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NCT05677100ClinicalTrials.gov

Diuretics Alone vs. Aortix Endovascular Device for Acute Heart Failure

DRAIN-HF: Diuretics Alone vs. Aortix Endovascular Device for Acute Heart Failure

In reclutamentoAccetta partecipanti ora, secondo la scheda del registro.
Contatta questo studio

In breve

Aortix is a circulatory support device for chronic heart failure patients on medical management who have been hospitalized for acute decompensated heart failure (ADHF) and have persistent congestion despite usual medical therapy. Eligible ADHF patients with diuretic resistance (irrespective of…

Interventistico320 partecipanti ricercati50 centri2 paesi

Categorie

Registrato in 1 registro

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How this study is set up

The points below are drawn from the public registry record for this study. Each one cites the field or sentence it came from. A dash (—) means the record does not state something — not that it is missing or wrong. Many well-run studies, especially small ones, leave some of these blank.

  • Present: Registered before enrolment beganFirst posted 2023-01-10; recorded start 2023-08-23
  • Present: Has a defined primary outcomeA primary outcome measure is listed in the record
  • Present: The primary outcome states a time frameThe primary outcome measure records a time frame
  • Present: Participants are randomly assignedAllocation is recorded as randomised
  • Present: Has a comparison groupThe record lists a placebo or comparator arm, or more than one study arm
  • Not stated: Open label (no blinding)Masking is recorded as none (open label)
  • Not stated: An ethics committee is not stated in the registry recordThis registry's ingested record has no ethics-committee field
  • Not stated: Regulatory oversight (such as an IND or IDE) is not stated in the registry recordThis registry's ingested record has no regulatory-authorisation field
  • Not stated: A data monitoring committee is not stated in the registry recordThis registry's ingested record has no data-monitoring-committee fieldA data monitoring committee is not required for many smaller studies, and its absence here is not unusual.
  • Present: No cost to participants is mentioned in the recordChecked the summary, description and eligibility text; no cost-to-participant phrase found
  • Not stated: No other studies from this sponsor are in this databaseCounted from the lead sponsor named in the record (Procyrion)
  • Not stated: No posted results from this sponsor are in this database yetBased on the sponsor’s studies in this database
  • The record lists 8 conditions.
  • Lead sponsor type recorded as: industry.

Trial stature

Three independent measures of this study, described from its registry record — not a recommendation about it. A rigorous study by investigators nobody has heard of is better evidence than a weak study led by a famous one. How these are scored.

Methodological rigourMODERATE

A moderately rigorous design for a study of this type, judged from its ClinicalTrials.gov record.

How this score is built
  • Randomised allocation20/20

    Participants are randomly allocated between arms

  • Blinding0/20

    Open-label

  • Control arm0/15

    No comparator arm stated in the record

  • Primary-outcome specificity10/10

    Named primary outcome with a defined time frame

  • Endpoint type3/10

    Surrogate or intermediate endpoint (conservative default)

  • Multi-centre8/8

    Multi-centre: 49 sites

  • Data monitoring committee7/7

    A data monitoring committee is in place

  • Prospective registration5/5

    Registered before the study start date

  • Protocol / SAP posted0/5

    No protocol or SAP posted to the registry

ScaleMEDIUM

A medium-sized study, international in scope: 320 participants (target), run at 50 sites, across 2 countries.

How this score is built
  • Enrolment24/40

    320 participants (target)

  • Site count20/25

    49 sites

  • Country count7/15

    2 countries

  • Planned duration9/10

    Planned over about 48 months

  • Sponsor scale0/10

    Procyrion has led 1 trials in our corpus

Investigator standingUNKNOWN

We have no verifiable track record for the investigator named on this trial. That is common for early-career investigators and for records held outside ClinicalTrials.gov — it is not a negative signal.

How this score is built
  • Investigator standing0/100

    No investigator recorded in the registry for this trial

These describe the registry record only, and today we hold ClinicalTrials.gov data. Absent fields lower a score, and absence often reflects registration practice rather than study quality. A high-stature trial is not necessarily safer or a better choice for you — enrolling in a large definitive trial can mean a higher chance of receiving placebo, while a small early-phase study may be the only route to a new therapy.

