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Trial registered on ANZCTR
Registration number
ACTRN12614000755639
Ethics application status
Approved
Date submitted
4/07/2014
Date registered
16/07/2014
Date last updated
11/11/2021
Date data sharing statement initially provided
8/01/2019
Date results provided
8/01/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Thiamine to improve stem cell function in patients undergoing bypass surgery: a randomised controlled trial
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Scientific title
A randomised trial comparing high-dose thiamine to placebo in patients undergoing coronary artery bypass surgery with proliferation of resident cardiac progenitor cells as measured by bromodeoxyuridine (BrdU) assay as primary outcome
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Secondary ID [1]
284889
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Nil
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Universal Trial Number (UTN)
U1111-1158-2217
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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:
Heart failure
292334
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Coronary artery disease
292335
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Diabetes mellitus
292336
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Condition category
Condition code
Cardiovascular
292668
292668
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0
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Coronary heart disease
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Metabolic and Endocrine
292763
292763
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Thiamine two 500mg capsules twice daily for 3-5 days prior to surgery. Treatment starts after the surgical list for the following week has been finalised and continues until the day before surgery. Adherence and adverse effects of treatment will be monitored by a pill count, questionnaire and blood tests prior to surgery.
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Intervention code [1]
289701
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Treatment: Drugs
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Comparator / control treatment
Placebo (maltodextrin) two 500mg capsules twice daily for 3-5 days prior to surgery.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Resident cardiac progenitor cell proliferation as measured by BrdU assay
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Assessment method [1]
292512
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Timepoint [1]
292512
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At time of coronary artery bypass grafting
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Secondary outcome [1]
309128
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Ability of resident cardiac progenitor cells to differentiate into cardiomyocytes, as measured by the number of GATA-4 and connexin-43 positive cells after exposure to differentiation medium
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Assessment method [1]
309128
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Timepoint [1]
309128
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At time of coronary artery bypass surgery
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Secondary outcome [2]
309129
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Level of activation of pentose phosphate pathway as measured by the level of transketolase in resident cardiac progenitor cells
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Assessment method [2]
309129
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Timepoint [2]
309129
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At the time of coronary artery bypass surgery
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Secondary outcome [3]
309385
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Circulating thiamine levels
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Assessment method [3]
309385
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Timepoint [3]
309385
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At the time of coronary artery bypass surgery.
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Secondary outcome [4]
309386
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Adverse effects assessment: headache, nausea, irritability, insomnia, rapid pulse, muscle weakness. These are assessed by interview and examination of vital signs.
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Assessment method [4]
309386
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Timepoint [4]
309386
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Day 3 (and day 4 if applicable) of being on study medication.
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Eligibility
Key inclusion criteria
1. Patients listed for inpatient coronary artery bypass surgery due to atherosclerotic coronary artery disease and
2. Aged 50 years and over and
3. Left ventricular systolic function normal on echocardiography (ejection fraction more than or equal to 50%) performed during this inpatient stay (or within three months if no myocardial infarction has occurred between date of echocardiogram and date of enrollment).
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Minimum age
50
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
1. Left ventricular systolic function impaired (echocardiographic ejection fraction < 50%) or
2. Renal failure with creatinine > 200 umol/l or requiring renal replacement therapy or
3. Already taking thiamine supplementation or
4. Previously had an adverse reaction to thiamine, or a supplement or medication containing thiamine or
5. Previous or current history of alcohol related problems. This refers to a previous diagnosis of a medical condition thought to be caused or exacerbated by alcohol, or harmful use of alcohol (International Classification of Diseases version 10 codes F10.0 to F10.9) or
6. Other major medical conditions that, in the opinion of the investigator, would make randomisation of the participant to thiamine unsafe or undesirable.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Numbered containers determined by computer-based randomisation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Block randomisation according to randomization.com
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
A standard two-tailed t-test will be used to compare the primary outcome between treated and non-treated groups, using an intention-to-treat analysis. Separate analysis of the primary outcomes stratified by diabetic status will be performed using a t-test.
