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Trial registered on ANZCTR
Registration number
ACTRN12612000934842
Ethics application status
Approved
Date submitted
3/09/2012
Date registered
3/09/2012
Date last updated
4/10/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Oxidative Stress in Coronary Artery Surgery
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Scientific title
Antioxidant response, Oxidative stress and Post-operative Atrial Fibrillation after high risk cardiac surgery
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Secondary ID [1]
281125
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Nil
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Universal Trial Number (UTN)
Nil
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Trial acronym
OSCArS study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Post-operative outcomes after Cardiovascular surgery
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Post-operative atrial fibrillation
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Condition category
Condition code
Cardiovascular
287625
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0
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Coronary heart disease
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Surgery
287644
287644
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0
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Other surgery
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Comparing the development of post-operative atrial fibrillation with oxidative stress and selenium levels in two risk groups of cardiac patients. Patients will have blood taken up to 5 days post-surgery to assess oxidative stress and selenium levels
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Intervention code [1]
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Not applicable
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Comparator / control treatment
uncontrolled
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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In two different risk groups of patients having coronary artery surgery we will measure selenium levels and oxidative stress markers at various time points to see if an association exists between these markers and the development of post-operative atrial fibrillation. Oxidative stress will be measured by using the lipid peroxidation marker malondialdehyde.
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Assessment method [1]
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Timepoint [1]
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Blood samples at following time points
Anaesthetic induction
Removal of aortic cross clamp
3 hours after separation from cardiopulmonary bypass
24 hours after separation from cardiopulmonary bypass
5 days post-surgery
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Secondary outcome [1]
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Monitoring Lung dysfunction after cardiac surgery (length of mechanical ventilation) and comparing to oxidative stress levels
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Assessment method [1]
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Timepoint [1]
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Time to extubation compared with 24 hr blood sample of oxidative stress
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Secondary outcome [2]
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Length of ICU stay versus pre-operative selenium levels
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Assessment method [2]
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Timepoint [2]
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selenium level at Anaesthetic induction
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Eligibility
Key inclusion criteria
Primary CABG
STS score <0.3 or > 2.0
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Minimum age
18
Years
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Maximum age
90
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Pre-operative atrial fibrillation
pacemaker
pre-operative steroids
previous cardiac surgery
off pump surgery
STS score >0.3 <2.0
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/10/2012
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Queensland Health-Health Practitioner Research Grant Scheme
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Address [1]
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Allied Health Workforce Advice and Coordination Unit
Level 6, Queensland Health Building
147-163 Charlotte Street
BRISBANE QLD 4000
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Charles McDonald
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Address
Main Operating Theatre
Level 2
The Prince Charles Hospital
Rode Rd
Chermside
Qld, 4032
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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John Fraser
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Address [1]
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Adult Intensive Care Unit
The Prince Charles Hospital
Rode Rd
Chermside
Qld, 4032
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Country [1]
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
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Yoke Lin Fung
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Address [1]
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Level 3
Clinical Sciences Building
The Prince Charles Hospital
Rode Rd
Chermside
Qld, 4032
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Country [1]
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Australia
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Other collaborator category [2]
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Individual
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Name [2]
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Andrew Clarke
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Address [2]
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Cardiac Surgical Department
Level 1
The Prince Charles Hospital
Rode Rd
Chermside
Qld, 4032
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Country [2]
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Australia
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Other collaborator category [3]
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Individual
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Name [3]
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Bronwyn Pearse
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Address [3]
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Level 5
Clinical Sciences Building
The Prince Charles Hospital
Rode Rd
Chermside
Qld, 4032
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Country [3]
277048
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Australia
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Other collaborator category [4]
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Individual
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Name [4]
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Sarah Gabriel
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Address [4]
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Level 5
Clinical Science Building
The Prince Charles Hospital
Rode Rd
Chermside
Qld, 4032
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Country [4]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Prince Charles Hospital HREC
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Ethics committee address [1]
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Research, Ethics & Governance Unit (REaGU) Metro North Hospital & Health Services The Prince Charles Hospital Administration Building Lower Ground, Rode Road CHERMSIDE Qld 4032
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
287936
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Approval date [1]
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14/10/2011
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Ethics approval number [1]
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HREC/11/QPCH/138
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Summary
Brief summary
Post-operative atrial fibrillation (POAF) is one of the most common complications after coronary artery surgery, affecting 20-50% of patients. It is a serious post surgical complication that is associated with increased morbidity and long-term health care costs. The development of this arrhythmia after surgery is multi-factorial and reliable pre-operative predictors have not been found. The inability to reliably predict patients at risk means that current methods of preventing POAF remain suboptimal. Mounting evidence suggests that increased reactive oxygen species and oxidative stress play a major part in POAF development, opening the possibility of antioxidant supplementation as a preventative measure. During cardiac surgery with cardiopulmonary bypass (CPB), increases in reactive oxygen species occurs after blood contact with the CPB circuit, the inflammatory response syndrome, ischemia-reperfusion and hyperoxia resulting in oxidative damage to myocytes. In addition there is also a reduced antioxidant response. Some of the primary antioxidants rely on appropriate levels of trace elements for normal function. One such trace element is selenium, which is required by the antioxidant glutathione peroxidase. Reductions in selenium during and after surgery are associated with increased mortality. This observational study will measure oxidative stress levels (by malondialdehyde), as well as selenium levels, pre-, intra- and up to 5 days post-operatively, to determine if an association exists between these levels and the development of POAF. The study will separate participants into patients at low risk of post-operative mortality and those at high risk. In this way we hope to better define the effect of pre- and intra-operative low levels of selenium (and increases in oxidative stress) on events such as POAF. Understanding the pathophysiological differences of low selenium between various patient risk groups may lead to targeted pre-operative antioxidant therapies that have better success at preventing POAF.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Bronwyn Pearse
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Address
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Level 5
Clinical Sciences Building
The Prince Charles Hospital
Rode Rd
Chermside
Qld, 4032
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Country
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Australia
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Phone
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+61 7 3139 5413
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Fax
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+61 7 3139 6140
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Email
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[email protected]
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Contact person for scientific queries
Name
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Charles McDonald
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Address
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Main Operating Theatre
Level 2
The Prince Charles Hospital
Rode Rd
Chermside
Qld, 4032
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Country
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Australia
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Phone
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+61 7 3139 4705
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Fax
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+61 7 3139 4659
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Email
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[email protected]
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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
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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