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Trial registered on ANZCTR
Registration number
ACTRN12610000396022
Ethics application status
Approved
Date submitted
13/04/2010
Date registered
18/05/2010
Date last updated
19/09/2024
Date data sharing statement initially provided
19/09/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
The Study of ability of plasma Pre-pro Brain natriuretic peptide (NP) Signal Peptide to detect Inducible Cardiac Ischemia
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Scientific title
The Study of ability of plasma Pre-pro Brain natriuretic peptide Signal Peptide (BNP-SP)to detect Inducible Cardiac Ischemia in those with intermediate to high risk.
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Secondary ID [1]
251779
0
None
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Universal Trial Number (UTN)
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Trial acronym
Signal Peptide and Inducible Cardiac Ischaemia : SP-ICI
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
cardiac ischaemia
257143
0
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Condition category
Condition code
Cardiovascular
257300
257300
0
0
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Coronary heart disease
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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
Serial sampling of plasma Pre-pro Brain natriuretic peptide Signal Peptide (BNP-SP)patients recruited over 1 year with controlled induced cardiac ischemia in the form of either dobutamine stress testing or treadmill exercise tolerance testing is proposed.
The dobutamine stress echocardiograph test takes about 1 hour and involves an injection of 10-40mcg/kg/min of dobutamine to stimulate the heart in a similar way to exercise while measuring the effect using ultrasound.
The Treadmill exercise tolerance test takes about 30 minutes in total and involves an electrocardiogragh recording while walking on a treadmill.
Venous blood samples will be drawn at baseline (0), 0.5, 1, 1.5, 2, 2.5, 3, 3.5, and 4 hours. Later sampling (=1wk) will not be carried out. For each blood sample, we will measure plasma BNP-SNP, troponin and N-terminal Brain natriuretic peptide (NT-proBNP). Other signal peptides will be looked at namely ghrelin SP. Depending on results this biomarker has the potential to improve the sensitivity of stress testing. In addition, this study may provide insights into the mechanisms of release of this novel group of peptides.
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Intervention code [1]
256298
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Not applicable
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Comparator / control treatment
Protocol 1: Treadmill exercise Test:
- 16 patients with intermediate to high pretest probability of cardiac chest pain.
- 5 individuals with low pretest probability of cardiac pathology
Protocol 2: Dobutamine Stress Echocardiography:
- 16 patients with intermediate to high pretest probability of cardiac chest pain.
- 5 individuals with low pretest probability of cardiac pathology
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Control group
Active
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Outcomes
Primary outcome [1]
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To determine whether serial measurements of BNP-SP measured via venous blood sampling will be able to detect inducible cardiac ischemia. The temporal pattern of release of BNP SP during 1) treadmill exercise tolerance testing and 2) dobutamine stress echocardiography will be determined in those with intermediate to high risk cardiac chest pain and compared to the pattern of release of patients with low risk of cardiac pathology
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Assessment method [1]
258207
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Timepoint [1]
258207
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at baseline (0), 0.5, 1, 1.5, 2, 2.5, 3, 3.5, and 4 hours for both treadmill and dobutamine stress tests
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Secondary outcome [1]
263857
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The pattern of release will also be compared and contrasted to N-terminal Brain natriuretic peptide (NT-BNP) and high sensitivity troponin in venous blood sampling
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Assessment method [1]
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Timepoint [1]
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at baseline (0), 0.5, 1, 1.5, 2, 2.5, 3, 3.5, and 4 hours for both treadmill and dobutamine stress tests
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Eligibility
Key inclusion criteria
Protocol 1)
Inclusion criteria:
Intermediate to high pretest probability of cardiac ischemia as judged by cardiac risk factors, nature of chest pain and past cardiac history.
5 healthy volunteers with no history of cardiovascular or other significant illness will enrolled as a control group.
Protocol 2)
Inclusion criteria:
Intermediate to high pretest probability of cardiac ischemia as judged by cardiac risk factors, nature of chest pain and past cardiac history.
5 healthy volunteers with no history of cardiovascular or other significant illness will enrolled as a control group.
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Minimum age
18
Years
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Maximum age
80
Years
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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
Protocol 1:
Exclusion Criteria:
Patients with atrial fibrillation, pacemakers, significant valvular disease, aged over 70, recent infarction will be excluded.