Sintesi

Aortix is a circulatory support device for chronic heart failure patients on medical management who have been hospitalized for acute decompensated heart failure (ADHF) and have persistent congestion despite usual medical therapy. Eligible ADHF patients with diuretic resistance (irrespective of ejection fraction) will be enrolled and randomized 1:1 to either the Aortix system or standard of care medical management.

The study is a prospective, multi-center, randomized, nonblinded study to evaluate the safety and effectiveness of the Aortix System versus standard of care medical therapy in patients hospitalized with acute decompensated heart failure (ADHF) and persistent congestion despite usual medical management.Eligible ADHF patients with diuretic resistance (irrespective of ejection fraction) will be enrolled and randomized 1:1 to either the Aortix system or standard of care medical management. Randomization will be stratified by ejection fraction.. An additional registry arm will enroll patients who are considered candidates for advanced therapies in the near-term, but need improvement in their renal function to be able to receive additional medical therapies. All eligible enrolled registry subjects will receive Aortix system support. Planned study population is male or female patients 21 years of age or greater, with acute decompensated heart failure and diuretic resistance who remain congested despite standard of care medical therapy. This study will enroll up to 320 subjects with heart failure at 50 clinical sites in the United States and up to 5 OUS sites. The randomized study includes up to 240 subjects and the Advanced HF registry includes up to 80 subjects.

Patologie

  • Heart Failure
  • Cardiorenal Syndrome
  • Cardio-Renal Syndrome
  • ADHF
  • Heart Failure, Systolic
  • Heart Failure, Diastolic
  • Heart Failure; With Decompensation
  • Heart Failure, Congestive

