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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03686696
Registration number
NCT03686696
Ethics application status
Date submitted
3/09/2018
Date registered
27/09/2018
Titles & IDs
Public title
Randomized Evaluation of Beta Blocker and ACEI/ARB Treatment in MINOCA Patients - MINOCA-BAT
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Scientific title
Randomized Evaluation of Beta Blocker and Angiotensin Converting Enzyme Inhibitor (ACEI) /Angiotensin Receptor Blocker (ARB) Treatment in MINOCA Patients.
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Secondary ID [1]
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EudraCT number 2018-000889-11
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Universal Trial Number (UTN)
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Trial acronym
MINOCA-BAT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Myocardial Infarction With Non-obstructive Coronary Arteries
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Condition category
Condition code
Cardiovascular
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Coronary heart disease
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Cardiovascular
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Other cardiovascular diseases
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Cardiovascular
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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
Treatment: Drugs - Beta blocker
Treatment: Drugs - ACEI
Treatment: Drugs - ARB
No intervention: No Beta blocker and no ACEI/ARB - No Beta blocker and no ACEI/ARB
Experimental: Beta blocker and ACEI/ARB - Beta blocker and either ACE inhibitor or Angiotensin receptor blocker
Experimental: Beta blocker alone - Beta blocker alone
Experimental: ACEI/ARB alone - Either ACE inhibitor or Angiotensin receptor blocker alone
Treatment: Drugs: Beta blocker
Patients randomized to beta-blockade will be administered the assigned treatment during the rest of the hospital stay and receive a prescription for the continued use at discharge. The treating physician is encouraged to aim for target dose or highest tolerable dose for the drug. Patients will be encouraged to continue the use of the randomized treatment following discharge until contraindications.
Treatment: Drugs: ACEI
Patients randomized to ACE inhibitor will be administered the assigned treatment during the rest of the hospital stay and receive a prescription for the continued use at discharge. The treating physician is encouraged to aim for target dose or highest tolerable dose for the drug. Patients will be encouraged to continue the use of the randomized treatment following discharge until contraindications.
Treatment: Drugs: ARB
Patients randomized to Angiotensin receptor blockers will be administered the assigned treatment during the rest of the hospital stay and receive a prescription for the continued use at discharge. The treating physician is encouraged to aim for target dose or highest tolerable dose for the drug. Patients will be encouraged to continue the use of the randomized treatment following discharge until contraindications
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Time to death of any cause, or time to readmission because of AMI, ischemic stroke or heart failure
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Assessment method [1]
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A Composite of time to all-cause Death and time to re-admission because of AMI, ischemic stroke or heart failure
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Timepoint [1]
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Time to event from the date of enrollment through study completion, an average of 4 years.
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Secondary outcome [1]
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a All-cause death b Cardiovascular death c Readmission because of AMI d Readmission because of ischemic stroke e Readmission because of heart failure f Readmission because of unstable angina pectoris g Readmission because of atrial fibrillation.
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Assessment method [1]
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Timepoint [1]
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a All-cause death: Time to event from the date of enrollment through study completion, an average of 4 years.
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Eligibility
Key inclusion criteria
* Age >18 years.
* A clinical diagnosis of MINOCA within the last 30 days.
* Left ventricular ejection fraction =40% measured with echocardiography, MRI or left ventriculography after admission and prior to randomization.
* Written informed consent obtained
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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
* Any condition that may influence the patient's ability to comply with study protocol.
* Previous revascularization (CABG or PCI)
* Clinical signs of heart failure
* MRI-proven myocarditis or a strong clinical suspicion of myocarditis or takotsubo as cause of the index event
* Contraindications for Beta blocker treatment
* Contraindications for ACEI and ARB treatment
* Prior use of ACEI, ARB, or Beta blockers, which must continue according to treating physician.