Patients in whom resting electrocardiograms (ECGs) show abnormalities that preclude interpretation of exercise-induced changes for example left bundle branch block, left ventricular hypertrophy, 1 mm ST segment changes or pre-excitation will be excluded.
Patients with poor echo windows will be excluded.
Anemia as defined as a hemoglobin level less than 100
Unable to give informed consent
Unable to comply with study requirements
Protocol 2:
Exclusion criteria:
Poor echocardiographic windows.
Chronic atrial fibrillation.
Age less than 18 or greater than 80.
Anemia as defined as a hemoglobin level less than 100
Unable to give informed consent
Unable to comply with study requirements
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Study design
Purpose
Screening
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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
Completed
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Date of first participant enrolment
Anticipated
25/03/2010
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Actual
25/03/2010
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Date of last participant enrolment
Anticipated
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Actual
1/03/2012
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Date of last data collection
Anticipated
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Actual
1/03/2012
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Sample size
Target
42
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Accrual to date
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Final
52
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Recruitment outside Australia
Country [1]
2583
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New Zealand
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State/province [1]
2583
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Funding & Sponsors
Funding source category [1]
256798
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Charities/Societies/Foundations
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Name [1]
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Christchurch Cardioendocrine Research Trust
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Address [1]
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Department of Medicine
University of Otago, Christchurch
PO Box 4345
Christchurch 8140
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Country [1]
256798
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New Zealand
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Primary sponsor type
Other
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Name
Christchurch Cardioendocrine Research Trust
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Address
Department of Medicine
University of Otago, Christchurch
PO Box 4345
Christchurch 8140
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Country
New Zealand
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Secondary sponsor category [1]
256074
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None
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Name [1]
256074
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Address [1]
256074
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Country [1]
256074
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
258821
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Upper South B Regional Ethics Committee
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Ethics committee address [1]
258821
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Ministry of Health PO Box 3877 Christchurch 8140
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Ethics committee country [1]
258821
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New Zealand
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Date submitted for ethics approval [1]
258821
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Approval date [1]
258821
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23/03/2010
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Ethics approval number [1]
258821
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Summary
Brief summary
This is a prospective observational pilot study of the diagnostic utility of a novel biomarker B-type natriuretic peptide signal peptide (BNP-SP)in the assessment of inducible cardiac ischemia. Previously performed studies have demonstrated a clear, consistent and early peak of BNP-SP in the setting of indisputable cardiac ischemia and necrosis in patients presenting with ST elevation myocardial infarction. The patterns of release in the setting of less extreme forms of cardiac ischemia have not been previously defined. Serial sampling of BNP-SP in patients with controlled induced cardiac ischemia in the form of dobutamine stress testing and treadmill exercise tolerance testing is proposed. Venous blood samples will be drawn at baseline (0), 0.5, 1, 1.5, 2, 2.5, 3, 3.5, and 4 hours. Later sampling (=1wk) will not be carried out. For each blood sample, we will measure plasma BNP-SNP, troponin and NT-proBNP. Other signal peptides will be looked at namely ghrelin SP. Depending on results this biomarker has the potential to improve the sensitivity of stress testing. In addition, this study may provide insights into the mechanisms of release of this novel group of peptides.
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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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Dr Maithri Siriwardena
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Address
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Department of Medicine University of Otago, Christchurch PO Box 4345 Christchurch 8140
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Country
31042
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New Zealand
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Phone
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+6433640640
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Fax
31042
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Email
31042
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Richard
[email protected]
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Contact person for public queries
Name
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Dr Maithri Siriwardena
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Address
14289
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Department of Medicine
University of Otago, Christchurch
PO Box 4345
Christchurch 8140
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Country
14289
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New Zealand
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Phone
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+643 364 0640
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Fax
14289
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Email
14289
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[email protected]
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Contact person for scientific queries
Name
5217
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Dr Maithri Siriwardena
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Address
5217
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Department of Medicine
University of Otago, Christchurch
PO Box 4345
Christchurch 8140
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Country
5217
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New Zealand
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Phone
5217
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+643 364 0640
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Fax
5217
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Email
5217
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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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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