Idoneità

Idoneità
SessoTutti
Età21 YearsNessun massimo
Volontari saniNo

Idoneità come riportata nel registro

Inclusion Criteria (Randomized Study): * Currently admitted to the hospital with a primary diagnosis of decompensated heart failure, irrespective of ejection fraction (EF); * Patients should be on maximally tolerated diuretic therapy and not diuresing sufficiently before being enrolled in DRAIN-HF. After being up-titrated on diuretics, patients should be followed for at least 24 hours on the higher of: i) furosemide 80 mg IV bid or equivalent or ii) IV furosemide or equivalent IV loop diuretic at a dose 2.5 x total daily home dose of furosemide equivalents in 2 divided doses, as tolerated, patient must have: Urine Output \<1,500mL in a 12-hour period OR a Net Fluid Loss ≤375mL in a 12-hour period. * Persistent signs and/or symptoms of congestion as evidenced by at least 2+ pitting edema, elevated jugular venous pressure \>12 cm water or ascites after treatment with IV diuretics per inclusion criterion 2.; * Age \>21 years and able to provide written informed consent; * Negative pregnancy test if patient is of child-bearing potential. Exclusion Criteria (Randomized Study): * Treatment with high dose IV inotropes within the last 48 hours prior to enrollment. High dose is defined as \>5 µg/kg/min dopamine OR \>5 µg/kg/min dobutamine OR \>0.375 µg/kg/min milrinone; * Active and ongoing hypotension with a systolic blood pressure \<90 mmHg lasting more than 30 minutes or a mean arterial pressure (MAP) \<60 mmHg lasting more than 30 minutes at enrollment; * Treatment with vasopressors (defined as phenylephrine, norepinephrine, epinephrine or, vasopressin) within 48 hours prior to enrollment; * An estimated PASP of \>80 mmHg as measured on echocardiogram or echocardiographic evidence of primarily right heart failure; * Acute kidney failure defined as an increase in serum creatinine to ≥4.0mg/dL (≥353.6 µmol/L) at enrollment; * Evidence of contrast induced nephropathy, nephritis or nephrotic syndrome; * Prior kidney transplant, single kidney, partial nephrectomy OR use of dialysis, continuous renal replacement therapy (CRRT) or ultrafiltration in the last 90 days prior to enrollment; * Confirmed decompensated cirrhosis (defined as Child Pugh class B or C) or concern for shock liver (AST \> 1000U/L or total Bilirubin \> 5.0mg/dl) at enrollment; * Presence of an active, uncontrolled infection that would preclude safe placement or removal of the device; * Prior heart transplant or likely heart transplantation before the 30- day follow-up visit; * Current or previous support with a durable LVAD at any time or planned LVAD insertion before the 30-day follow-up visit; * Use of an intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO), or percutaneous ventricular assist devices (e.g. Impella or TandemHeart) within the last 30 days; * Confirmed diagnosis of AL amyloidosis; * Acute myocardial infarction Type 1 within 30 days of enrollment, or planned coronary revascularization in the next 30 days; * Stroke within 30 days of enrollment; * Severe Bleeding Risk (any of the following): 1. Previous intracranial bleed unless there is documentation in the medical record (from a physician that is not part of the study) that the patient can safely use anticoagulation for 7 days, 2. GI bleeding within 6 months requiring hospitalization and/or transfusion, 3. Recent major surgery within 30 days if the surgical wound is judged to be associated with an increased risk of bleeding, 4. Procedure with arterial ilio-femoral access \> 6 FR within 30 days, 5. Platelet count \<75,000 cells/mm3, 6. Uncorrectable bleeding diathesis or coagulopathy (e.g. INR ≥2 not due to anticoagulation therapy) or hypercoaguable state including HIT; 7. Inability to tolerate anticoagulation therapy for up to 7 days. * Contraindicated Anatomy : 1. Descending aortic anatomy that would prevent safe placement of the device \[\<18 mm or \>31 mm aorta diameter at deployment location (measured between the superior aspect of the T10 vertebra and superior aspect of the L1 vertebra)\], 2. Ilio-femoral diameter or peripheral vascular anatomy that would preclude safe placement of a 21F (outer diameter) introducer sheath, 3. Femoral artery depth inconsistent with use of closure device, 4. Abnormalities or severe vascular disease that would preclude safe access and device delivery (e.g. aneurysm with thrombus, marked tortuosity, significant narrowing or inadequate size of the abdominal aorta, iliac or femoral arteries, or severe calcification), 5. Known connective tissue disorder (e.g. Marfan Syndrome) or other aortopathy at risk of vascular injury, 6. Any endovascular stent graft in the descending aorta. Any endovascular stent graft in the femoro-iliac vessels that is not well endothelialized and would preclude safe introduction/removal of the Aortix pump as demonstrated by imaging. * Known hypersensitivity or contraindication to study or procedure medications (e.g. anticoagulation therapy) or device materials (e.g. history of severe reaction to nickel or nitinol); * Participation in any other clinical investigation that is likely to confound study results or affect the study; * Poor health such that the patient is unable to undergo the Aortix device placement/retrieval and/or unlikely to be able to survive to the 30-day visit; * Unable or unwilling to undergo screening (imaging, PA Catheter placement), device implant and retrieval procedures or return for 30-day visit. Inclusion Criteria (Advanced Heart Failure Registry): * Currently admitted to the hospital with a primary diagnosis of decompensated HF, irrespective of ejection fraction (EF). * Patient has already been evaluated and indicated to receive an LVAD or heart transplant and will receive the LVAD or be listed for heart transplantation in the next 30 days if their congestion status and renal function improves. * Patient must have been treated with ≥ 80 mg IV furosemide bid or equivalent and have evidence of increasing diuretic dosing requirements over the past 12 months, as tolerated. * Must have evidence of refractoriness to medical management as documented by persistent signs and/or symptoms of congestion as evidenced by at least 2+ pitting edema, elevated jugular venous pressure \>12 cm water, or ascites after treatment with IV diuretics for a minimum of 24 hours. * Serum creatinine ≥ 2.0 mg/dL AND eGFR ≤ 45 ml/min/1.73m2 at time of enrollment * Age ≥ 21 years and able to provide written informed consent. * Negative pregnancy test if patient is of childbearing potential. Exclusion Criteria (Advanced Heart Failure Registry): * Treatment with high dose IV inotropes within 48 hours prior to enrollment. High dose is defined as any one of the following: \>5 µg/kg/min dopamine OR \>5 µg/kg/min dobutamine OR \>0.375 µg/kg/min milrinone. * Active and ongoing hypotension with a systolic blood pressure \<80 mmHg lasting more than 30 minutes or a mean arterial pressure (MAP) \<55 mmHg lasting more than 30 minutes at enrollment. * Treatment with vasopressors (defined as phenylephrine, norepinephrine, epinephrine or, vasopressin) within 48 hours prior to enrollment. * An estimated PASP of \>80 mmHg as measured on echocardiogram or echocardiographic evidence of primarily right heart failure. * Acute kidney failure defined as an increase in serum creatinine to ≥ 4.0mg/dL at enrollment. * Evidence of contrast-induced nephropathy, nephritis, or nephrotic syndrome. * Prior kidney transplant, single kidney, partial nephrectomy OR use of dialysis, continuous renal replacement therapy (CRRT), or ultrafiltration in the last 90 days prior to enrollment. * Confirmed decompensated cirrhosis (defined as Child Pugh class B or C) or concern for shock liver (AST \> 1000U/L or total Bilirubin \> 5.0mg/dl) at enrollment. * Presence of an active, uncontrolled infection that would preclude safe placement or removal of the device. * Current or previous support with a durable LVAD. * INTERMACS Profile 1 at enrollment. * Currently on mechanical ventilatory support. * Use of an extracorporeal membrane oxygenation (ECMO) or percutaneous ventricular assist device (e.g., Impella or TandemHeart) within the last 30 days. * Confirmed diagnosis of AL amyloidosis. * Acute myocardial infarction Type 1 within 30 days of enrollment or planned coronary revascularization in the next 30 days. * Stroke within 30 days of enrollment. * Severe Bleeding Risk (any of the following): * Previous intracranial bleed unless there is documentation in the medical record (from a physician that is not part of the study) that the patient can safely use anticoagulation for 7 days. * GI bleeding within 6 months requiring hospitalization and/or transfusion. * Recent major surgery within 30 days if the surgical wound is judged to be associated with an increased risk of bleeding. * Procedure with arterial ilio-femoral access \> 6 Fr within 30 days. * Platelet count \<75,000 cells/mm3 . * Uncorrectable bleeding diathesis or coagulopathy (e.g., INR≥ 2 not due to anticoagulation therapy) or hypercoagulable state including HIT. * Inability to tolerate anticoagulation therapy for up to 7 days. * Contraindicated Anatomy : * Descending aortic anatomy that would prevent safe placement of the device \[\<18 mm or \>31 mm aorta diameter at deployment location (measured between the superior aspect of the T10 vertebra and superior aspect of the L1 vertebra)\]. * Ilio-femoral diameter or peripheral vascular anatomy that would preclude safe placement of a 21 Fr (outer diameter) introducer sheath. * Femoral artery depth inconsistent with use of closure device. * Abnormalities or severe vascular disease that would preclude safe access and device delivery (e.g., aneurysm with thrombus; marked tortuosity; significant narrowing or inadequate size of the abdominal aorta, iliac, or femoral arteries; or severe calcification). * Known connective tissue disorder (e.g., Marfan Syndrome) or other aortopathy at risk of vascular injury. * Any endovascular stent graft in the descending aorta. Any endovascular stent graft in the femoro-iliac vessels that is not well endothelialized and would preclude safe introduction/removal of the Aortix pump as demonstrated by imaging. * Known hypersensitivity or contraindication to study or procedure medications (e.g., anticoagulation therapy) or device materials (e.g., history of severe reaction to nickel or nitinol). * Participation in any other clinical investigation that is likely to confound study results or affect the study. * Poor health such that the patient is unable to undergo the Aortix device placement/retrieval and/or unlikely to be able to survive to the 30-day visit. * Unable or unwilling to undergo screening, device implant and retrieval procedures, or return for 30-day visit.

