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Recruiting NCT06487585

ANG-First Trial (Angiotensin II as First-Line Vasopressor Therapy in Cardiac Surgery)

Phase IV Interventional Vasodilatory Hypotension During or After Cardiac Surgery

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Angiotensin II.
Who it may be relevant to
Registry conditions: Vasodilatory Hypotension During or After Cardiac Surgery. Basic parameters: from 18 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
United States
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Official title

Angiotensin II as First-Line Vasopressor Therapy in Cardiac Surgery (ANG-First Trial)

Overview

The purpose of this research is to evaluate the use of Angiotensin II in patients with low blood pressure post-surgery. Your information will be collected for 28 days post the procedure and initiation of the study drug to assess for safety events and complications.

Interventions

  • Drug Angiotensin II
    Angiotensin II: Starting dose of 2.5 ng/kg/min administered IV; may dose escalate up to 80 ng/kg/min in order to achieve a MAP of 65 mmHg or higher in the first 3 hours. After 3 hours, may escalate dose up to 40 ng/kg/min in order to achieve a MAP of 65 mmHg. Dose titration in increments of 10 ng/kg/min every 2 minutes.

Primary outcome measures

  • Incidence of postoperative acute kidney injury, atrial fibrillation [Time frame: 28 days]
Secondary outcome measures (7)
  • Hours on Vasopressors [Time frame: 28 days]
  • Total IVF [Time frame: 28 days]
  • ICU LOS [Time frame: 28 days]
  • Postoperative LOS [Time frame: 28 days]
  • Any major STS complication [Time frame: 28 days]
  • 30-day mortality [Time frame: 30 days]
  • Cost [Time frame: 28 days]

Eligibility criteria

Inclusion criteria

  • Adult patients ≥ 18 years of age undergoing cardiac surgery requiring CPB
  • Patients must have clinical features of vasodilation as determined by a MAP < 65 mmHg that is non-transient in the opinion of the treating physician
  • Patients must be adequately volume resuscitated in the opinion of the treating physician
  • Systemic Vascular Resistance index (SVRi) < 1970 dynes·sec/cm⁵/m² to support the clinical diagnosis of vasodilation; if no pulmonary artery catheter is in place, vasodilatory hypotension diagnosis according to the judgement of the critical care team
  • Biventricular systolic function is at or greater than pre-cardiopulmonary bypass baseline as demonstrated by echocardiographic evaluation, or the patient is concomitantly treated with

Exclusion criteria

  • Bleeding as primary etiology of hypotension, as determined by > 4 units RBC transfusion in 24 hours.
  • Patients on ECMO
  • Patients with active endocarditis
  • Patients already on renal replacement therapy or creatinine of > 4 mg/dl within 2 weeks of surgery
  • Patients with contraindications to Angiotensin II including women who are pregnant or breastfeeding or have active coronary ischemia, mesenteric ischemia, limb ischemia, or high potassium (> 5.5 meq/L) while receiving Angiotensin II

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation
N/A
Model
Single group
Masking
Open label
Primary purpose
Treatment

Study locations

United States · 1 center
  • University of Maryland St. Joseph Medical Center — Towson

Identifiers

NCT: NCT06487585 · 00109542

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