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Trial registered on ANZCTR
Registration number
ACTRN12624001248550p
Ethics application status
Submitted, not yet approved
Date submitted
16/09/2024
Date registered
11/10/2024
Date last updated
11/10/2024
Date data sharing statement initially provided
11/10/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Assessment for coronary artery vasospasm as a cause for patients with unexplained cardiac arrest.
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Scientific title
Provocative coronary testing in patients with unexplained cardiac arrest (PROCORA)
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Secondary ID [1]
312975
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Nil known
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Universal Trial Number (UTN)
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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:
Cardiac arrest
335155
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Coronary artery vasospasm
335156
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Condition category
Condition code
Cardiovascular
331649
331649
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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 with unexplained cardiac arrest will undergo an invasive functional angiography 4-6 weeks following their cardiac arrest, with administration of intracoronary acetylcholine boluses to assess for coronary artery vasospasm. The left coronary artery will be assessed first, by injecting escalating doses of acetylcholine from 50mcg, 100mcg, 150mcg and 200mcg. If a diagnosis of coronary vasospasm is achieved prior to reaching the maximum 200mcg dose then no further boluses will be administered. If no diagnosis is achieved following assessment of the left coronary artery then the right coronary artery will be assessed with escalating boluses of acetylcholine from 20mcg, 40mcg, 60mcg and 80mcg. If a diagnosis of coronary vasospasm is achieved prior to reaching the maximum 80mcg dose then no further boluses will be administered. This will be performed by the cardiologists participating as study investigators in this study. The procedure will take approximately 1 hour to perform. Results from this investigation and adherence will be obtained from hospital medical records. Patients not wishing to participate in this study may also be recommended to undergo invasive functional angiography however this would be up to the discretion of their treating clinician and is not part of standard work up.
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Intervention code [1]
329513
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Diagnosis / Prognosis
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Comparator / control treatment
A comparator group will be used in this study, and will consist of patients with explained cardiac arrest due to obstructive coronary atherosclerotic disease. These patients will be selected from patients who will require staged percutaneous coronary intervention, 4-6 weeks following their initial cardiac arrest. They will undergo invasive functional coronary angiography as an additional component to their percutaneous coronary intervention.
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Control group
Active
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Outcomes
Primary outcome [1]
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Percentage of patients with a diagnosis of coronary artery vasospasm.
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Assessment method [1]
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Invasive functional angiography, with a diagnosis based on the criteria outlined by the Coronary Vasomotor Disorders International Study Group.
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Timepoint [1]
339380
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Once off assessment 4-6 weeks following cardiac arrest.
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Secondary outcome [1]
440030
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Nil
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Assessment method [1]
440030
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Nil
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Timepoint [1]
440030
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Nil
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Eligibility
Key inclusion criteria
Patients aged 18 years with unexplained cardiac arrest.
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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
Patients with an identifiable or clinically suspected cause for cardiac arrest according to clinicians caring for the patient inclusive of but not limited to:
- Acute coronary syndrome due to plaque rupture or severe disease
- Suspected cardiac arrhythmias from LQTS, Brugada or other arrhythmogenic cause
- Non-cardiac causes e.g. acute renal failure, pulmonary emboli, sepsis
- Acute myocardial dysfunction or inflammation e.g. myocarditis, infection (COVID)
Contraindications to receiving acetylcholine.
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Study design
Purpose
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Duration
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Selection
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Timing
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
3/02/2025
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Actual
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Date of last participant enrolment
Anticipated
31/01/2027
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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
70
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,SA,WA,VIC
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Funding & Sponsors
Funding source category [1]
317415
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Self funded/Unfunded
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Name [1]
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Address [1]
317415
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Country [1]
317415
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Primary sponsor type
Government body
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Name
Alfred Health
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Address
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Country
Australia
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Secondary sponsor category [1]
319697
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None
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Name [1]
319697
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Address [1]
319697
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Country [1]
319697
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
316135
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
316135
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https://www.alfredhealth.org.au/research/ethics-research-governance
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Ethics committee country [1]
316135
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Australia
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Date submitted for ethics approval [1]
316135
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02/10/2024
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Approval date [1]
316135
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Ethics approval number [1]
316135
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Summary
Brief summary
A national, multi-centre observational study is proposed to evaluate the prevalence of coronary artery vasospasm in patients with unexplained cardiac arrest. Patients over the age of 18 years who have suffered an unexplained cardiac arrest (n=60) will undergo invasive functional angiography with acetylcholine challenge to assess for coronary artery vasospasm as a potential cause for their cardiac arrest. A small control group of patients with explained cardiac arrest (n=10) will also undergo functional coronary angiography as a comparator. The primary end point is the percentage of patients with a diagnosis of coronary artery vasospasm as defined by the Coronary Vasomotor Disorders International Study Group (COVADIS) criteria. The secondary end point is the association of risk factors leading to a diagnosis of coronary artery vasospasm. We expect this study will show a significant percentage of patients with a diagnosis of coronary artery vasospasm as a potential cause for their cardiac arrest, which will allow for targeted treatment in the prevention of further cardiac arrest, leading to improved patient outcomes.
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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 William Chan
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Address
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The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria, 3004
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Country
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Australia
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Phone
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+61 435612868
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Fax
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Email
136898
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[email protected]
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Contact person for public queries
Name
136899
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Brendan Backhouse
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Address
136899
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The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria, 3004
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Country
136899
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Australia
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Phone
136899
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+61 421189381
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Fax
136899
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Email
136899
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[email protected]
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Contact person for scientific queries
Name
136900
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Brendan Backhouse
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Address
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The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria, 3004
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Country
136900
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Australia
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Phone
136900
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+61 421189381
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Fax
136900
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Email
136900
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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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