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Trial registered on ANZCTR
Registration number
ACTRN12612001178831
Ethics application status
Approved
Date submitted
30/10/2012
Date registered
6/11/2012
Date last updated
11/09/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Diabetic cardiomyopathy: predictors of progression and outcome after 10 years of follow up.
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Scientific title
Diabetic cardiomyopathy: predictors of progression and outcome after 10 years of follow up. A ten year follow up of participants in an earlier original research study by the same group which studied a large cohort of type II diabetes patients, looking for early identification of cardiomyopathy.
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Secondary ID [1]
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Nil
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Universal Trial Number (UTN)
U1111-1136-5107
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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:
Diabetic cardiomyopathy
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Condition category
Condition code
Cardiovascular
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0
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Coronary heart disease
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Metabolic and Endocrine
288067
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0
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Diabetes
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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
10 year follow up to assess development of cardiomyopathy in diabetic patients. Participation involves:
*Measurement of height, weight, waist circumference and blood pressure
Fasting blood test
* Cardiac echocardiograph test, including a carotid artery ultrasound scan
*An exercise stress test (if participants are able to exercise)
*Participants will also be asked to provide a list to the study staff of all medications, including the length of time each medication has been taken.
The testing will be arranged to take place in one 2 hour session.
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Intervention code [1]
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Not applicable
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Comparator / control treatment
N/A
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Incidence of major cardiac adverse events (MACE), and complications related to T2DM - as assessed by data linkage to medical records.
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Assessment method [1]
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Timepoint [1]
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From commencement of original study in 2003 which provided 3 years of data, to 30th June 2012
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Primary outcome [2]
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That ACE inhibitor/ARB therapy and/or beta-blocker therapy will prevent progression of diabetic cardiomyopathy.
The use of these medications by participants will be noted over the 10 year period and compared with participant echocardiographic and exercise stress test measurements which assess the degree of cardiomyopathy, major adverse cardiac events and mortality.
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Assessment method [2]
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Timepoint [2]
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From commencement of original study in 2003 which provided 3 years of data, to 30th June 2012
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Primary outcome [3]
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To establish that 2D speckle tracking strain (2DS) is superior to current echocardiographic techniques for the detection of DCM and better able to assess risk in diabetic cardiomyopathy over long term follow up.
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Assessment method [3]
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Timepoint [3]
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From commencement of original study in 2003 which provided 3 years of data, to 30th June 2012
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Secondary outcome [1]
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Nil
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Assessment method [1]
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Timepoint [1]
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Nil
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Eligibility
Key inclusion criteria
Participation will be invited from all surviving participants of the original study commenced in 2003.
Inclusion criteria:
-Age >18 years, and <85 years
-Diagnosed with type 2 diabetes
-Appropriate informed consent obtained and signed
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Minimum age
18
Years
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Maximum age
85
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
-Patients unwilling to comply with frequent follow-up
-Patients currently enrolled in another investigational study
-Patients whose life expectancy is severely limited due to pre-existing malignancy or other disease (< 6 months)
-Pregnancy
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Both
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
29/01/2013
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Actual
15/08/2013
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Date of last participant enrolment
Anticipated
20/08/2014
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Actual
20/08/2014
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
200
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Queensland, Cardiovascular Imaging Research Centre, School of Medicine
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Address [1]
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Princess Alexandra Hospital
Ipswich Road
Woolloongabba QLD 4102
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Dr Tony Stanton
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Address
School of Medicine, University of Queensland
Princess Alexandra Hospital
Ipswich Road
WOOLLOONGABBA QLD 4102
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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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Dr Brian Haluska
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Address [1]
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School of Medicine, University of Queensland
Princess Alexandra Hospital
Ipswich Road
WOOLLOONGABBA QLD 4102
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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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Prof Thomas Marwick
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Address [1]
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Menzies Institute
Medical Science 1
17 Liverpool Street
Hobart TAS 7000
Australia
Postal Address:
Private Bag 23
Hobart TAS 7000
Australia
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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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Prof John Prins
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Address [2]
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Mater Medical Research Unit
Mater Hospital
550 Stanley Street
SOUTH BRISBANE QLD 4101
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Country [2]
