (Canadian Cardiovascular Society) class \> 2/4) epicardial coronary artery disease (CAD) that has not been revascularized (revascularized CAD is defined by a history of myocardial infarction, percutaneous intervention, or coronary artery bypass grafting),
  • History of hypersensitivity to colchicine,
  • Evidence of hepatic disease as determined by any 1 of the following: AST or ALT values exceeding 3× the upper limit of normal at enrollment; or patient with a history of cirrhosis, chronic active hepatitis, or severe hepatic disease,
  • Patients with estimated glomerular filtration rate (eGFR) \<30 ml/min/1.73 m2 as calculated by the Modification in Diet in Renal Disease (MDRD) formula at enrollment,
  • Subject with inflammatory bowel disease (Crohn's disease or ulcerative colitis) or patient with chronic diarrhea,
  • Patient with pre-existent progressive neuromuscular disease,
  • Patient currently taking colchicine for other indications (mainly chronic indications represented by Familial Mediterranean Fever or gout). There is no wash-out period required for patients who have been treated with colchicine and stopped treatment prior to enrolment,
  • Patients under long-term steroid medication for a chronic condition,
  • Contraindication to dipyridamole-containing medication, acute myocardial infarction or unstable angina in the past 48h,
  • Positive pregnancy test results at the screening visit, and females of childbearing potential who do not agree to use adequate methods of contraception for the duration of the study; acceptable means of birth control include: implantable contraceptives, injectable contraceptives, oral contraceptives, transdermal contraceptives, intrauterine devices, male or female condoms with spermicide, abstinence, or a sterile sexual partner,
  • History or presence of any other disease with a life expectancy of \<1 year,
  • Patient considered by the investigator, for any reason, to be an unsuitable candidate for the study.

Key Trial Info

Start Date :

March 1 2024

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

March 1 2026

Estimated Enrollment :

60 Patients enrolled

Trial Details

Trial ID

NCT06217120

Start Date

March 1 2024

End Date

March 1 2026

Last Update

January 25 2024

Active Locations (1)

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Montreal Heart Institute

Montreal, Quebec, Canada, H1T1C8