Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Trial Review
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Download to PDF
Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01149044
Registration number
NCT01149044
Ethics application status
Date submitted
22/06/2010
Date registered
23/06/2010
Date last updated
20/10/2015
Titles & IDs
Public title
A Trial of Routine Aspiration Thrombectomy With Percutaneous Coronary Intervention (PCI) Versus PCI Alone in Patients With ST-Segment Elevation Myocardial Infarction (STEMI) Undergoing Primary PCI
Query!
Scientific title
TOTAL Trial: A Randomized Trial of Routine Aspiration ThrOmbecTomy With PCI Versus PCI ALone in Patients With STEMI Undergoing Primary PCI
Query!
Secondary ID [1]
0
0
TOTAL Trial
Query!
Universal Trial Number (UTN)
Query!
Trial acronym
TOTAL
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Acute Coronary Syndrome
0
0
Query!
ST Elevation Myocardial Infarction
0
0
Query!
Percutaneous Coronary Intervention
0
0
Query!
Condition category
Condition code
Cardiovascular
0
0
0
0
Query!
Coronary heart disease
Query!
Cardiovascular
0
0
0
0
Query!
Other cardiovascular diseases
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
Active comparator: Upfront Thrombectomy followed by PCI - Upfront manual aspiration thrombectomy followed by PCI
Active comparator: PCI Alone - PCI without upfront manual aspiration thrombectomy
Query!
Comparator / control treatment
Query!
Control group
Query!
Outcomes
Primary outcome [1]
0
0
The first occurrence of cardiovascular death, recurrent myocardial infarction, cardiogenic shock, or new or worsening NYHA Class IV heart failure
Query!
Assessment method [1]
0
0
Query!
Timepoint [1]
0
0
up to 180 days
Query!
Secondary outcome [1]
0
0
Stroke
Query!
Assessment method [1]
0
0
Query!
Timepoint [1]
0
0
up to 30 days
Query!
Secondary outcome [2]
0
0
Key Net Benefit Outcome: The first occurence of CV death, MI, stroke, cardiogenic shock or new or worsening NHYA Class IV heart failure
Query!
Assessment method [2]
0
0
Query!
Timepoint [2]
0
0
up to 1 year
Query!
Secondary outcome [3]
0
0
Cardiovascular Mortality
Query!
Assessment method [3]
0
0
Query!
Timepoint [3]
0
0
up to 180 days
Query!
Secondary outcome [4]
0
0
Key Secondary Efficacy Outcome: The first occurence of cardiovascular death, myocardial infarction, cardiogenic shock, new or worsening NYHA class IV heart failure, stent thrombosis and target vessel revascularization
Query!
Assessment method [4]
0
0
Query!
Timepoint [4]
0
0
up to 180 days
Query!
Eligibility
Key inclusion criteria
1. Patients presenting with:
* Symptoms of myocardial ischemia lasting for = 30 minutes AND
* Definite ECG changes indicating STEMI: ST elevation of greater than 0.1 mV in two contiguous limb leads or 0.2 mV in two contiguous precordial leads
2. Referred for primary PCI
3. Randomized within 12 hours of symptoms onset and prior to diagnostic angiography
4. Informed consent
Query!
Minimum age
19
Years
Query!
Query!
Maximum age
No limit
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
1. Age = 18 years
2. Prior coronary artery bypass surgery (CABG)
3. Life expectancy less than six months due to non-cardiac condition
4. Treatment with fibrinolytic therapy for qualifying index STEMI event
Query!
Study design
Purpose of the study
Treatment
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Query!
Masking / blinding
Open (masking not used)
Query!
Who is / are masked / blinded?
Query!
Query!
Query!
Query!
Intervention assignment
Parallel
Query!
Other design features
Query!
Phase
NA
Query!
Type of endpoint/s
Query!
Statistical methods / analysis
Query!
Recruitment
Recruitment status
Completed
Query!
Data analysis
Query!
Reason for early stopping/withdrawal
Query!
Other reasons
Query!
Date of first participant enrolment
Anticipated
Query!
Actual
1/08/2010
Query!
Date of last participant enrolment
Anticipated
Query!
Actual
Query!
Date of last data collection
Anticipated
Query!
Actual
1/10/2015
Query!
Sample size
Target
Query!
Accrual to date
Query!
Final
10732
Query!
Recruitment in Australia
Recruitment state(s)
NSW,QLD
Query!
