• Culprit only + staged (within six weeks after index procedure) complete revascularization in all vessels ≥ 2.5mm with ≥ 70% stenosis by visual estimation or positive coronary physiology test per operator's discretion (Control arm)

• Immediate complete revascularization in all vessels ≥ 2.5mm with ≥ 70% stenosis by visual estimation or positive coronary physiology test per operator's discretion (Experimental arm)

Acute Coronary Syndrome

At the index procedure, the culprit lesion (cause of complaints/acute coronary syndrome) will be treated according to standard of care with a Biotronik Orsiro DES (Sirolimus-Eluting stent). If there are additional significant lesions besides the culprit lesion, patients will be randomized to direct complete revascularization or staged complete revascularization. In the direct complete revascularization group all lesions will be treated during the index procedure. In the staged complete revascularization group, only the culprit lesion will be treated during the index procedure. The remaining significant lesions will be treated later but within six weeks after the index procedure. In both arms the additional lesions will also be treated with Biotronik Orsiro DES (Sirolimus-Eluting stent).

Percutaneous coronary intervention

Erasmus Medical Center

Direct Complete Versus Staged Complete Revascularization in Patients Presenting With Acute Coronary Syndromes and Multivessel Disease

Percutaneous Complete Revascularization Strategies Using Sirolimus Eluting Biodegradable Polymer Coated Stents in Patients Presenting With Acute Coronary Syndrome and Multivessel Disease

a composite clinical outcome of all-cause mortality, myocardial infarction, any unplanned ischemia driven revascularization, and cerebrovascular events

Composite clinical outcome of all-cause mortality, myocardial infarction, any unplanned ischemia driven revascularization, and cerebrovascular events

Any unplanned ischemia driven coronary revascularization procedure

Major bleeding (not related to coronary-artery bypass grafting, BARC 3-5)

Seattle Angina Questionnaire. Scale 1-5. Higher values represent better outcome

EQ5D EQ5D EQ5D. Scale 1-5. Higher values represent worse outcome

EQ5D. Scale 1-5. Higher values represent worse outcome

Roberto Diletti

Biotronik SE & Co. KG

This study is a prospective, multicenter, randomized, two-arm, international, open-label, non-inferiority study. Due to the design characteristics of the study, the study investigators and operators cannot be blinded.

The clinical event adjudication committee, consisting of cardiologists who are not participating in the study, will be blinded for the treatment arm of the patients to avoid a potential bias in the adjudication process of events

60 grams protein before, during, after eccentric exercise

60 grams placebo before, during, after eccentric exercise

Muscle Damage

Inflammation

24 g protein before, 12 g during, and 24 g after eccentric exercise

Protein supplement

Placebo

ASU-NCRC Human Performance Lab

Protein and Recovery From Exercise-induced Muscle Damage

Influence of Protein-amino Acid Supplementation on Recovery From Exercise-induced Muscle Damage in NASCAR Pit Crew Athletes

Serum myoglobin and creatine kinase will be measured pre- and post-eccentric exercise, and each morning during three days recovery.

Measured pre- and post-eccentric exercise, and each morning during 3 days of recovery.
Kneeling medicine ball toss.
Vertical jump.
Wingate anaerobic power cycling test.

Measured pre- and post-eccentric exercise, and during each morning during 3 days recovery.
DOMS will be self-reported by the subjects using a 10-point Likert-scale questionnaire (Res Quart Exerc Sport 1993;64:103-107).

Measured from blood samples taken pre- and post-eccentric exercise, and each morning during 3 days recovery.
Serum C-reactive protein (CRP) will be analyzed by the clinical hematology laboratory at the Carolina Medical Center (Charlotte, NC). CRP will be measured using an LX-20 clinical analyzer (Beckman Coulter Electronics, Brea, CA). Total plasma concentrations of interleukin-6 will be determined using an electrochemiluminescence based solid-phase sandwich immunoassay (Meso Scale Discovery, Gaithersburg, MD).

Will be measured from blood samples taken pre- and post-eccentric exercise, and each morning during 3 days of recovery.
Granulocyte and monocyte phagocytosis (G-PHAG, M-PHAG), and oxidative burst activity (G-OBA, M-OBA) will be assayed at the immunology laboratory at UNC-Charlotte (Dr. Didier Dreau).

Appalachian State University

Herbalife International of America, Inc.

Weight Gain

Obesity

chromium piccolinate

placebo for chromium piccolinate

Chromium Piccolinate in the Prevention of Weight Gain Induced by Serotonergic Medications Initiated on Psychiatric Inpatient Units.

A 6 Week, Blinded, Randomized, Controlled Pilot Study to Evaluate the Safety and Efficacy of Chromium Piccolinate in the Prevention of Weight Gain Induced by Serotonergic Medications Initiated on Psychiatric Inpatient Units.

chromium/fatigue

Direct Complete Versus Staged Complete Revascularization in Patients Presenting With Acute Coronary Syndromes and Multivessel Disease

Protein and Recovery From Exercise-induced Muscle Damage

Chromium Piccolinate in the Prevention of Weight Gain Induced by Serotonergic Medications Initiated on Psychiatric Inpatient Units.

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