For secondary analyses, differences across multiple groups will be assessed using an analysis of variance (ANOVA) test followed by a Sidak-Holm multiple comparison test. Comparison between two groups will be assessed using t-tests.
Pre-specified subgroup analysis is according to diabetic status.
The sample size has been calculated to provide more than 90% power in the subgroups to detect a two-tailed 30% difference in primary outcome with treatment at a significance level of 0.05.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/03/2015
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Actual
10/04/2015
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Date of last participant enrolment
Anticipated
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Actual
22/03/2017
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Date of last data collection
Anticipated
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Actual
17/09/2018
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Sample size
Target
40
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Accrual to date
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Final
42
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Recruitment outside Australia
Country [1]
6182
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New Zealand
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State/province [1]
6182
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Otago
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Funding & Sponsors
Funding source category [1]
289514
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Government body
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Name [1]
289514
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Lottery Health Research
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Address [1]
289514
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Local Government and Community Branch
Department of Internal Affairs
PO Box 805
Wellington 6140
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Country [1]
289514
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New Zealand
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Primary sponsor type
University
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Name
University of Otago
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Address
Department of Medicine
Dunedin School of Medicine
PO Box 56
Dunedin 9054
New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
288201
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None
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Name [1]
288201
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Address [1]
288201
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Country [1]
288201
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
291259
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Southern Health and Disability Ethics Committee
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Ethics committee address [1]
291259
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c/o Ministry of Health No 1 The Terrace PO Box 5013 Wellington 6145
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Ethics committee country [1]
291259
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New Zealand
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Date submitted for ethics approval [1]
291259
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30/06/2014
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Approval date [1]
291259
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20/10/2014
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Ethics approval number [1]
291259
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Summary
Brief summary
Cardiac dysfunction is common in patients undergoing coronary artery bypass grafting (CABG) surgery. The heart’s intrinsic regenerative capability is related to the presence and function of resident cardiac stem cells, but there are limited ways of improving this capability. We have shown that thiamine analogues increase the profileration of resident cardiac stem cells in-vitro, by stimulating the pentose phosphate pathway. In addtion, we have shown that patients with type 2 diabetes have reduced number and less proliferation of resident cardiac stem cells, due to dysfunction of the pentose phosphate pathway. We aim to translate these findings to humans, by randomising patients undergoing CABG surgery to either short-term high dose thiamine or placebo, with a primary endpoint of the ability of resident cardiac stem cells to proliferate. In addition to the valuable findings of the trial itself, if we show that this approach is successful, this study could directly be used to design a larger clinical outcome driven randomised control trial.
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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
49558
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Prof Michael Williams
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Address
49558
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Department of Cardiology,
7th Floor, Dunedin Hospital
201 Great King Street
Dunedin 9016
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Country
49558
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New Zealand
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Phone
49558
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+64 3 474 0999
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Fax
49558
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Email
49558
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[email protected]
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Contact person for public queries
Name
49559
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Mary Blok
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Address
49559
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Research Nurse
Department of Cardiology
9th Floor, Dunedin Hospital
201 Great King Street
Dunedin 9016
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Country
49559
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New Zealand
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Phone
49559
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+64 3 474 0999
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Fax
49559
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Email
49559
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[email protected]
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Contact person for scientific queries
Name
49560
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Sean Coffey
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Address
49560
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Department of Medicine,
Dunedin School of Medicine,
PO Box 56
Dunedin 9054
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Country
49560
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New Zealand
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Phone
49560
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+64 34740999
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Fax
49560
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Email
49560
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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
Ethics Committee approval was only granted for data use by the local study investigators.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
945
Study protocol
366625-(Uploaded-07-01-2019-13-18-57)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Thiamine increases resident endoglin positive cardiac progenitor cells and atrial contractile force in humans: A randomised controlled trial.
2021
https://dx.doi.org/10.1016/j.ijcard.2021.08.039
N.B. These documents automatically identified may not have been verified by the study sponsor.
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