Idoneità in frasi semplici

I criteri di questa scheda non sono ancora stati suddivisi in affermazioni distinte. Il testo del registro qui sopra è completo ed è la versione autorevole.

Disegno dello studio

Disegno dello studio
Tipo di studioInterventistico
FaseNon applicabile
AssegnazioneRandomizzata
Modello di interventoPARALLEL
Finalità principaleTREATMENT
MascheramentoNONE (0)
Arruolamento320 partecipanti ricercati

Sponsor e collaboratori

  • Procyrion Sponsor

Bracci e interventi

  • Treatment ArmEXPERIMENTAL

    Eligible ADHF patients with diuretic resistance (irrespective of ejection fraction) will be enrolled and randomized 2:1 to either the Aortix system or standard of care medical management. Randomization will be stratified by ejection fraction.

  • Control ArmNO_INTERVENTION

    The Control arm should receive standard of care therapy as per the study directed Diuretic Care Treatment Algorithm.

  • Advanced HF RegistryEXPERIMENTAL

    For the Advanced HF registry, all eligible enrolled subjects will receive Aortix system support.

Interventi

  • Dispositivo Aortix System

    Aortix is a circulatory support device for chronic heart failure patients on medical management who have been hospitalized for acute decompensated heart failure (ADHF) and are resistant to diuretic therapy.

Esiti misurati

  1. Esito primario

    Primary Safety Endpoint: Incidence of Aortix Device / Procedural-Related Major Adverse Events (MAE) through 30 days of Follow-up.

    Incidence of Major Adverse Events

    Orizzonte temporale Baseline to 30 day Follow-Up

  2. Esito primario

    Primary Effectiveness Endpoint: Combined composite of clinically significant reduction in net fluid loss over 7 days and freedom from mortality or heart failure re-hospitalization/therapy escalation from the baseline visit to the 30-day follow-up visit.

    Composite of net fluid loss, mortality and HF hospitalization/escalation of therapy

    Orizzonte temporale Baseline to 30 day Follow-Up

  3. Esito secondario

    Net Fluid Loss

    Change in Net Fluid Loss from Baseline to Day 7/Discharge

    Orizzonte temporale Baseline to Day 7

  4. Esito secondario

    All-cause Mortality

    Rate of mortality

    Orizzonte temporale Baseline to 30 day Follow-Up

  5. Esito secondario

    HF Re-Hospitalization or escalation of HF therapy

    Evaluation of HF re-hospitalization and therapy escalation

    Orizzonte temporale Baseline to 30 day Follow-Up

  6. Esito secondario

    eGFR

    Evaluation of changes in eGFR

    Orizzonte temporale Baseline to 30 day Follow-Up

  7. Esito secondario

    NT-proBNP

    Evaluation of NT-proBNP

    Orizzonte temporale Baseline to 30 day Follow-Up

  8. Esito secondario

    Patient Reported Dyspnea Assessment

    Change in patient reported dyspnea scale

    Orizzonte temporale Baseline to 30 day Follow-Up

  9. Esito secondario

    Standing body weight

    Change in standing body weight

    Orizzonte temporale Baseline to 30 day Follow-Up

  10. Esito secondario

    Incidence and percentages of major adverse events (MAE) Pooled

    Incidence and percentages of major adverse events (MAE) pooled analysis of Aortix randomized cohort and registry cohort

    Orizzonte temporale Baseline to 30 day Follow-Up

Date

Date
Data di inizio23 agosto 2023 (effettiva)
Conclusione primaria1 gennaio 2028 (stimata)
Conclusione1 agosto 2028 (stimata)
Prima pubblicazione10 gennaio 2023 (effettiva)
Ultimo aggiornamento25 agosto 2026
Risultati pubblicatiNon indicato nella scheda del registro
Stato verificato l'ultima voltaagosto 2026

«Effettiva» significa che l'evento è avvenuto. «Stimata» significa che lo sponsor lo prevede. Le due cose non sono equivalenti.

