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Safety and Efficacy of IV Diazoxide as an Additive to Hyperkalemic Cardioplegia in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass

Johns Hopkins University logo

Johns Hopkins University

Status and phase

Withdrawn
Phase 1

Conditions

Myocardial Stunning

Treatments

Other: Placebo
Drug: IV Diazoxide

Study type

Interventional

Funder types

Other

Identifiers

NCT04830982
IRB00265542

Details and patient eligibility

About

This study aims to confirm the safety and efficacy of diazoxide as an additive to hyperkalemic cardioplegia in patients undergoing cardiac surgery with cardiopulmonary bypass. The investigators hypothesize that diazoxide combined with hyperkalemic cardioplegia provides superior myocardial protection and reduced myocardial stunning compared with standard cardioplegia alone. The investigators will randomize 30 patients in a 2:1 fashion to treatment vs control. Safety will be assessed by comparing mean arterial blood pressure measurements, glucose levels and incidence of adverse events between the two groups. Efficacy will be assessed by comparing right and left ventricular function in pre-operative vs post-operative transesophageal echocardiograms, need for mechanical circulatory support, ease of separation from bypass and Vasoactive Inotrope Score (VIS) between the two groups. The information gained could pave the way for the use of Katp (Potassium-atp) channel openers to prevent stunning, improve patient outcomes, and reduce health care costs related to myocardial stunning that requires inotropic and mechanical support following cardiac surgery.

Full description

This is a randomized blinded Phase I clinical trial. Thirty patients total will be randomized on a 2:1 basis to treatment (IV Diazoxide added to cardioplegia) vs control (cardioplegia alone). Diazoxide will be added to the first dose of cardioplegia only. Subsequent doses of cardioplegia will not contain additives.

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Age 18 years or older
  • Scheduled for cardiac surgery with cardiopulmonary bypass and cardioplegic arrest
  • Patient scheduled for elective cardiac surgery

Exclusion criteria

  • Patient with Diabetes Mellitus on sulfonylurea medications
  • Scheduled for left ventricular assist device (LVAD) or heart transplant
  • Left ventricular ejection fraction < 30%
  • Pre-operative placement or planned use of mechanical circulatory support during surgery
  • Allergy to Thiazide and its derivatives
  • History of gout
  • Patient is pregnant or breastfeeding

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Quadruple Blind

0 participants in 2 patient groups, including a placebo group

Diazoxide
Experimental group
Description:
IV Diazoxide as additive to hypothermic hyperkalemic cardioplegia.
Treatment:
Drug: IV Diazoxide
Placebo
Placebo Comparator group
Description:
Placebo as additive to hypothermic hyperkalemic cardioplegia.
Treatment:
Other: Placebo

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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