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Aldosterone Blockade in Heart Failure (ARCTIC-D)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00523757
Recruitment Status : Completed
First Posted : August 31, 2007
Last Update Posted : November 7, 2018
Information provided by (Responsible Party):
Justin Ezekowitz, University of Alberta

Brief Summary:

Heart failure causes significant morbidity and mortality and is the most rapidly increasing cardiovascular diagnosis in North America overall prevalence is estimated at 0.4% to 2.4%. Recently, heart failure with a preserved ejection fraction (HFNEF) was found in up to 50% of patients with symptomatic heart failure. Many studies have demonstrated that HFNEF has a poor prognosis with a mortality rate of up to 8% per year and a 50% chance of needing to be admitted to hospital in the next year. There are no proven therapies for this type of heart failure.

Aldosterone blockers (these drugs block a hormone that is elevated in patients with heart failure) are used in other types of heart failure. Our goal is to see if this type of drug improves the function of the heart by looking at the thickness of the heart muscle using MRI. Also we will measure the amount of tissue formation and breakdown in the heart. The trial will be done using both the drug and a placebo so that we can see what effects are due to the drug.

Condition or disease Intervention/treatment Phase
Heart Failure Drug: Spironolactone Drug: Placebo Phase 3

Detailed Description:

Aldosterone antagonists have shown efficacy in systolic heart failure and in patients with post-myocardial infarction systolic dysfunction in three major randomized placebo controlled trials. Together these trials have demonstrated a reduction in mortality, hospitalization and a regression in left ventricular mass by MRI.

Primary Objective The primary objective of this study will be to assess the change in markers of collagen turnover and correlate this with specific measures of left ventricular mass regression and diastolic function on MRI after 4 months of aldosterone blockade.

Study Design and Methods This study is a double-blind, concealed allocation, randomized trial at the University of Alberta where patients with diastolic heart failure will be randomized to spironolactone or matching placebo for 4 months. Outcomes assessed include LV mass by MRI, collagen markers, other biomarkers, clinical outcomes, quality of life and exercise testing

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 8 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Aldosterone-blockade Randomized Controlled Trial In CHF - Diastolic
Study Start Date : August 2007
Actual Primary Completion Date : April 30, 2010
Actual Study Completion Date : April 30, 2010

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Failure

Arm Intervention/treatment
Experimental: 1
Drug: Spironolactone
Placebo Comparator: 2 Drug: Placebo

Primary Outcome Measures :
  1. LVH [ Time Frame: 4 months ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 90 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. HF by Framingham criteria
  2. At least one admission to hospital for HF within the last 180 days
  3. New York Heart Association Class II thru IV
  4. Echocardiographic criteria:At least moderate diastolic dysfunction, Ejection fraction >45%

Exclusion Criteria:

  1. Creatinine clearance <40 mls/min/1.73m2
  2. Potassium >5.0 mmol/L
  3. Recent acute coronary syndrome in the prior 4 weeks
  4. Planned revascularization, defibrillator or pacemaker in next 4 months
  5. Known previous intolerance to aldosterone antagonist

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00523757

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Canada, Alberta
University of Alberta Hospital
Edmonton, Alberta, Canada
Sponsors and Collaborators
Justin Ezekowitz
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Principal Investigator: Justin Ezekowitz, MBBCh MSc University of Alberta
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Responsible Party: Justin Ezekowitz, Professor, University of Alberta Identifier: NCT00523757    
Other Study ID Numbers: UHF-G533000207
First Posted: August 31, 2007    Key Record Dates
Last Update Posted: November 7, 2018
Last Verified: November 2018
Keywords provided by Justin Ezekowitz, University of Alberta:
heart failure
diastolic function
Additional relevant MeSH terms:
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Heart Failure
Heart Diseases
Cardiovascular Diseases
Mineralocorticoid Receptor Antagonists
Hormone Antagonists
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Diuretics, Potassium Sparing
Natriuretic Agents