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Trial registered on ANZCTR
Registration number
ACTRN12613000689774
Ethics application status
Approved
Date submitted
14/06/2013
Date registered
24/06/2013
Date last updated
15/12/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Randomised double blinded controlled pilot trial investigating the effect dietary nitrate in the treatment of acute decompensated heart failure.
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Scientific title
Randomised double blinded controlled pilot trial investigating the effect dietary nitrate in the treatment of acute decompensated heart failure.
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Secondary ID [1]
282676
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NIl
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Heart Failure
289376
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Condition category
Condition code
Cardiovascular
289710
289710
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0
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Coronary heart disease
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Cardiovascular
289711
289711
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The dietary nitrate will be in the form of a commercially available beetroot supplement manufactured from organic beetroot by James White Drinks (UK). It is a 70ml preparation that contains 0.4g of dietary nitrate. The researchers have no financial relationship with James White Drinks.
For this study the investigational product and placebo control will be sourced directly from the manufacturer in the UK.
Study Frequency - 5 days of treatment, once daily for 5 days
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Intervention code [1]
287334
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Treatment: Other
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Comparator / control treatment
Placebo
The placebo control is also manufactured by the same company and is a nitrate depleted version and is indistinguishable from the nitrate containing preparation
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Control group
Placebo
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Outcomes
Primary outcome [1]
289803
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The primary hypothesis in this study is that dietary nitrate supplementation will improve vascular function in ADHF patients.
Assessment of outcome - improvement in symptoms via KCCQ, Endopat tool to assess vascular function,
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Assessment method [1]
289803
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Timepoint [1]
289803
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Day 5
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Secondary outcome [1]
303265
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The secondary end point is overall ‘treatment success’ . This composite parameter has been widely used in HF trials. Outcomes are defined as ‘treatment success’, treatment failure, or no change in the patient’s condition. Success is defined as patient-reported moderate or marked improvement in dyspnoea at 5 days, in the absence of any criterion for failure.
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Assessment method [1]
303265
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Timepoint [1]
303265
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Day 5
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Eligibility
Key inclusion criteria
Age 18-75 years
Acute decompensated HF requiring hospitalization (at the discretion of the treating physician), reflected by clinical signs or symptoms of peripheral or pulmonary congestion
NYHAC III or IV
And LVEF less than 40% (either previously documented or documented at admission)
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Minimum age
18
Years
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Maximum age
75
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
Age between 18, and 75
Hypotension (BP less than 90)
inotropic therapy
anticipated need for LVAD or ECMO within 48 hrs
endotracheal intubation/ventilation
cardiac or other solid organ transplantation
STEMI at presentation
suspected sepsis
arrhyhthmia as a primary cause for ADHF
Allergy to Beetroot
Pregnancy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Based upon our data and the above hypothesis, with power 80% and the null hypothesis set for rejection at p less than 0.05 we calculate that we require n equals 13 per group. Based on our previous experience we anticipate a drop-out rate of up to 50% per group due to a variety of factors (eg conversion to inotropic therapy, patient withdrawal, loss to follow up, unplanned discharge) hence we request approval of a total of 40 patients.
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Recruitment
Recruitment status
Withdrawn
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Reason for early stopping/withdrawal
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Date of first participant enrolment
Anticipated
1/08/2013
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Actual
7/01/2014
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Date of last participant enrolment
Anticipated
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Actual
7/01/2014
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
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Final
1
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment postcode(s) [1]
6962
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3004 - Melbourne
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Funding & Sponsors
Funding source category [1]
287449
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Hospital
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Name [1]
287449
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Alfred Health
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Address [1]
287449
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Alfred Hospital, Commercial Road, Melbourne, Victoria, 3004
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Country [1]
287449
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Australia
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Primary sponsor type
Hospital
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Name
Alfred Health
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Address
Alfred Hospital, Commercial Road, Heart Centre, Melbourne, Victoria, 3004
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Country
Australia
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Secondary sponsor category [1]
286191
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None
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Name [1]
286191
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Address [1]
286191
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Country [1]
286191
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
289425
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Alfred Research & Ethics Committee
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Ethics committee address [1]
289425
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The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia
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Ethics committee country [1]
289425
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Australia
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Date submitted for ethics approval [1]
289425
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05/06/2013
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Approval date [1]
289425
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24/07/2013
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Ethics approval number [1]
289425
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194/13
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Summary
Brief summary
The trial will invite patients at the Alfred Hospital, Melbourne, Victoria presenting with acute decompensated heart failure to participate in a study of a dietary supplement (Beetroot extract - Dietary Nitrate) within 48 hours of their hospital admission. Heart failure is a condition where the heart fails to provide enough blood pumping power for the needs of normal body function. At times the condition may worsen significantly leading to fluid retention, low blood pressure, kidney failure and breathlessness, which usually each requires hospitalization. Currently there are limited treatment options available for these patients and there is a high risk of further hospitalization or death in subsequent months after the patient’s admission to hospital. In this study we propose to study the effects of dietary nitrate in th patients described above. There is a growing body of evidence that dietary nitrate in the form of concentrated beetroot supplementation has beneficial cardiovascular effects including lowering blood pressure and enhances exercise performance during sub-maximal exercise. Forty patients will be invited to participate in the trial. After obtaining informed consent, twenty patients will be randomly assigned to treatment with oral Dietary Nitrate (70ml concentrated beetroot juice, manufactured by James White UK) or nitrate depleted placebo once daily for five days. This is in addition to any other medication prescribed by their treating doctor. At enrolment the patients will be educated and counselled about the trial and the intervention medication. Various parameters will be monitored on a daily basis, including objective and subjective symptom review, observations, blood vessel function, weight, kidney function, and medication requirement. Blood samples will also be taken and stored for analysis. We will contact the patient by telephone after 30 days to ask about their health. The primary objective of the trial is to see whether the administration of dietary nitrate will improve blood vessel function and overall treatment outcomes.
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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
40782
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Prof David Kaye
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Address
40782
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The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia
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Country
40782
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Australia
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Phone
40782
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+61 3 9076 3263
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Fax
40782
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Email
40782
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[email protected]
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Contact person for public queries
Name
40783
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Joshua Martin
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Address
40783
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The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia
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Country
40783
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Australia
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Phone
40783
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+61 3 9076 2948
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Fax
40783
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Email
40783
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[email protected]
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Contact person for scientific queries
Name
40784
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Joshua Martin
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Address
40784
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The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia
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Country
40784
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Australia
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Phone
40784
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+61 3 9076 2948
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Fax
40784
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Email
40784
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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
Source
Title
Year of Publication
DOI
Embase
Present and future pharmacotherapeutic agents in heart failure: An evolving paradigm.
2016
https://dx.doi.org/10.1111/bph.13480
N.B. These documents automatically identified may not have been verified by the study sponsor.
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