Print

Purpose

Various patient groups with the On-X Valve can be maintained safely on lower doses of blood thinner(Coumadin®) or on antiplatelet drugs (aspirin/Plavix®) only rather than the standard dose of Coumadin and aspirin presently recommended by ACC/AHA or ACCP professional societies.

Condition

Eligibility

Eligible Ages
Between 18 Years and 70 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Patients requiring isolated aortic valve replacement (AVR), or isolated mitral valve replacement (MVR).
  • AVR patients receiving low dose or antiplatelet only anticoagulation will be divided into groups at low risk and high risk for thromboembolism with all patients being in the low risk group except for patients with the following conditions which place a patient in the high risk group:
  • Chronic atrial fibrillation
  • Left ventricular ejection fraction < 30 %
  • Enlarged left atrium >50mm diameter
  • Spontaneous echo contrasts in the left atrium
  • Vascular pathology
  • Neurological events
  • Hypercoagulability
  • Left or right ventricular aneurysm
  • Lack of platelet response to aspirin or clopidogrel
  • Women receiving estrogen replacement therapy
  • Concomitant cardiac surgery is allowed
  • Adult patients

Exclusion Criteria

  • Right side valve replacement
  • Double (aortic plus mitral) valve replacement
  • Patients with active endocarditis at the time of implant
  • Previous confirmed or suspected thromboembolic event or thrombophlebitis
  • Other terminal illness
  • Patients who are in an emergency state
  • Inability to return for required follow-ups
  • Patients with an On-X valve implanted within the study and subsequently explanted
  • Patients who are known to be pregnant, plan to become pregnant or are lactating
  • Patients with acquired immunodeficiency syndrome or know to be HIV positive
  • Patients who are prison inmates or known drug or alcohol abusers
  • Patients unable to give adequate informed consent.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Prevention
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
AVR Low Risk without warfarin
AVR Low Risk without warfarin
  • Device: On-X valve using reduced anticoagulation
    Valve replacement with antiplatelet agents or lowered warfarin
    Other names:
    • On-X Prosthetic Heart Valve
Active Comparator
AVR low risk with standard warfarin
AVR low risk with standard warfarin
  • Device: On-X Valve with Standard warfarin Therapy
    Valve replacement with standard dosage warfarin
    Other names:
    • On-X Prosthetic Heart Valve
Experimental
AVR High risk with lower warfarin
AVR High risk with lower warfarin
  • Device: On-X valve using reduced anticoagulation
    Valve replacement with antiplatelet agents or lowered warfarin
    Other names:
    • On-X Prosthetic Heart Valve
Active Comparator
AVR High Risk with standard warfarin
AVR High Risk with standard warfarin
  • Device: On-X Valve with Standard warfarin Therapy
    Valve replacement with standard dosage warfarin
    Other names:
    • On-X Prosthetic Heart Valve
Experimental
MVR with lower warfarin
MVR with lower warfarin
  • Device: On-X valve using reduced anticoagulation
    Valve replacement with antiplatelet agents or lowered warfarin
    Other names:
    • On-X Prosthetic Heart Valve
Active Comparator
MVR with standard warfarin
MVR with standard warfarin
  • Device: On-X Valve with Standard warfarin Therapy
    Valve replacement with standard dosage warfarin
    Other names:
    • On-X Prosthetic Heart Valve

Recruiting Locations

More Details

NCT ID
NCT00291525
Status
Active, not recruiting
Sponsor
On-X Life Technologies, Inc.

Detailed Description

This is a longitudinal, randomized (randomization to occur at the 3-month follow-up) study comparing the On-X valve on low dose anticoagulation (test group) to concomitant control groups of On-X valves receiving standard Coumadin/aspirin therapy, and also to FDA objective performance criteria (OPC) for heart valve replacement. It is a multicenter study consisting of up to 50 centers in the United States, Canada, and Italy enrolling and randomizing no more than 1200 patients (200 in each of 6 groups). There are three test arms of the study: low risk aortic valve replacement, high risk aortic valve replacement, and mitral valve replacement. Each arm has an equivalent control. Test therapies are: low risk aortic valve replacement - aspirin/Plavix, high risk aortic valve replacement - Coumadin at INR of 1.5 to 2.0 plus aspirin, and mitral valve replacement - Coumadin at an INR of 2.0 to 2.5 plus aspirin. Follow-up will run for up to 8 years in each patient. Each arm is independent and the low risk aortic and high risk aortic arms are completed. The low risk aortic arm was closed early resulting in a reduction of the estimated total enrollment with randomization to 1000. The high risk arm is completed with FDA review and this arm had 375 randomized enrollees. The mitral arm continues to enroll with a planned randomized enrollment of 400.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.