Recruitment hospital [1]
0
0
Royal North Shore Hospital - Sydney
Query!
Recruitment hospital [2]
0
0
St. George Public Hospital - Sydney
Query!
Recruitment hospital [3]
0
0
Gold Coast Hospital - Southport
Query!
Recruitment postcode(s) [1]
0
0
- Sydney
Query!
Recruitment postcode(s) [2]
0
0
- Southport
Query!
Recruitment outside Australia
Country [1]
0
0
United States of America
Query!
State/province [1]
0
0
California
Query!
Country [2]
0
0
United States of America
Query!
State/province [2]
0
0
Georgia
Query!
Country [3]
0
0
United States of America
Query!
State/province [3]
0
0
New Mexico
Query!
Country [4]
0
0
United States of America
Query!
State/province [4]
0
0
Ohio
Query!
Country [5]
0
0
United States of America
Query!
State/province [5]
0
0
Pennsylvania
Query!
Country [6]
0
0
Austria
Query!
State/province [6]
0
0
Vienna
Query!
Country [7]
0
0
Belgium
Query!
State/province [7]
0
0
Lige
Query!
Country [8]
0
0
Brazil
Query!
State/province [8]
0
0
RS
Query!
Country [9]
0
0
Brazil
Query!
State/province [9]
0
0
Santa Catarina
Query!
Country [10]
0
0
Brazil
Query!
State/province [10]
0
0
Sao Paulo
Query!
Country [11]
0
0
Brazil
Query!
State/province [11]
0
0
Porto Elegre
Query!
Country [12]
0
0
Canada
Query!
State/province [12]
0
0
Alberta
Query!
Country [13]
0
0
Canada
Query!
State/province [13]
0
0
British Columbia
Query!
Country [14]
0
0
Canada
Query!
State/province [14]
0
0
Nova Scotia
Query!
Country [15]
0
0
Canada
Query!
State/province [15]
0
0
Ontario
Query!
Country [16]
0
0
Canada
Query!
State/province [16]
0
0
Quebec
Query!
Country [17]
0
0
China
Query!
State/province [17]
0
0
Shanghai
Query!
Country [18]
0
0
Czech Republic
Query!
State/province [18]
0
0
Liberec
Query!
Country [19]
0
0
Czech Republic
Query!
State/province [19]
0
0
Pilsen
Query!
Country [20]
0
0
Czech Republic
Query!
State/province [20]
0
0
Prague
Query!
Country [21]
0
0
Czech Republic
Query!
State/province [21]
0
0
Praha
Query!
Country [22]
0
0
Czech Republic
Query!
State/province [22]
0
0
Usti nad Labem
Query!
Country [23]
0
0
Finland
Query!
State/province [23]
0
0
Kuopio
Query!
Country [24]
0
0
Finland
Query!
State/province [24]
0
0
Tampere
Query!
Country [25]
0
0
France
Query!
State/province [25]
0
0
Besancon
Query!
Country [26]
0
0
France
Query!
State/province [26]
0
0
Grenoble
Query!
Country [27]
0
0
France
Query!
State/province [27]
0
0
Paris
Query!
Country [28]
0
0
France
Query!
State/province [28]
0
0
Pau
Query!
Country [29]
0
0
Germany
Query!
State/province [29]
0
0
Bonn
Query!
Country [30]
0
0
Germany
Query!
State/province [30]
0
0
Essen
Query!
Country [31]
0
0
Germany
Query!
State/province [31]
0
0
Immenstadt
Query!
Country [32]
0
0
Germany
Query!
State/province [32]
0
0
Munchen
Query!
Country [33]
0
0
Greece
Query!
State/province [33]
0
0
Patras
Query!
Country [34]
0
0
Greece
Query!
State/province [34]
0
0
Thessaloniki
Query!
Country [35]
0
0
Hungary
Query!
State/province [35]
0
0
Budapest
Query!
Country [36]
0
0
Hungary
Query!
State/province [36]
0
0
Szeged
Query!
Country [37]
0
0
Korea, Republic of
Query!
State/province [37]
0
0
Cheonan
Query!
Country [38]
0
0
Korea, Republic of
Query!
State/province [38]
0
0
Gwangju
Query!
Country [39]
0
0
Korea, Republic of
Query!
State/province [39]
0
0
Seoul
Query!
Country [40]
0
0
Macedonia, The Former Yugoslav Republic of
Query!
State/province [40]
0
0
Skopje
Query!
