Improvement of Patients With Chronic Heart Failure Using NT-proBNP (EXIMPROVECHF)

This study is currently recruiting participants. (see Contacts and Locations)
Verified July 2009 by St. Michael's Hospital, Toronto
Sponsor:
Collaborator:
Hoffmann-La Roche
Information provided by (Responsible Party):
St. Michael's Hospital, Toronto
ClinicalTrials.gov Identifier:
NCT00601679
First received: January 8, 2008
Last updated: December 28, 2012
Last verified: July 2009

January 8, 2008
December 28, 2012
December 2007
December 2013   (final data collection date for primary outcome measure)
Heart failure hospitalization and death [ Time Frame: 2 years ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT00601679 on ClinicalTrials.gov Archive Site
Time to hospitalization/admission to ED due to HF, total number of HF events, total number of hospitalizations for cardiovascular events, all-cause mortality, cardiovascular mortality, worsening in clinical status but not requiring hospital admission [ Time Frame: 2 years ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Improvement of Patients With Chronic Heart Failure Using NT-proBNP
Improvement in Clinical Outcomes of Patients With Chronic Heart Failure Using Serial NT-proBNP Monitoring: The EX-IMPROVE-CHF Study

This will be a multicentre Phase IV study in which patients with chronic HF who are managed and followed by HF/heart functions clinics will be followed over a period of two years.

Clinic patients who are recruited into the study will have obligatory blood sampling for the surveillance measurement of NT-proBNP level every three months for a minimum of one year (4 samples). One-half of the subjects in each clinic will be randomized to have these NT-proBNP values made known to the attending clinic physicians and nurses, the other half will have these values blinded. During the study, attending clinic physicians can order open-label NT-proBNP or BNP assays, if available in their institution, to assist the management of their patients if they feel it is clinically needed.

Once an eligible clinic patient is identified, written informed consent will be obtained. All patients will have blood drawn for the measurement of NT-proBNP immediately after consent is obtained. The patient will then be randomized to either the usual care or NT-proBNP arm.

For each patient enrolled into the study the attending physician will ensure obligatory blood sampling for the measurement of NT-proBNP level every three months for a minimum of one year (4 samples). Conventional measures used in programmed management settings including history taking, physical and radiographic examination and echocardiography will also be undertaken as per clinical practice. Patients from both arms will be treated with the same conventional measures.

One-half of the subjects in each clinic will be randomized to have these NT-proBNP values made known to the attending clinic physicians and nurse practitioners. The other half (Usual Care) will have these values blinded. During the study, attending clinic physicians can order NT-proBNP or BNP assays, if available in their institution, to assist the management of their patients if they feel it is clinically needed. Demographic variables such as age, gender, BMI, serum creatinine, and eGFR will also be collected in both arms. A dedicated research coordinator based in St. Michael's Hospital, the core centre, will monitor patients, data and blood sample collection from all participating clinics. NT-proBNP will be measured on site in clinics with the facility to measure NT-proBNP. For clinics that do not have the facility, the samples will be shipped to the core centre for measurement and the results will be provided to the clinic within one week for those patients who are randomized to open-label NT-proBNP. The research coordinator, via close communications with the clinic nurses and physicians, will ensure the process is immaculately executed and blinding is maintained.

All patients will be followed every three months for a minimum of one year (4 samples) and will include an initial evaluation (Visit 1) along with four follow-up visits in the HF/heart functions clinics (Visits 2 - 5). A clinic visit will be requested for those patients having experienced a serious adverse event since Visit 1.

Interventional
Phase 4
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Congestive Heart Failure
Other: NT-proBNP guided care
knowledge of NT-proBNP results
Other Name: NT-proBNP guided care
  • Experimental: NT-proBNP
    Surveillance NT-proBNP levels disclosed to physicians
    Intervention: Other: NT-proBNP guided care
  • No Intervention: Usual Care
    Surveillance NT-proBNP levels blinded
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
400
December 2014
December 2013   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Age ≥ 18 years of age
  • NYHA class II-IV heart failure
  • Followed in a programmed heart failure (HF) management setting

Exclusion Criteria:

  • Life expectancy <1 year due to causes other than HF such as advanced cancer
  • Any other conditions that may render the patient ineligible according to the investigator's judgment
Both
18 Years and older
Yes
Contact: Gordon W Moe, MD, FACC 416-864-6060 ext 5319 moeg@smh.ca
Contact: Carlos S Fernando, MD 416-864-6060 ext 2886 fernandoc@smh.ca
Canada
 
NCT00601679
CAN0013
No
St. Michael's Hospital, Toronto
St. Michael's Hospital, Toronto
Hoffmann-La Roche
Principal Investigator: Gordon W Moe, MD, FACC St. Michael's Hospital, Toronto
St. Michael's Hospital, Toronto
July 2009

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP