Pradaxa or Warfarin for Prevention of Recurrent VTE in Patients With Angiographically Confirmed Acute Massive Pulmonary Embolism undergoIng Endovascular Mechanical Fragmentation and Thrombolytic Therapy (Re-Spire)

Meshalkin Research Institute of Pathology of Circulation

Status and phase

Unknown

Phase 4

Conditions

Angiographically Confirmed Acute Massive Pulmonary Embolism Treated With Endovascular Mechanical Fragmentation and Thrombolytic Therapy

Treatments

Drug: Warfarin

Drug: Dabigatran Etexilate

Study type

Interventional

Funder types

NETWORK

Identifiers

NCT02979561

RE-SPIRE study

Details and patient eligibility

About

A prospective randomised controlled study to evaluate outcomes of the treatment with pradaxa or warfarin for prevention of recurrent DVT in patients with angiographically confirmed acute massive pulmonary embolism undergoIng endovascular mechanical fragmentation and thrombolytic therapy. [RE-SPIRE study]

Enrollment

200 estimated patients

Sex

All

Ages

18 to 80 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Men and women aged > 18 years
Angiographically confirmed acute massive pulmonary embolism with involvement of Central pulmonary arteries.
endovascular mechanical thrombus fragmentation + thrombolytic therapy (using recombinant tissue activator of plasminogen), performed for treatment of the above-mentioned pulmonary embolism in less than 48 hours before randomization. The patient should be randomized no earlier than 24 hours after procedures endovascular mechanical thrombus fragmentation + thrombolytic therapy
Written informed consent signed by patient.

Exclusion criteria

Signs of hemodynamic instability (i.e. systolic blood pressure <100 mm Hg.St. or episode of systolic blood pressure fall for ≥40 mm Hg. / or heart rate > 110 lasting more than 15 min) or need for ventilatory support within 12 hours prior to randomisation.
The indication for oral anticoagulation, associated with others disease.
malignant neoplasm of any location
Contraindications to warfarin or pradaxa according to Russian Instructions for medical use of these drugs
Indications for concomitant treatment with antiplatelet agents
Any stroke within 6 months before randomization
Intracranial hemorrhage in anamnesis
Active bleeding, bleeding diathesis.
Clinically significant bleeding within the last 30 days.
Trauma or extensive surgery within 1 month before randomization or surgery planned in the next 6 months after randomization.
Intracranial pathology: tumor, arteriovenous fistula or aneurysm.
Gastrointestinal bleeding in the previous 3 months.
Gastric ulcer or duodenal ulcer with clinical manifestations or endoscopically identified acute ulcer without signs of scarring during previous 30 days.
Uncontrolled hypertension (systolic blood pressure> 180 mm Hg. and / or diastolic blood pressure> 100 mm.hg in patients receiving antihypertensive drugs).
Pregnancy, lactation.
Life expectancy <6 months.
Clinically significant liver disease.
Creatinine clearance (estimated by Cockcroft-Gault) <30 ml / min.
hemoglobin level <90 g/l), thrombocytopenia <100x10^9 / L.
Patients who, in the opinion of the researcher, are not suitable for inclusion in the study, for example, due to the low likelihood of doctor's recommendations following.
Long-term use of NSAIDs
Current participation in another clinical study.
Allergic to contrast substance or radioisotope drugs used in procedures to assess endpoints of the study, which according to researchers, may be a contraindication to the implementation of these research methods.