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Trial registered on ANZCTR
Registration number
ACTRN12614001020673
Ethics application status
Approved
Date submitted
12/09/2014
Date registered
23/09/2014
Date last updated
7/04/2024
Date data sharing statement initially provided
10/12/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
An observational cohort study of serial blood sampling to measure the levels of biomarkers expressed prior to and after transcoronary ablation of septal hypertrophy (TASH).
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Scientific title
SErial biomArker profiling in tRansCoronary ablation of septal Hypertrophy
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Secondary ID [1]
285325
0
nil
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Universal Trial Number (UTN)
U1111-1157-8380
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Trial acronym
The SEARCH Study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
coronary heart disease
293047
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Condition category
Condition code
Cardiovascular
293321
293321
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0
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Coronary heart disease
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Intervention/exposure
Study type
Observational
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Patient registry
False
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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
Patients undergoing transcoronary ablation of septal hypertrophy (TASH) will be invited to participate in an observational cohort study of serial blood sampling to measure the levels of biomarkers expressed prior to and after the procedure.
The TASH procedure is the perfect human model of acute myocardial infarction (AMI) with the onset of cardiac injury known to the second. Measurement of new high sensitivity troponin assays (hsTnT and hsTnI) and other candidate early markers like copeptin, Brain Natriuretic Peptide signal peptide (BNPsp) and circulating microRNA and DNA in serial blood samples will be performed to determine the earliest and most informative biomarkers in the first minutes to hours after onset of coronary ischaemic injury. High end lipidomic and other metabolomic analysis will also be applied and analysed. These analyses will be performed in order to better understand the biochemical response to TASH and to identify prognostic markers that may be useful in predicting outcomes.
The overall duration of observation is from immediately prior to surgery and for 24 hours afterwards.
As per usual clinical care and procedure, septal ablation occurs via temporary septal artery branch occlusion and injection of 1ml 100% ethanol after heparin administration (bolus, 5000 IU heparin).
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Intervention code [1]
290236
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Not applicable
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Comparator / control treatment
not applicable
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Serum Brain Natriuretic Peptide signal peptide (BNPsp) as assessed using an immunoassay.
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Assessment method [1]
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Timepoint [1]
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Samples will be taken at 10 minutes, +15, +30, +45, +60, +120, +240 and +1440 minutes after ethanol administration.
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Primary outcome [2]
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Novel Natriuretic Peptides peptide as assessed using an immunoassay.
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Assessment method [2]
293149
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Timepoint [2]
293149
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From blood samples taken at 10 minutes, +15, +30, +45, +60, +120, +240 and +1440 minutes after ethanol administration
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Primary outcome [3]
293150
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Evaluate the well documented temporal rise of cardiac troponin as a reference using a serum immunoassay.
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Assessment method [3]
293150
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Timepoint [3]
293150
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Blood samples will be taken at 10 minutes, +15, +30, +45, +60, +120, +240 and +1440 minutes after ethanol administration.
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Secondary outcome [1]
310453
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nil
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Assessment method [1]
310453
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Timepoint [1]
310453
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nil
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Eligibility
Key inclusion criteria
Patients admitted for a septal ablation procedure in the Cardiac Catheter Lab
Ability to provide informed written consent.
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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
Clinical contraindications to invasive angiography or percutaneous procedures.
Inability to sign informed consent
Unwilling to participate
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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
Up to 50 consecutive patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing septal ablation will be included. As this is an observation case series study design based on similar studies of biomarker kinetics statistical assumptions supporting sample size calculations, e.g. effect size to be detected, statistical power are not necessary .The methodology has been well tested in studies of earlier generation biomarkers. The outcome will be the identification of potential new biomarkers that can more accurately and rapidly identify patients suffering a myocardial infarction, thereby facilitating more expeditious treatment and facilitating outcomes.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/10/2014
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Actual
10/11/2014
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Date of last participant enrolment
Anticipated
31/12/2025
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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
50
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Accrual to date
7
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Final
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Recruitment outside Australia
Country [1]
6351
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New Zealand
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State/province [1]
6351
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Christchurch
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Christchurch Heart Institute
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Address [1]
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University of Otago, Christchurch
2 Riccarton Avenue
Christchurch 8011
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Country [1]
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New Zealand
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Primary sponsor type
Charities/Societies/Foundations
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Name
Christchurch Heart Institute
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Address
University of Otago, Christchurch
2 Riccarton Avenue
Christchurch 8011
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
288635
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Address [1]
288635
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Country [1]
288635
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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NZ Health & Disability Ethics Committee
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Ethics committee address [1]
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C/- MEDSAFE, Level 6, Deloitte House. 10 Brandon Street, PO Box 5013. Wellington. 6011.
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Ethics committee country [1]
291659
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New Zealand
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Date submitted for ethics approval [1]
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09/06/2014
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Approval date [1]
291659
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24/09/2014
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Ethics approval number [1]
291659
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14/STH/73
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Summary
Brief summary
The principle hypothesis of this study proposal is that the clinical procedure of septal ablation (TASH) offers the most accurate and controlled circumstance of acute cardiac injury, mimicking a myocardial infarction. As the precise time of myocardial cell death can be documented, this then allows precise temporal profiling of novel markers that could be used to make further improvements in the diagnosis and management of heart attacks, as they present in "real world" clinical experience. This study will identify rapidly responding biomarkers that are specific to myocardial infarction. Knowledge of these markers and their temporal profile can then be applied to future clinical studies directly assessing their potential to be applied in an emergency department setting to assist in the rapid, accurate identification of patients suffering acute coronary syndromes. Consecutive patients (up to n=50) with hypertrophic obstructive cardiomyopathy (HOCM) undergoing septal ablation will be included. As per usual clinical care and procedure, septal ablation occurs via temporary septal artery branch occlusion and injection of 1ml 100% ethanol after heparin administration (bolus, 5000 IU heparin). Postprocedural management included monitoring at the intensive care unit for 48 hours. All patients will be provided with complete study information before being asked to provide consent. Blood samples (10ml serum and 10ml EDTA) will be taken at each time point given, ie. 20ml per time point. Samples will be taken at 10 minutes, +15, +30, +45, +60, +120, +240 and +1440 minutes after ethanol administration. Samples will be drawn at each time point from a forearm antecubital vein. Cardiac coronary sinus samples will be taken at 10 and +15 minutes only.
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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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Dr John Lainchbury
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Address
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Cardiology Department
Christchurch Hospital
2 Riccarton Avenue
Christchurch 8011
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Country
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New Zealand
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Phone
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+643 364 0640
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Fax
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+643 364 1115
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Email
51398
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[email protected]
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Contact person for public queries
Name
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Lorraine Skelton
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Address
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Christchurch Heart Institute
University of Otago, Christchurch
2 Riccarton Avenue
Christchurch 8011
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Country
51399
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New Zealand
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Phone
51399
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+643 364 1063
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Fax
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+643 364 1115
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Email
51399
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[email protected]
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Contact person for scientific queries
Name
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Chris Pemberton
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Address
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Christchurch Heart Institute
University of Otago, Christchurch
2 Riccarton Avenue
Christchurch 8011
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Country
51400
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New Zealand
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Phone
51400
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+643 3640887
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Fax
51400
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+643 3641115
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Email
51400
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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)?
No
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No/undecided IPD sharing reason/comment
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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
No additional documents have been identified.
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