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Trial Review
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Trial registered on ANZCTR
Registration number
ACTRN12619000450112
Ethics application status
Approved
Date submitted
6/03/2019
Date registered
19/03/2019
Date last updated
5/07/2021
Date data sharing statement initially provided
19/03/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
The Macro- and Micro-circulation in Coronary Heart Disease
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Scientific title
Assessing the macro- and micro-circulation and their relation to cardiovascular events in patients with coronary heart disease
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Secondary ID [1]
297460
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None
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Universal Trial Number (UTN)
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Trial acronym
None
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Linked study record
N/A
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Health condition
Health condition(s) or problem(s) studied:
Coronary heart disease
311646
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Condition category
Condition code
Cardiovascular
310270
310270
0
0
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Coronary heart disease
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
5
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Target follow-up type
Years
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Description of intervention(s) / exposure
Patients referred to the cardiac catheter laboratory are invited to participate in the study. Invasive physiology testing including fractional flow reserve and index of micro-circulatory resistance will be measured in all participants. Coronary pressure wires will be inserted into the coronary arteries via a guiding catheter, and measurements including pressure and mean saline transit time will be measured under both resting and hyperaemic conditions.
Every 5th presenting patient will also have endothelial function and wall shear stress assessed. Patients will be followed up to 5 years, and be assessed for recurrent chest pain, revascularization, myocardial infarction, and death.
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Intervention code [1]
313715
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Combined end point of cardiac death, myocardial infarction, hospitalization for heart failure, or revascularization will be collected via telephone follow-up +/- data linkage to medical records.
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Assessment method [1]
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Timepoint [1]
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1 year
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Secondary outcome [1]
367153
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Cardiac death via telephone follow-up +/- data linkage to medical records.
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Assessment method [1]
367153
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Timepoint [1]
367153
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1,2, and 5 years
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Secondary outcome [2]
367154
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Myocardial infarction via telephone follow-up +/- data linkage to medical records.
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Assessment method [2]
367154
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Timepoint [2]
367154
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1,2, and 5 years
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Secondary outcome [3]
367155
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Revascularization via telephone follow-up +/- data linkage to medical records.
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Assessment method [3]
367155
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Timepoint [3]
367155
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1,2, and 5 years
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Secondary outcome [4]
367156
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Canadian Cardiovascular Society Angina Grade
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Assessment method [4]
367156
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Timepoint [4]
367156
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1,2,and 5 years
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Secondary outcome [5]
367157
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Seattle Angina Questionnaire Score
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Assessment method [5]
367157
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Timepoint [5]
367157
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1,2, and 5 years
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Secondary outcome [6]
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Hospitalization for heart failure via telephone follow-up +/- data linkage to medical records.
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Assessment method [6]
367210
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Timepoint [6]
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1,2, and 5 years
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Eligibility
Key inclusion criteria
Patients referred to the cardiac catheter laboratory for coronary angiography or percutaneous coronary intervention
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Minimum age
18
Years
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Maximum age
No limit
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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
Pregnancy, cardiogenic shock, contraindication to adenosine, severe asthma, heavily calcified or tortuous vessels leading to inability to advance pressure wire
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
600 patients are anticipated to be enrolled into the study, based on an estimated recruitment rate of 4 patients per week (across 2 sites) over 3 years. This represents a similar study population size compared to the multi-center PROSPECT observational study.
Patients will be followed up for up to 5 years for cardiac death, myocardial infarction, revascularization, hospitalization for heart failure, and recurrent chest pain. Cox regression analysis will be used to identify both univariable and multivariable predictors of MACE in the entire study cohort.
The study cohort will be divided into those with microcirculatory disease and those without. The baseline characteristics of the two groups will be compared using the independent samples t test for continuous variables, and Pearson’s chi square test for dichotomous variables. The outcome of major adverse cardiac events (including death, MI, or revascularization) will be compared between the two groups using the Kaplan-Meier method.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
22/03/2019
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Actual
6/06/2019
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Date of last participant enrolment
Anticipated
30/01/2022
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Actual
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Date of last data collection
Anticipated
31/01/2027
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Actual
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Sample size
Target
600
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Accrual to date
65
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
13207
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Royal Prince Alfred Hospital - Camperdown
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Recruitment hospital [2]
13208
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Concord Repatriation Hospital - Concord
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Recruitment postcode(s) [1]
25764
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2050 - Camperdown
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Recruitment postcode(s) [2]
25765
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2139 - Concord
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Funding & Sponsors
Funding source category [1]
302030
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Hospital
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Name [1]
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Royal Prince Alfred Hospital (Sydney Local Health D=iIstrict)
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Address [1]
302030
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50 Missenden Rd, Camperdown NSW 2050
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Country [1]
302030
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Australia
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Primary sponsor type
Hospital
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Name
Royal Prince Alfred Hospital (Sydney Local Health District)
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Address
50 Missenden Rd, Camperdown NSW 2050
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Country
Australia
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Secondary sponsor category [1]
301828
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None
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Name [1]
301828
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Address [1]
301828
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Country [1]
301828
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
302711
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Sydney Local Health District Ethics Review Committee (RPAH Zone)
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Ethics committee address [1]
302711
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Research Ethics and Governance Office Suite 210A, Level 2 RPAH Medical Centre 100 Carillon Ave Newton NSW 2042
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Ethics committee country [1]
302711
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Australia
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Date submitted for ethics approval [1]
302711
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08/11/2018
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Approval date [1]
302711
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22/03/2019
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Ethics approval number [1]
302711
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Summary
Brief summary
The purpose of this study is to improve our understanding of coronary microvascular disease (small vessel disease in the blood vessels supplying the heart), and to evaluate whether microvascular disease correlates with poor outcomes. We aim to measure blood flow in the large and small vessels that supply the heart in a range of participants, as well as assess the function of the cells that line the blood vessels. We hope to enhance our knowledge in this area and develop new strategies to treat future patients with this under-recognized condition.
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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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A/Prof Martin Ng
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Address
91130
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Royal Prince Alfred Hospital
50 Missenden Road, Camperdown, NSW 2050
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Country
91130
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Australia
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Phone
91130
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+61 2 95156111
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Fax
91130
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Email
91130
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[email protected]
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Contact person for public queries
Name
91131
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Christopher Wong
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Address
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Royal Prince Alfred Hospital
50 Missenden Road, Camperdown, NSW 2050
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Country
91131
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Australia
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Phone
91131
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+61 2 95156111
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Fax
91131
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Email
91131
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[email protected]
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Contact person for scientific queries
Name
91132
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Christopher Wong
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Address
91132
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Royal Prince Alfred Hospital
50 Missenden Road, Camperdown, NSW 2050
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Country
91132
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Australia
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Phone
91132
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+61 2 95156111
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Fax
91132
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Email
91132
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All baseline characteristics, physiology measurements, outcomes.
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When will data be available (start and end dates)?
25/03/2019 to 31/01/2027
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Available to whom?
Available to journal reviewers and authors of meta-analyses if requested
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Available for what types of analyses?
Reviews and meta-analyses
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How or where can data be obtained?
Emailed in individually unidentifiable form
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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
Dimensions AI
Fractional Flow Reserve and Instantaneous Wave-Free Ratio Predict Pathological Wall Shear Stress in Coronary Arteries: Implications for Understanding the Pathophysiological Impact of Functionally Significant Coronary Stenoses
2022
https://doi.org/10.1161/jaha.121.023502
N.B. These documents automatically identified may not have been verified by the study sponsor.
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