Clinical trial NCT04480892: Fibrinolytic Deficit in Patients With Acute PE
Official title: Fibrinolytic Deficit in Patients With Acute Pulmonary Embolism
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Acute Pulmonary Embolism
Fibrinolytic Deficit
Keywords: Acute Pulmonary Embolism
Fibrinolytic System
Fibrinolysis
Lead sponsor: Loyola University
Sponsor class: OTHER
Collaborators: name: Boston Scientific Corporation
First posted: 2020-07-22
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Maximum age (years): 90
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients with acute PE being treated by the PERT.

Brief summary: Fibrinolysis is the body's process that prevents blood clots. The investigators hypothesize that patients presenting with acute pulmonary embolism (PE) or blood clots in the lungs differ in their fibrinolytic deficit phenotype. The investigators aim to use biomarkers directly involved in endogenous fibrinolytic cascade including PAI-1, Alpha-2-Antiplasmin (A2A), TAFI, D-dimer, and Fibrinogen to phenotypically characterize patients presenting with acute PE and to correlate these biomarkers with clinical, echocardiographic, computed tomography (CT), and functional status outcomes.

Detailed description: Patients (n=100) identified by the Pulmonary Embolism Response Team (PERT) suffering from a PE will be identified by the PI. Blood plasma samples from these patients which have been drawn for routine lab tests will be identified and the Sub-I who will pick the samples up from the clinical lab after the routine analysis has been completed. These samples will be de-identified by giving them a study number. These samples will be recentrifuged and aliquoted. Samples will be stored in a -80ᵒC freezer in the Hemostasis \& Thrombosis Research Laboratory. When all 100 de-identified samples have been collected they will be analyzed blindly by the technical staff of the hemostasis laboratory for the fibrinolytic parameters PAI-1, Alpha-2-Antiplasmin, TAFI, tPA, D-dimer, Plasminogen, and Fibrinogen. PAI-1 and TAFI will be quantified with an Enzyme Linked-Immuno-Sorbent Assay (ELISA), while A2A is measured using functional assay. PAI-1 is measured as ug/ml, while TAFI and A2A are measured as % of normal controls. Normal controls are derived from pooled normal human plasma from volunteers purchased from outside vendor. Results will be compiled and sent to the PERT team for analysis and correlation withclinical, echocardiographic, computed tomography (CT), and functional status outcomes.

Eligibility criteria: Inclusion Criteria:

* Patients age 18 - 90 years
* Patients suffering an acute PE
* Blood collected for clinical evaluation of PE

Exclusion Criteria:

* Blood not collected or not sufficient quantity/quality

Primary outcomes:
measure: Plasminogen Activator Inhibitor-1 (PAI-1)
timeFrame: Baseline-Day 1
measure: Alpha-2 Antiplasmin level (A2P)
timeFrame: Baseline-Day 1
measure: Thrombin Activatable Fibrinolysis Inhibitor (TAFI)
timeFrame: Baseline-Day 1
measure: Tissue plasminogen activator (tPA)
timeFrame: Baseline-Day 1
measure: D-dimer
timeFrame: Baseline-Day 1
measure: Plasminogen
timeFrame: Baseline-Day 1
measure: Fibrinogen
timeFrame: Baseline-Day 1
measure: Clinical Presentation Risk Score
timeFrame: Baseline-Day 1
measure: Right Ventricular Function
timeFrame: Baseline-Day 1
measure: Pulmonary Artery Pressure
timeFrame: Baseline-Day 1
measure: Cardiac Output
timeFrame: Baseline-Day 1
Secondary outcomes:
Other outcomes:
Locations:
city: Maywood
country: United States
facility: Loyola University Medical Center
state: Illinois
Study officials:
affiliation: Loyola University
name: Amir Darki, MD
role: PRINCIPAL_INVESTIGATOR
References:
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