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Trial registered on ANZCTR
Registration number
ACTRN12623001296628
Ethics application status
Approved
Date submitted
16/11/2023
Date registered
13/12/2023
Date last updated
25/07/2024
Date data sharing statement initially provided
13/12/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluate the effectiveness of Acute Flu Vaccination on Recurrent Cardiovascular Events (AFLUENT): A Pilot Randomised Clinical Trial
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Scientific title
Evaluate the effectiveness of Acute Flu Vaccination on Recurrent Cardiovascular Events (AFLUENT): A Pilot Randomised Clinical Trial
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Secondary ID [1]
310935
0
None
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Universal Trial Number (UTN)
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Trial acronym
AFLUENT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute myocardial infarction (Type 1)
331996
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Condition category
Condition code
Cardiovascular
328736
328736
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
AFLUENT is a pragmatic, investigator initiated, open label, randomised, pilot clinical trial that will be undertaken within the Cardiology department at Royal Perth Hospital.
This trial will compare an intervention of “early” routine influenza vaccination of patients diagnosed with acute myocardial infarction within one week of the event, to “standard care”, where patients will be advised to seek their influenza vaccination in the community at their own discretion with guidance from their primary care physician.
If a patient is randomised to the intervention of the influenza vaccination, a delegated research nurse who has undertaken an accredited immunisation course will administer the intramuscular vaccination prescribed by the treating physician on the Cardiology wards at Royal Perth Hospital.
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Intervention code [1]
327364
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Prevention
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Comparator / control treatment
Patients randomised to the control group will not receive the influenza vaccine. These patients will still receive routine standard care, of which they will be advised to seek their influenza vaccination in the community at their own discretion with guidance from their primary care physician.
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Control group
Active
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Outcomes
Primary outcome [1]
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Composite primary outcome, including incidence of cardiovascular death, myocardial infarction and stroke.
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Assessment method [1]
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Data linkage: Patient medical records, and Data Linkage Services, Department of Health, Government of Western Australia
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Timepoint [1]
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12 months after randomisation.
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Secondary outcome [1]
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Composite secondary outcome, including the primary outcome plus hospitalisation for unstable angina requiring unplanned revascularisation.
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Assessment method [1]
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Data linkage: Patient medical records, and Data Linkage Services, Department of Health, Government of Western Australia
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Timepoint [1]
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12 months after randomisation.
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Secondary outcome [2]
428762
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Quality of life
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Assessment method [2]
428762
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EQ-5D-5L questionnaire
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Timepoint [2]
428762
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12 months after randomisation.
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Secondary outcome [3]
429515
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Incidence of cardiovascular death
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Assessment method [3]
429515
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Data linkage: Patient medical records, and Data Linkage Services, Department of Health, Government of Western Australia
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Timepoint [3]
429515
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12 months after randomisation
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Secondary outcome [4]
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Myocardial infarction
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Assessment method [4]
429516
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Data linkage: Patient medical records, and Data Linkage Services, Department of Health, Government of Western Australia
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Timepoint [4]
429516
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12 months post randomisation
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Secondary outcome [5]
429517
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Stroke
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Assessment method [5]
429517
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Data linkage: Patient medical records, and Data Linkage Services, Department of Health, Government of Western Australia
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Timepoint [5]
429517
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12 months post randomisation
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Secondary outcome [6]
429518
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All cause death
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Assessment method [6]
429518
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Data linkage: Patient medical records, and Data Linkage Services, Department of Health, Government of Western Australia
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Timepoint [6]
429518
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12 months post randomisation
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Secondary outcome [7]
429519
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Days alive and out of hospital
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Assessment method [7]
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Data linkage: Patient medical records, and Data Linkage Services, Department of Health, Government of Western Australia
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Timepoint [7]
429519
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12 months post randomisation
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Eligibility
Key inclusion criteria
Acute type 1 myocardial infarction
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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
a) Influenza vaccination in the previous 3 months
b) Previous anaphylactic reaction to influenza vaccination
c) Previous anaphylactic reaction to any component of influenza vaccine (if no suitable alternate vaccine is available)
d) Intercurrent active infection or febrile illness
e) Prior history of Guillain-Barré Syndrome within 6 weeks of previous influenza vaccination
f) Other severe medical condition with life expectancy <1 year
g) Unable or unwilling to provide informed consent.
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Study design
Purpose of the study
Prevention
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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)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Eligible patients that agree to participate in the trial will be randomised by the delegated research coordinator using the randomisation module in a computer generated randomisation schedule.