Country [41]
0
0
Netherlands
Query!
State/province [41]
0
0
Nieuwegein
Query!
Country [42]
0
0
New Zealand
Query!
State/province [42]
0
0
Hamilton
Query!
Country [43]
0
0
Serbia
Query!
State/province [43]
0
0
Belgrade
Query!
Country [44]
0
0
Spain
Query!
State/province [44]
0
0
Baldona
Query!
Country [45]
0
0
Spain
Query!
State/province [45]
0
0
Barcelona
Query!
Country [46]
0
0
Spain
Query!
State/province [46]
0
0
Madrid
Query!
Country [47]
0
0
Spain
Query!
State/province [47]
0
0
Palma de Mallorca
Query!
Country [48]
0
0
Spain
Query!
State/province [48]
0
0
Vigo
Query!
Country [49]
0
0
United Kingdom
Query!
State/province [49]
0
0
Basingstoke
Query!
Country [50]
0
0
United Kingdom
Query!
State/province [50]
0
0
Bethnal Green
Query!
Country [51]
0
0
United Kingdom
Query!
State/province [51]
0
0
Camberley
Query!
Country [52]
0
0
United Kingdom
Query!
State/province [52]
0
0
Hull
Query!
Country [53]
0
0
United Kingdom
Query!
State/province [53]
0
0
Kettering
Query!
Country [54]
0
0
United Kingdom
Query!
State/province [54]
0
0
Leicester
Query!
Country [55]
0
0
United Kingdom
Query!
State/province [55]
0
0
Manchester
Query!
Country [56]
0
0
United Kingdom
Query!
State/province [56]
0
0
Margate
Query!
Country [57]
0
0
United Kingdom
Query!
State/province [57]
0
0
Sheffield
Query!
Country [58]
0
0
United Kingdom
Query!
State/province [58]
0
0
Southampton
Query!
Country [59]
0
0
United Kingdom
Query!
State/province [59]
0
0
Taunton
Query!
Funding & Sponsors
Primary sponsor type
Other
Query!
Name
Population Health Research Institute
Query!
Address
Query!
Country
Query!
Ethics approval
Ethics application status
Query!
Summary
Brief summary
This is an international, randomized, controlled, parallel group study in which patients with ST-Segment Elevation Myocardial Infarction (STEMI) will be allocated to one of the following: Manual aspiration thrombectomy with Percutaneous Coronary Intervention (PCI) or PCI alone.
Query!
Trial website
https://clinicaltrials.gov/study/NCT01149044
Query!
Trial related presentations / publications
Jolly SS, Cairns J, Yusuf S, Meeks B, Shestakovska O, Thabane L, Niemela K, Steg PG, Bertrand OF, Rao SV, Avezum A, Cantor WJ, Pancholy SB, Moreno R, Gershlick A, Bhindi R, Welsh RC, Cheema AN, Lavi S, Rokoss M, Dzavik V. Design and rationale of the TOTAL trial: a randomized trial of routine aspiration ThrOmbecTomy with percutaneous coronary intervention (PCI) versus PCI ALone in patients with ST-elevation myocardial infarction undergoing primary PCI. Am Heart J. 2014 Mar;167(3):315-321.e1. doi: 10.1016/j.ahj.2013.12.002. Epub 2013 Dec 14. Jolly SS, Cairns JA, Yusuf S, Meeks B, Pogue J, Rokoss MJ, Kedev S, Thabane L, Stankovic G, Moreno R, Gershlick A, Chowdhary S, Lavi S, Niemela K, Steg PG, Bernat I, Xu Y, Cantor WJ, Overgaard CB, Naber CK, Cheema AN, Welsh RC, Bertrand OF, Avezum A, Bhindi R, Pancholy S, Rao SV, Natarajan MK, ten Berg JM, Shestakovska O, Gao P, Widimsky P, Dzavik V; TOTAL Investigators. Randomized trial of primary PCI with or without routine manual thrombectomy. N Engl J Med. 2015 Apr 9;372(15):1389-98. doi: 10.1056/NEJMoa1415098. Epub 2015 Mar 16. Alkhalil M, Kuzemczak M, Zhao R, Kavvouras C, Cantor WJ, Overgaard CB, Lavi S, Sharma V, Chowdhary S, Stankovic G, Kedev S, Bernat I, Bhindi R, Sheth T, Niemela K, Jolly SS, Dzavik V. Prognostic Role of Residual Thrombus Burden Following Thrombectomy: Insights From the TOTAL Trial. Circ Cardiovasc Interv. 