Trial record 9 of 58 for:    cardiogenic shock

CardShock Study and Registry

This study has been completed.
Sponsor:
Collaborators:
Aarne Koskelo Foundation
Finnish Foundation for Cardiovascular Research
Information provided by (Responsible Party):
Veli-Pekka Harjola, Helsinki University Central Hospital
ClinicalTrials.gov Identifier:
NCT01374867
First received: June 9, 2011
Last updated: January 2, 2014
Last verified: January 2014
  Purpose

The aim of CardShock Study is to recognise significant prognostic factors in order to detect patients with increased mortality risk to which one could possibly direct more intensive treatments.

The study will provide clinical, functional and invasive haemodynamic measures with systematic serial sampling and evaluation. In addition, the knowledge on the pathophysiology of cardiogenic shock is increased.


Condition
Cardiogenic Shock

Study Type: Observational
Study Design: Observational Model: Case-Only
Time Perspective: Prospective
Official Title: Pathophysiology and Prognostic Factors in Cardiogenic Shock - CardShock Study

Resource links provided by NLM:


Further study details as provided by Helsinki University Central Hospital:

Primary Outcome Measures:
  • All-cause mortality [ Time Frame: participants will be followed for 1 year ] [ Designated as safety issue: No ]
    during follow-up additional analyses will be performed after ICU/CCU and total hospital stay,and at 90 and 180 days, In patients with impanted cardioverter defibrillator firing for fatal VTach or VFib is recorded

  • Major cardiac interventions and implantation of devices [ Time Frame: 1 year ] [ Designated as safety issue: No ]
    Heart transplant, CABG, valve surgery, PCI etc and implantation of devices LVADs, CRT, ICD etc are recorded during follow-up.


Secondary Outcome Measures:
  • Quality of life [ Time Frame: 1-year ] [ Designated as safety issue: No ]
    The patients will receive EQ5-D questionnaire in their own language and will be asked to fill it at 12 months


Biospecimen Retention:   Samples Without DNA

plasma, urine


Enrollment: 220
Study Start Date: October 2010
Study Completion Date: December 2013
Primary Completion Date: December 2013 (Final data collection date for primary outcome measure)
Detailed Description:

Cardiogenic shock (CS) is a life-threatening emergency situation with high hospital mortality up to 50%. Despite of better treatment strategies including early echocardiography, insertion of pulmonary artery catheter to optimize haemodynamic status, early revascularization therapy, and the use of intra-aortic balloon pump, the prognosis has remained poor and only 50% of patients are discharged alive from the hospital. Most commonly CS occurs after a massive ST-elevation myocardial infarction (AMI) - in 8% of AMIs. The importance of early clinical recognition of the developing CS is the crucial since over 2/3 of CS develop only after hospital admission. In addition, about 20% of the cardiogenic shock patients develop systemic inflammatory response syndrome resembling the clinical picture of septic shock. The clinical picture of CS ranges from florid shock to low-output state. The in-hospital length of stay and the costs of care are many times higher than in other shock or AMI patients

Despite the extreme clinical importance of CS, mostly descriptive parameters but not serial evaluation of biomarkers or clinical condition have been analysed. All in all, the scientific data are still very sparse.

Study design

European investigator initiated multicentre study. A minimum of 100 (up to 200) consecutive patients with cardiogenic shock will be recruited in the study. Standardized treatment protocols of the individual participating centres based on international guidelines on heart failure will be applied to every patient in the study. Coronary angiography with percutaneous coronary intervention, vasoactive and inotropic medication, pulmonary artery catheter and intra-aortic balloon pump are utilized when applicable. Echocardiographies and 14-lead ECG will be recorded. Demographic and clinical data as well as serial blood and urine samples (at up to 8 time points during CCU/ICU stay) are collected.

CardShock Registry The patients who are excluded from the study due to time from onset of shock longer than six hours are recorded to Registry (screening failure) log. These patients will form CardShock Registry which includes clinical data (including in-hospital mortality) but not study sampling nor post-discharge follow-up.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population

Hospitals

Criteria

Inclusion Criteria:

  • Cardiogenic shock with hypotension or severe low output syndrome within 6 hours from identification of it Clinical findings of cardiogenic shock: acute heart failure and

    • Hypotension (systolic blood pressure under 90mmHg despite adequate fluid challenge) over 30 min time
    • OR a need for vasopressor treatment (eg dopamine or norepinephrine) to maintain systolic blood pressure > 90mmHg
    • AND signs of hypoperfusion (either altered mental status, cool periphery, oliguria (< 0.5ml/kg/h for last six hours), or blood lactate > 2 mmol/l)
  • Age > 18 years
  • Written informed consent by patient or a close person or a relative if the patient is unable to give the consent on admission according to local regulations.

Exclusion Criteria:

  • Postoperative patients
  • Haemodynamically significant ongoing arrhythmia . (However, e.g. patient resuscitated from serious arrhythmia can be included if the arrhythmia is not ongoing at the time of detection of shock)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01374867

Locations
Finland
Helsinki UCH
Helsinki, Finland, FI-00029
Sponsors and Collaborators
Helsinki University Central Hospital
Aarne Koskelo Foundation
Finnish Foundation for Cardiovascular Research
Investigators
Principal Investigator: Veli-Pekka Harjola, MD, PhD, Associate professor Helsinki UCH
  More Information

No publications provided

Responsible Party: Veli-Pekka Harjola, Chief Physician, Helsinki University Central Hospital
ClinicalTrials.gov Identifier: NCT01374867     History of Changes
Other Study ID Numbers: 117/13/03/01/2010
Study First Received: June 9, 2011
Last Updated: January 2, 2014
Health Authority: Finland: Ethics Committee

Keywords provided by Helsinki University Central Hospital:
Cardiogenic shock
Myocardial infarction
Low-output syndrome
Prognosis
Biomarkers
Pathophysiology

Additional relevant MeSH terms:
Shock
Shock, Cardiogenic
Pathologic Processes
Myocardial Infarction
Myocardial Ischemia
Heart Diseases
Cardiovascular Diseases
Vascular Diseases

ClinicalTrials.gov processed this record on September 14, 2014