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Trial registered on ANZCTR
Registration number
ACTRN12607000202460
Ethics application status
Approved
Date submitted
3/04/2007
Date registered
12/04/2007
Date last updated
14/09/2007
Type of registration
Prospectively registered
Titles & IDs
Public title
Oxygen therapy and myocardial ischaemia during exercise testing
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Scientific title
A double blind randomised controlled cross-over trial of the effect of high flow oxygen on myocardial ischaemia during exercise treadmill testing (ETT)
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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:
Myocardial ischaemia
1727
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Condition category
Condition code
Cardiovascular
1818
1818
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients will receive two oxygen regimes in a cross over fashion: room air (placebo) for 5 minutes before the start and continued until the end of the ETT, and high flow oxygen (15/L minute) (comparator) via a non-rebreather mask for 5 minutes before the start and continued until the end of the ETT. The order that the regimes are received will be allocated randomly and there will be approximately 90 minutes between tests. Exercise will be standardised according to the Bruce protocol for exercise stress tests. The ETT will be stopped for any of the following reasons
ST elevation, LBBB or arrhythmia occurs
The patient requests to stop the test
The development of diagnostic ECG ischaemia for 15 seconds
The cardiology registrar determines that the ETT should be stopped
If none of these endpoints are reached then the duration of the ETT will be determined by the exercise capacity of the patient.
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Intervention code [1]
1676
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Treatment: Other
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Comparator / control treatment
Room air (placebo) for 5 minutes before the start and continued until the end of the ETT
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Time to onset of chest pain and inducible ischaemia
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Assessment method [1]
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Timepoint [1]
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Monitored continuously as per normal ETT.
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Secondary outcome [1]
4391
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Magnitude of ST depression at peak exercise. The ST segment represents the period from the end of ventricular depolarization to the beginning of ventricular repolarization.
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Assessment method [1]
4391
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Timepoint [1]
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Measured at the end of ETT.
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Secondary outcome [2]
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Number of leads showing ST depression.
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Assessment method [2]
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Timepoint [2]
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Measured at the end of ETT.
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Secondary outcome [3]
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Blood pressure and heart rate changes.
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Assessment method [3]
4393
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Timepoint [3]
4393
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Measured every 3 minutes as per standard ETT.
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Eligibility
Key inclusion criteria
Inducible ischaemia on ETT with chest pain.
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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
Abnormal resting electrocardiogram (ECG)ST-elevation during the ETTGlobal ischaemia during the ETT suggesting a possible left main stem lesionArrythmia during the ETTUnstable angina (daily episodes at rest)Left bundle branch block developing during the ETTCongestive heart failureSevere hypertension (systolic >200mmHg)Chronic obstructive respiratory disease or other respiratory disease with oxygen saturations measured at <92% on room airPatients who do not develop chest pain despite evidence of inducible ischaemiaUnstable gaitPatients with contraindication to aspirin, metoprolol or simvastatin.
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Study design
Purpose of the study
Treatment
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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)
Subjects that consent and meet study criteria will be enrolled into the study and allocated treatment by accessing a randomisation list at a central administration site
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A computer generated list of randomised subject assignments will be used
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
An unblinded staff member will administer the treatment. The assessor(s) and data analyst(s) will be blinded.
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
13/04/2007
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Actual
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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
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
501
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New Zealand
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State/province [1]
501
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Funding & Sponsors
Funding source category [1]
1970
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Government body
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Name [1]
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Capital and Coast District Health Board
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Address [1]
1970
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Private Bag 7902
Wellington
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Country [1]
1970
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Mark Simmonds
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Address
Wellington Hospital
Private Bag 7902
Wellington
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Country
New Zealand
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Secondary sponsor category [1]
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Government body
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Name [1]
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Capital and Coast District Health Board
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Address [1]
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Private Bag 7902
Wellington
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Country [1]
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New Zealand
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Secondary sponsor category [2]
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Charities/Societies/Foundations
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Name [2]
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Wellington Cardiology Research Trust
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Address [2]
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Wellington Hospital
Private Bag 7902
Wellington
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Country [2]
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Central Regional Ethics Committee
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Ethics committee address [1]
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PO Bpx 5013 Wellington
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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Approval date [1]
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28/02/2007
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Ethics approval number [1]
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CEN/06/11/102
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Summary
Brief summary
It is routine clinical practice to administer high flow oxygen to all patients with a heart attack. However, there is evidence to suggest that this approach may be harmful, particularly to those patients who are not hypoxic. High flow oxygen causing hyperoxia has been shown to increase blood pressure and reduce cardiac output, and possibly also reduce coronary artery blood flow. As a result it is crucial that the effects of high flow oxygen on myocardial ischaemia is investigated further in patients with ischaemic heart disease. A double-blind randomised controlled cross-over trial using exercise treadmill testing is an ideal method to measure the effect of supplementary oxygen on myocardial ischaemia.
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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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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Anil Ranchord
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Address
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Cardiology Department
Wellington Hospital
Private Bag 7902
Wellington
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Country
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New Zealand
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Phone
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+64 4 385 5999
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Fax
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+64 4 385 5856
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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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Dr Mark Simmonds
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Address
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Cardiology Department
Wellington Hospital
Private Bag 7902
Wellington
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Country
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New Zealand
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Phone
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+64 4 385 5999
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Fax
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+64 4 385 5856
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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
No additional documents have been identified.
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