* New indication for Beta blocker or ACEI/ARB treatment other than as secondary prevention according to treating physician
* Ongoing pregnancy or woman of childbearing potential not using adequate contraceptives
* Participation in a trial evaluating a drug known to interact with Beta blockers or ACEI/ARB
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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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Factorial
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
16/12/2018
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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
22/08/2023
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Sample size
Target
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Accrual to date
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Final
198
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Recruitment in Australia
Recruitment state(s)
Sout Austral
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Recruitment hospital [1]
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Royal Adelaide Hospital - Adelaide
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Recruitment hospital [2]
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The Lyell McEwin Hospital - Adelaide
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Recruitment hospital [3]
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The Queen Elizabeth Hospital - Adelaide
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Recruitment hospital [4]
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Gold Coast Hospital - Gold Coast
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Recruitment hospital [5]
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Sunshine Hospital - Melbourne
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Royal Perth Hospital - Perth
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Recruitment hospital [7]
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Gosford Hospital - Sydney
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Recruitment hospital [8]
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John Hunter Hospital - Sydney
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Recruitment postcode(s) [1]
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- Adelaide
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Recruitment postcode(s) [2]
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- Gold Coast
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Recruitment postcode(s) [3]
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- Melbourne
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Recruitment postcode(s) [4]
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- Perth
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Recruitment postcode(s) [5]
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- Sydney
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Recruitment outside Australia
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New Zealand
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State/province [1]
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Auckland
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Norway
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Bergen
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Norway
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Oslo
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Spain
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Getafe
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Spain
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Ourense
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Spain
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Santiago De Compostela
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Sweden
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Eskilstuna
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Sweden
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Falun
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Sweden
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Gävle
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Sweden
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Göteborg
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Sweden
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Halmstad
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Sweden
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Helsingborg
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Sweden
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Jönköping
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Karlstad
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Köping
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Sweden
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Linköping
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Sweden
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Lund
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Sweden
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Malmö
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Sweden
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Norrköping
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Sweden
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Stockholm
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Sweden
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Uppsala
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Sweden
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Västerås
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Sweden
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State/province [23]
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Örebro
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Funding & Sponsors
Primary sponsor type
Other
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Name
Uppsala University
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Address
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Other collaborator category [1]
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Other
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Name [1]
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Karolinska Institutet
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Other collaborator category [2]
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Other
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Name [2]
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Göteborg University
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Address [2]
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Other collaborator category [3]
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Other
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Name [3]
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University of Leeds
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Address [3]
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Other collaborator category [4]
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Other
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Name [4]
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University of Adelaide
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Other
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Name [5]
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Oslo University Hospital
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Address [5]
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Other collaborator category [6]
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Other
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Name [6]
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New York University
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Address [6]
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Ethics approval
Ethics application status
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Summary
Brief summary
Myocardial infarction with non-obstructive coronary arteries" (MINOCA) occurs in 5-10% of all patients with AMI. There are neither any randomized clinical trials in MINOCA patients evaluating effects of secondary preventive treatments proven beneficial in patients with classic AMI, nor any treatment guidelines. The primary objective of this multi-national, multi-center pragmatic randomized clinical trial is to determine whether oral beta-blockade compared to no oral beta-blockade, and whether Angiotensin Converting Enzyme Inhibitors (ACEI/ Angiotensin Receptor Blockers (ARB) compared to no ACEI/ARB, reduce the composite endpoint of death of any cause and readmission because of AMI, ischemic stroke or heart failure in patients discharged with myocardial infarction with non-obstructive coronary artery disease (MINOCA) and with no clinical signs of heart failure and with left ventricular (LV) systolic ejection fraction =40%.
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Trial website
https://clinicaltrials.gov/study/NCT03686696
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Trial related presentations / publications
Nordenskjold AM, Agewall S, Atar D, Baron T, Beltrame J, Bergstrom O, Erlinge D, Gale CP, Lopez-Pais J, Jernberg T, Johansson P, Ravn-Fisher A, Reynolds HR, Somaratne JB, Tornvall P, Lindahl B. Randomized evaluation of beta blocker and ACE-inhibitor/angiotensin receptor blocker treatment in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA-BAT): Rationale and design. Am Heart J. 2021 Jan;231:96-104. doi: 10.1016/j.ahj.2020.10.059. Epub 2020 Oct 24.
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Public notes
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Contacts
Principal investigator
Name
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Bertil Lindahl, Prof
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Address
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Uppsala University
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Phone
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Fax
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Email
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Contact person for public queries
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Contact person for scientific queries
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?
We will make a limited, de-identified set of data available for researchers outside the primary investigators two years after the publication of the primary results of the study. Before data are shared, a data-sharing agreement should be established documenting what data are being shared and how the data can be used. The agreement serves two purposes. First, it protects the agency providing the data, ensuring that the data will not be misused. Second, it prevents miscommunication on the part of the provider of the data and the agency receiving the data by making certain that any questions about data use are discussed. The following items should be covered in the data-sharing agreement:
* Period of agreement
* Intended use of the data
* Constraints on use of the data
* Data confidentiality
* Data security
* Methods of data-sharing
Supporting document/s available: Study protocol, Statistical analysis plan (SAP)
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03686696