Centri

33 centri stanno reclutando

Hungary

Hungary
StrutturaCittàStato o regioneStato
Semmelweis UniversityBudapestIn reclutamento

United States

United States
StrutturaCittàStato o regioneStato
Jefferson Abington HospitalAbingtonPennsylvaniaIn reclutamento
AnMed HealthAndersonSouth CarolinaIn reclutamento
University of Michigan, Cardiovascular MedicineAnn ArborMichiganRitirato
Emory University HospitalAtlantaGeorgiaIn reclutamento
Piedmont Healthcare Inc.AugustaGeorgiaIn reclutamento
New York Presbyterian - Brooklyn Methodist HospitalBrooklynNew YorkIn reclutamento
Atrium Health Sanger Heart and Vascular InstituteCharlotteNorth CarolinaIn reclutamento
University of VirginiaCharlottesvilleVirginiaInterrotto
University of ChicagoChicagoIllinoisIn reclutamento
Advocate IMMCChicagoIllinoisIn reclutamento
The Ohio State UniversityColumbusOhioIn reclutamento
John Muir HealthConcordCaliforniaIn reclutamento
Henry FordDetroitMichiganIn reclutamento
Advocate Aurora - Good SamaritanDowners GroveIllinoisInterrotto
Duke University Medical CenterDurhamNorth CarolinaAttivo, non in reclutamento
Ascenscion Alexian BrothersElk Grove VillageIllinoisIn reclutamento
Broward HealthFort LauderdaleFloridaIn reclutamento
Baylor Scott & WhiteFort WorthTexasRitirato
Hackensack University Medical CenterHackensackNew JerseyIn reclutamento
Texas Heart InstituteHoustonTexasIn reclutamento
University of Mississippi Medical CenterJacksonMississippiIn reclutamento
Wellstar Research InstitueMariettaGeorgiaInterrotto
Intermountain HealthMurrayUtahRitirato
Jersey Shore University Medical CenterNeptune CityNew JerseyIn reclutamento
Nyph/CumcNew YorkNew YorkIn reclutamento
Northwell Health (Lenox Hill)New YorkNew YorkInterrotto
Mount Sinai MorningsideNew YorkNew YorkIn reclutamento
Oklahoma Cardiovascular Research GroupOklahoma CityOklahomaIn reclutamento
Ascension Sacred HeartPensacolaFloridaRitirato
Thomas Jefferson University HospitalPhiladelphiaPennsylvaniaRitirato
Penn Presbyterian Medical CenterPhiladelphiaPennsylvaniaIn reclutamento
Mayo Clinic - ArizonaPhoenixArizonaIn reclutamento
Banner--University Medical Center PhoenixPhoenixArizonaIn reclutamento
Baylor Scott & WhitePlanoTexasRitirato
Oregon Health & Sciences UniversityPortlandOregonAttivo, non in reclutamento
Nuvance HealthPoughkeepsieNew YorkIn reclutamento
Virginia Commonwealth UniversityRichmondVirginiaIn reclutamento
San Francisco Veterans AdministrationSan FranciscoCaliforniaInterrotto
University of California San FranciscoSan FranciscoCaliforniaIn reclutamento
Zuckerberg San Francisco GeneralSan FranciscoCaliforniaIn reclutamento
HonorHealth Medical CenterScottsdaleArizonaInterrotto
Northwell Health (Staten Island)Staten IslandNew YorkIn reclutamento
Tallahassee Research InstituteTallahasseeFloridaInterrotto
AdventHealth TampaTampaFloridaIn reclutamento
BayCare Medical/St. Joseph's HospitalTampaFloridaIn reclutamento
University of South FloridaTampaFloridaIn reclutamento
Cleveland Clinic FloridaWestonFloridaIn reclutamento
Ascension via Christi KansasWichitaKansasInterrotto
Novant Health New Hanover Regional Medical CenterWilmingtonNorth CarolinaRitirato

Documenti dello studio

In questa scheda del registro non sono collegati documenti.

Modifiche nel tempo

  1. 25 agosto 2026

    Centro aggiunto

    1 site added (50 total)

    4950

  2. 4 agosto 2026

    Data di conclusione posticipata

    Primary completion delayed 365 days

    2027-01-012028-01-01