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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00619593
Registration number
NCT00619593
Ethics application status
Date submitted
11/02/2008
Date registered
21/02/2008
Date last updated
12/01/2015
Titles & IDs
Public title
Survival of Patients With Primary Prophylactic ICD Indication
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Scientific title
Survival of Patients With Primary Prophylactic ICD Indication, Provided With Intensified Care After 1st ICD Therapy
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Secondary ID [1]
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TA079
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Universal Trial Number (UTN)
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Trial acronym
SPIRIT-ICD
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Primary Prevention
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Tachycardia, Ventricular
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Sudden Cardiac Death
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Condition category
Condition code
Cardiovascular
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Other cardiovascular diseases
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Cardiovascular
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Coronary heart disease
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Cardiovascular
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Diseases of the vasculature and circulation including the lymphatic system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Other interventions - Intensified diagnostic and treatment measures following 1st appropriate ICD therapy
Other interventions - Standard follow-up
Active comparator: 2 - Standard follow-up in patients without appropriate ICD therapy
Experimental: 1 - Following 1st appropriate ICD therapy, the patients have to be called to the clinic for intensified clinical diagnostics and, if necessary or useful, intensified therapy.
Other interventions: Intensified diagnostic and treatment measures following 1st appropriate ICD therapy
* Assessment of general health status (weight, BP, NYHA)
* Laboratory tests (hemoglobin, Nt-proBNP, creatinine, GDF-15)
* Echocardiography (LVEF, LVEDD, mitral regurgitation)
* Non-invasive ischemia evaluation
* Coronary angiography (if indicated by ischemia evaluation)
* Upgrade to CRT, if indicated
* Ventricular ablation (if indicated: VT storm, slow VT, bundle branch reentry)
* 24 hrs ECG Holter (Heart rate variability)
* Further treatment (if applicable)
* Changes in ICD settings, or medication
Other interventions: Standard follow-up
Standard follow-up in patients without appropriate ICD therapy
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Intervention code [1]
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Other interventions
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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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Mortality
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Assessment method [1]
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Timepoint [1]
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12 months
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Secondary outcome [1]
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Sudden cardiac death
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Assessment method [1]
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Timepoint [1]
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12 months
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Secondary outcome [2]
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Non-sudden cardiac death
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Assessment method [2]
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Timepoint [2]
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12 months
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Secondary outcome [3]
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Risk of 1st heart failure hospitalization
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Assessment method [3]
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Timepoint [3]
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12 months
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Secondary outcome [4]
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No. of VT Storms (> 3 VT/24h)
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Assessment method [4]
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Timepoint [4]
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12 months
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Secondary outcome [5]
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No. of delivered ICD therapies
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Assessment method [5]
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Timepoint [5]
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12 months
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Eligibility
Key inclusion criteria
* Indication for ICD implantation according to MADIT-II:
* Myocardial infarction 30 days or more before implantation
* LVEF of 30% or less within 3 months before implantation
* Angiography within the preceding 12 months
* The patient is willing and able to comply with the clinical investigation plan and has provided written informed consent
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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 contraindication for ICD implantation
* Conventional ICD indication (i.e. other than MADIT-II)
* Myocardial infarction within the past 30 days
* Coronary revascularisation within the preceding 3 months (i.e., if revascularization has been performed wait at least 3 months until enrolment, given that no appropriate/ inappropriate ICD therapy has occured)
* NYHA functional class IV
* Unexplained syncope within 3 years
* Advanced cerebrovascular disease
* Life expectancy very probably below 12 months
* Pregnant or breast-feeding women
* Age < 18 years
* Patients who are already enrolled in another study (therapy/intervention phase)
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised 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
Parallel
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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
Completed
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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
1/02/2008
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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
1/07/2014
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Sample size
Target
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Accrual to date
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Final
504
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Recruitment in Australia
Recruitment state(s)
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Recruitment outside Australia
Country [1]
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Austria
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State/province [1]
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Linz
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Austria
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St. Poelten
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Austria
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Wien
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Czech Republic
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Brno
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Czech Republic
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Olomouc
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Czech Republic
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Praha
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Germany
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Aachen
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Germany
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Bad Neustadt
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Germany
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Bielefeld
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Germany
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Bonn
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Germany
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Detmold
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Germany
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Dortmund
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Germany
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Dresden
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Germany
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Düsseldorf
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Germany
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Erkelenz
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Germany
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Gießen
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Germany
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Hannover
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Germany
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Landshut
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Germany
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Mönchengladbach
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Germany
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Paderborn
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Germany
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Rostock
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Germany
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Unna
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Hungary
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Budapest
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Hungary
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Debrecen
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Israel
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Tel Hashomer
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Latvia
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Riga
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New Zealand
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Hamilton
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Poland
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Lodz
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Poland
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Warzawa
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Slovakia
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Banska Bystrica
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Slovakia
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Bratislava
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Slovakia
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Kosice
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Spain
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Valencia
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Switzerland
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Basel
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Biotronik SE & Co. KG
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The MADIT-II trial has shown that patients with severely reduced left ventricular ejection fraction (LVEF) post myocardial infarction benefit from the implantable cardioverter-defibrillator (ICD). However, retrospective analyses of the MADIT-II data have revealed a significantly increased morbidity and mortality in patients with appropriate ICD therapy: Appropriate ICD therapy is associated with 3.3-fold increased all-cause mortality, and the risk of a first heart failure hospitalization is 90% higher after 1st appropriate ICD therapy. Hence, the 1st appropriate therapy might indicate the necessity and utility of further clinical diagnostics and therapy in these patients. This trial is designed to (i) improve the knowledge of the group characteristics of patients suffering from 1st appropriate ICD therapy, (ii) but moreover to take additional therapeutic steps to reduce the mortality of this patient population.
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Trial website
https://clinicaltrials.gov/study/NCT00619593
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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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Robert Hatala, Prof. MUDr.
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Address
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Národný ústav srdcových a cievnych chorôb, Kardiologická klinika, Pod Krásnou Hôrkou 1, 833 48 Bratislava, Slovakia
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Contact person for public queries
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Contact person for scientific queries
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
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT00619593
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