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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
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
Primary Outcome (time to event) will be measured from randomisation until event or last known event-free observation during the follow-up period (12 months). Patients not experiencing the primary outcome event will have their time to event censored at last follow-up date. The primary outcome will be compared between each intervention group using restricted mean survival analyses, a point estimate, 95% confidence interval and 2-sided p-value. Statistical significance will occur if the p-value is <0.05. The primary analysis will follow the intention to treat principle. A secondary analysis will be performed based on whether patients did or did not receive any influenza vaccination during the trial period.
Secondary Outcome will be analysed using appropriate methodology: time to event using restricted mean survival analysis, binary outcomes using logistic regression, continuous outcomes using linear regression or where not normally distributed using appropriate non-parametric methods.
Exploratory analyses will compare the outcomes a) in patients randomised during ‘flu season’ with those randomised at other times and b) in patients who had received influenza vaccination in the year prior to randomisation with those who had not. We will also compare outcomes in important subgroups such as patients with diabetes, patients = or > 75 years, men and women etc.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
8/05/2024
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Actual
9/05/2024
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Date of last participant enrolment
Anticipated
30/04/2025
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Actual
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Date of last data collection
Anticipated
30/04/2026
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Actual
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Sample size
Target
300
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Accrual to date
16
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
25830
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Royal Perth Hospital - Perth
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Recruitment postcode(s) [1]
41657
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6000 - Perth
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Funding & Sponsors
Funding source category [1]
315245
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University
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Name [1]
315245
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Curtin University
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Address [1]
315245
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Kent St, Bentley WA 6102
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Country [1]
315245
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Australia
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Primary sponsor type
Hospital
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Name
Royal Perth Hospital
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Address
197 Wellington St, Perth WA 6000
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Country
Australia
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Secondary sponsor category [1]
317275
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None
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Name [1]
317275
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Address [1]
317275
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Country [1]
317275
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Other collaborator category [1]
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University
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Name [1]
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The University of Western Australia
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Address [1]
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35 Stirling Hwy, Crawley WA 6009
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Country [1]
282875
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Australia
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Other collaborator category [2]
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University
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Name [2]
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Curtin University
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Address [2]
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Kent St, Bentley WA 6102
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Country [2]
282876
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Australia
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Other collaborator category [3]
282877
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Hospital
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Name [3]
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Royal Perth Hospital
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Address [3]
282877
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197 Wellington Street, Perth WA 6000
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Country [3]
282877
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314123
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Royal Perth Hospital Human Research Ethics Committee
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Ethics committee address [1]
314123
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Level 2, Kirkman House, 198 Wellington Street, Perth, Western Australia 6000
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Ethics committee country [1]
314123
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Australia
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Date submitted for ethics approval [1]
314123
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15/11/2023
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Approval date [1]
314123
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07/02/2024
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Ethics approval number [1]
314123
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RGS0000006476
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Summary
Brief summary
AFLUENT is a pragmatic, investigator initiated, open label, randomised, pilot clinical trial that will be undertaken within the Cardiology department at Royal Perth Hospital. This trial will compare an intervention of “early” routine influenza vaccination of patients diagnosed with acute myocardial infarction within one week of the event, to “standard care”, where patients will be advised to seek their influenza vaccination in the community at their own discretion with guidance from their primary care physician. As per guideline recommendations, it is specifically recommended that “high risk” cardiac patients such as those within this study population receive their influenza vaccination in the community prior to the onset of “flu season”. However, enrolment of trial patients into AFLUENT will occur all year round, regardless of whether it is “flu season” or not. It is anticipated that patients within the “standard care” group may delay their vaccination or not receive it at all. Thus, the trial is testing a strategy of routine early administration to all patients in the intervention group, with currently recommended strategy whereby patients are encouraged to access vaccination in the community but often do not. The likely failure of many control patients to seek vaccination plus the inevitable delay in doing so are fundamental to the design of this trial.
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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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Prof Graham Hillis
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Address
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Department of Cardiology, Level 4, South Block, Royal Perth Hospital, Victoria Square, Perth, WA, 6000
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Country
130490
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Australia
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Phone
130490
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+61 8 9224 3180
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Fax
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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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Justine Chan
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Address
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Department of Cardiology, Level 4, South Block, Royal Perth Hospital, Victoria Square, Perth, WA, 6000
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Country
130491
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Australia
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Phone
130491
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+61 8 9224 3281
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Fax
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Email
130491
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[email protected]
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Contact person for scientific queries
Name
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Graham Hillis
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Address
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Department of Cardiology, Level 4, South Block, Royal Perth Hospital, Victoria Square, Perth, WA, 6000
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Country
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Australia
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Phone
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+61 8 9224 3180
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Fax
130492
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Email
130492
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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.
Download to PDF