2022 May;15(5):e011336. doi: 10.1161/CIRCINTERVENTIONS.121.011336. Epub 2022 May 17. Moxham R, Dzavik V, Cairns J, Natarajan MK, Bainey KR, Akl E, Tsang MB, Lavi S, Cantor WJ, Madan M, Liu YY, Jolly SS. Association of Thrombus Aspiration With Time and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction: A Post Hoc Analysis of the Randomized TOTAL Trial. JAMA Netw Open. 2021 Mar 1;4(3):e213505. doi: 10.1001/jamanetworkopen.2021.3505. Jolly SS, Cairns JA, Lavi S, Cantor WJ, Bernat I, Cheema AN, Moreno R, Kedev S, Stankovic G, Rao SV, Meeks B, Chowdhary S, Gao P, Sibbald M, Velianou JL, Mehta SR, Tsang M, Sheth T, Dzavik V; TOTAL Investigators. Thrombus Aspiration in Patients With High Thrombus Burden in the TOTAL Trial. J Am Coll Cardiol. 2018 Oct 2;72(14):1589-1596. doi: 10.1016/j.jacc.2018.07.047. Sheth TN, Kajander OA, Lavi S, Bhindi R, Cantor WJ, Cheema AN, Stankovic G, Niemela K, Natarajan MK, Shestakovska O, Tittarelli R, Meeks B, Jolly SS. Optical Coherence Tomography-Guided Percutaneous Coronary Intervention in ST-Segment-Elevation Myocardial Infarction: A Prospective Propensity-Matched Cohort of the Thrombectomy Versus Percutaneous Coronary Intervention Alone Trial. Circ Cardiovasc Interv. 2016 Apr;9(4):e003414. doi: 10.1161/CIRCINTERVENTIONS.115.003414. Jolly SS, Cairns JA, Yusuf S, Rokoss MJ, Gao P, Meeks B, Kedev S, Stankovic G, Moreno R, Gershlick A, Chowdhary S, Lavi S, Niemela K, Bernat I, Cantor WJ, Cheema AN, Steg PG, Welsh RC, Sheth T, Bertrand OF, Avezum A, Bhindi R, Natarajan MK, Horak D, Leung RC, Kassam S, Rao SV, El-Omar M, Mehta SR, Velianou JL, Pancholy S, Dzavik V; TOTAL Investigators. Outcomes after thrombus aspiration for ST elevation myocardial infarction: 1-year follow-up of the prospective randomised TOTAL trial. Lancet. 2016 Jan 9;387(10014):127-35. doi: 10.1016/S0140-6736(15)00448-1. Epub 2015 Oct 22. Jolly SS, Cairns JA, Yusuf S, Meeks B, Gao P, Hart RG, Kedev S, Stankovic G, Moreno R, Horak D, Kassam S, Rokoss MJ, Leung RC, El-Omar M, Romppanen HO, Alazzoni A, Alak A, Fung A, Alexopoulos D, Schwalm JD, Valettas N, Dzavik V; TOTAL Investigators. Stroke in the TOTAL trial: a randomized trial of routine thrombectomy vs. percutaneous coronary intervention alone in ST elevation myocardial infarction. Eur Heart J. 2015 Sep 14;36(35):2364-72. doi: 10.1093/eurheartj/ehv296. Epub 2015 Jun 29. Williams PD, Mamas MA, Fraser DG. A coronary artery cast. Can J Cardiol. 2011 Nov-Dec;27(6):871.e5-6. doi: 10.1016/j.cjca.2011.08.108. Epub 2011 Oct 14. No abstract available.
Query!
Public notes
Query!
Contacts
Principal investigator
Name
0
0
Sanjit S. Jolly, MD, MSc, FRCP
Query!
Address
0
0
Hamilton Health Sciences Corporation
Query!
Country
0
0
Query!
Phone
0
0
Query!
Fax
0
0
Query!
Email
0
0
Query!
Contact person for public queries
Name
0
0
Query!
Address
0
0
Query!
Country
0
0
Query!
Phone
0
0
Query!
Fax
0
0
Query!
Email
0
0
Query!
Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Type
Citations or Other Details
Journal
Jolly SS, Cairns JA, Yusuf S, Meeks B, Pogue J, Ro...
[
More Details
]
Results not provided in
https://clinicaltrials.gov/study/NCT01149044
Download to PDF