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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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Metro South Hospital and Health Service HREC
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Ethics committee address [1]
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Princess Alexandra Hospital Ipswich Road WOOLLOONGABBA QLD 4102
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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19/09/2012
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Ethics approval number [1]
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HREC/12/QPAH/353
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Summary
Brief summary
Type 2 diabetes mellitus (T2DM) is the fastest growing chronic disease in Australia today with an estimated 275 new cases every day. Currently 1.7 million Australians have diabetes and it is thought that up to half of these individuals are as yet undiagnosed. The annual cost of diabetes to the Australian healthcare system is estimated at least $3 billion. Diabetes was the underlying cause for 3.0% deaths registered in Australia in 2009 and additionally contributed to 10.1% deaths as either an underlying or associated cause of death. Worldwide it is anticipated that by the year 2025 there will be 300 million people with the disease especially given the epidemic of obesity and impact of sedentary lifestyles. It is known that individuals with diabetes have a significantly increased risk of cardiovascular disease. Recent data showed that this condition is underappreciated with 48% of all diabetic individuals, who had no previous history of structural heart disease, having evidence of Diabetic Cardiomyopathy echocardiographically. In diabetics, a complex series of metabolic disturbances results in heart fibrosis and enlargement. which ultimately leads to clinical heart failure. Despite 4 decades of research there are currently no specific treatments for diabetic cardiomyopathy. Prevention of this condition requires its early identification and treatment. Early treatment with medications known to improve heart failure outcome such as angiotensin-converting enzyme inhibitors (ACEI) and beta-blockers has been suggested from meta-analysis data specifically looking at diabetic subjects in the major heart failure trials to be beneficial . There is yet to be a long term follow-up study to definitively confirm this. Much of the previous work focusing on the early identification of this condition has been carried out by the Cardiovascular Imaging Research group through involvement in an NHMRC Centre of Clinical Research Excellence Award (455832). Work initiated in 2003 studied a large cohort of T2DM patients in a randomized controlled trial of lifestyle intervention. The results of this research were groundbreaking, proving that diabetic cardiomyopathy was able to be identified using novel echocardiographic imaging techniques. The proposed project aims to provide long term (10 year) follow up data on these original participants. To our knowledge this will be unique data within the literature allowing identification of markers of long term adverse prognosis and information about the factors affecting the progression of diabetic cardiomyopathy over time. Hypotheses The following hypotheses will be tested: 1. Diabetic cardiomyopathy is prevalent and progressive over time. Clinical and widely available testing including echocardiography and cardiopulmonary exercise testing is able to identify long term risk markers for diabetic cardiomyopathy which result in adverse cardiovascular morbidity and mortality. 2. Novel echocardiographic techniques, are superior to current echocardiographic techniques for the detection of diabetic cardiomyopathy and are better able to assess cardiac risk as evidenced by subclinical left ventricular dysfunction. 3. ACE inhibitor/Angiotensin Receptor Blocker (ARB) therapy and/or beta-blocker therapy will prevent the progression of DCM over long term follow-up.
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Trial website
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Trial related presentations / publications
Original RCT trial was not registered in 2003. Publications resulting from the earlier trial are as follows: Fang ZY, Schull-Meade R, Downey M, Prins J, Marwick TH. Determinants of subclinical diabetic heart disease. Diabetologia 2005; 48: 394–402. . Fang ZY, Sharman J, Prins JB, Marwick TH. Determinants of exercise capacity in patients with type 2 diabetes. Diabetes Care. 2005; 28(7): 1643-8. Hordern MD, Coombes JS, Cooney LM, Jeffriess L, Prins JB, Marwick TH. Effects of exercise intervention on myocardial function in type 2 diabetes. Heart 2009; 95(16): 1343-9. Hare JL, Hordern MD, Leano R, Stanton T, Prins JB, Marwick TH. Application of an exercise intervention on the evolution of diastolic dysfunction in patients with diabetes mellitus: efficacy and effectiveness. Circ Heart Fail. 2011; 4(4): 441-9.
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Tony Stanton
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Address
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Cardiovascular Imaging Research Centre
University of Queensland School of Medicine
Princess Alexandra Hospital
Ipswich Road
WOOLLOONGABBA QLD 4102
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Country
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Australia
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Phone
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+61 7 3176 5813
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Fax
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+61 7 3176 5399
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Email
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[email protected]
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Contact person for public queries
Name
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Julie Holliday
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Address
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School of Medicine
Princess Alexandra Hospital
Ipswich Road
WOOLLOONGABBA QLD 4102
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Country
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Australia
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Phone
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+61731766146
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Fax
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+61731765399
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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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A/Prof Tony Stanton
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Address
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School of Medicine
Princess Alexandra Hospital
Ipswich Road
WOOLLOONGABBA QLD 4102
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Country
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Australia
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Phone
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+61731765813
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Fax
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+61731765399
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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
Source
Title
Year of Publication
DOI
Embase
Subclinical LV dysfunction and 10-year outcomes in type 2 diabetes mellitus.
2015
https://dx.doi.org/10.1136/heartjnl-2014-307391
N.B. These documents automatically identified may not have been verified by the study sponsor.
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