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Trial registered on ANZCTR
Registration number
ACTRN12609000055202
Ethics application status
Approved
Date submitted
30/06/2008
Date registered
23/01/2009
Date last updated
23/01/2009
Type of registration
Retrospectively registered
Titles & IDs
Public title
Assessing the correlations of anticoagulant effects between Thromboelastography [TEG] and anti-Xa activity in patients on therapeutic dose of low-molecular-weight heparin (LMWH)?
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Scientific title
Assessing the correlations of anticoagulant effects between Thromboelastography [TEG] and anti-Xa activity in patients on therapeutic dose of low-molecular-weight heparin (LMWH)?
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Secondary ID [1]
774
0
Nil
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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:
Acute coronary syndrome
3340
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Condition category
Condition code
Blood
3493
3493
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0
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Other blood disorders
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Intervention/exposure
Study type
Observational
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Patient registry
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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
1."The thromboelastography is used to define the viscoelastic properties of blood to potentially predict the degree of anticoagulation from LMWH. All patients admitted to the critical care unit (CCU) with acute coronary syndromes (ACS) are started on LMWH. A blood sample will be taken once 4 hours after the therapeutic dose of enoxaparin is given on day 3. A TEG will be performed on these samples along with the anti-Xa levels and other coagulation parameters. Thromboelastograph Protocol for Sodium Citrated samples Specimen 1. Blood is drawn via venipuncture from the patient into Greiner Vacuette(Registered) #9NC (sodium citrate) Coagulation tubes. The samples must be filled to the mark and inverted 3 times to adequately mix the sample. 2. The exact collection time MUST be written onto the specimen. 3. The specimen will then be sent immediately to pathology for processing. 4. Samples are "rested" (undisturbed) for a minimum of 15 mins prior to analysis. Protocol 1. Routine daily maintenance and QC will be undertaken as per lab protocol. 2. Disposable cups and pins are placed into the TEG cup and allowed to warm to 370C. 3. Patient data is entered into the computer as required. 4. 20µl of 0.2M Calcium Chloride (CaCl2) is added to the TEG test cup. 5. The citrated sample is well mixed by gentle inversion, and 1 ml transferred to a vial of Kaolin activator. 6. This sample is mixed 5 times by inversion and 340µl pipetted into the TEG cup. 7. The carrier is raised until flush with the instrument, the lever placed in the "test" position and the test started in the usual manner. 8. The second channel can by activated by following steps from 2 above for additional testing if required."
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3.Pts do not receive LMWH prior to admission
4.Normal patients receive enoxaparin 1mg/kg twice daily subcutaneously
5.Patients with eGFR < 30 ml/min receive 1mg/kg daily
6.Obese patients (BMI > 35kg/m2) receive 1 mb/kg based on lean body mass
(note. the length of time patients are on enoxaparin once TEG has been performed is irrelevant to the study.)
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Intervention code [1]
3072
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Not applicable
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Comparator / control treatment
There is no control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
4398
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Correlations between thromboelastogram and anti-Xa activity
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Assessment method [1]
4398
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Timepoint [1]
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4 hours post dose on day 3
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Secondary outcome [1]
7428
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Effects of dose levels on renal function and obesity measured by renal failure and body mass.
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Assessment method [1]
7428
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Timepoint [1]
7428
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On admission
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Eligibility
Key inclusion criteria
All patients on high dose enoxaparin for acute coronary syndrome in the coronary care unit
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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
No exclusion criteria
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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
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/07/2008
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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
60
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
3536
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Self funded/Unfunded
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Name [1]
3536
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Hayden White
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Address [1]
3536
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Logan Hospital
Cnr Armstrong & Loganlea Roads MEADOWBROOK Qld 4131
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Country [1]
3536
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Australia
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Primary sponsor type
Individual
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Name
Hayden White
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Address
Logan Hospital
Cnr Armstrong & Loganlea Roads MEADOWBROOK Qld 4131
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Country
Australia
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Secondary sponsor category [1]
3174
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None
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Name [1]
3174
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Address [1]
3174
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Country [1]
3174
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
5574
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Princess Alexandra Hospital ethics committee
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Ethics committee address [1]
5574
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Princess Alexandra Hospital 199 Ipswich Road WOOLLOONGABBA QLD 4102
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Ethics committee country [1]
5574
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Australia
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Date submitted for ethics approval [1]
5574
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Approval date [1]
5574
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20/06/2008
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Ethics approval number [1]
5574
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2008/115
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Summary
Brief summary
Aim of the study In this study we intend to find whether TEG parameters in patients on therapeutic dosage of LMWH correlated with anti Xa levels and other coagulation parameters. Background Low molecular weight heparin is commonly used in the management of acute coronary syndromes (ACS). Currently there is no easy method to monitor the degree of anticoagulation from LMWH. Since LMWH inhibits coagulation factor Xa, measuring the anti-Xa activity is a good way to assess the anticoagulant effects of LMWH, but the results may not be readily available. Other coagulation parameters like the activated partial thromboplastin time [aPTT] may not correlate well with the degree of anticoagulation. The thromboelastography is a near patient test which can be used to define the viscoelastic properties of blood. It also provides information about platelet activation, fibrin formation and clot retraction. As a result TEG has the potential to predict the degree of anticoagulation from LMWH. From the available data, TEG parameters have been compared with the anti-Xa levels when LMWH was given in low doses as prophylaxis for deep vein thrombosis. There is no literature to highlight the usefulness of TEG in patients on therapeutic doses of LMWH for acute coronary syndromes. The purpose of the study is to investigate the correlation between the TEG parameters, anti Xa levels and other coagulation tests in patients on therapeutic dose LMWH. Furthermore, we intend to investigate the effects of renal function and body mass on the current dosing guidelines for LMWH.
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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
28713
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Address
28713
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Country
28713
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Phone
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Fax
28713
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Email
28713
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Contact person for public queries
Name
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Hayden White
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Address
11870
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Logan Hospital
Cnr Armstrong & Loganlea Roads MEADOWBROOK Qld 4131
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Country
11870
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Australia
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Phone
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+61732998775
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Fax
11870
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Email
11870
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[email protected]
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Contact person for scientific queries
Name
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Hayden White
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Address
2798
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Logan Hospital
Cnr Armstrong & Loganlea Roads MEADOWBROOK Qld 4131
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Country
2798
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Australia
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Phone
2798
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+61732998775
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Fax
2798
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Email
2798
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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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