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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01467466
Registration number
NCT01467466
Ethics application status
Date submitted
26/10/2011
Date registered
8/11/2011
Titles & IDs
Public title
Prevention of Serious Adverse Events Following Angiography
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Scientific title
CSP #578 - Prevention of Serious Adverse Events Following Angiography (PRESERVE)
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Secondary ID [1]
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1011387
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Secondary ID [2]
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578
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Universal Trial Number (UTN)
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Trial acronym
PRESERVE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute Renal Failure
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Kidney Disease
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Coronary Artery Disease
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Condition category
Condition code
Renal and Urogenital
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Kidney disease
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Injuries and Accidents
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Other injuries and accidents
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Cardiovascular
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - IV isotonic saline
Treatment: Drugs - IV isotonic bicarbonate
Treatment: Drugs - N-acetylcysteine
Treatment: Drugs - Placebo
Active comparator: Saline & oral placebo - IV isotonic saline and oral placebo drug capsule
Active comparator: Saline & oral N-acetylcysteine - IV isotonic saline and oral N-acetylcysteine drug capsule
Active comparator: Bicarbonate & oral placebo - IV isotonic bicarbonate and oral placebo drug capsule
Active comparator: Bicarbonate & oral N-acetylcysteine - IV isotonic bicarbonate and oral N-acetylcysteine drug capsule
Treatment: Drugs: IV isotonic saline
The investigators will administer 3 ml/kg of isotonic saline over 1 hour at an infusion rate of not less than 1 mL/kg per hour and not more than 3 mL/kg per hour prior to the angiographic procedure, 1-1.5ml/kg per hour during angiography, and 6 ml/kg of isotonic saline over 4 hours following the procedure at an infusion rate of not less than 1 mL/kg per hour and not more than 1.5 mL/kg per hour. Providers will retain discretion to administer larger volumes of isotonic saline (up to a maximum of 12 mL/kg) over durations of up to 12 hours pre and 12 hours post-procedure.
Treatment: Drugs: IV isotonic bicarbonate
The investigators will administer 3 ml/kg of isotonic bicarbonate over 1 hour at an infusion rate of not less than 1 mL/kg per hour and not more than 3 mL/kg per hour prior to the angiographic procedure, 1-1.5ml/kg per hour during angiography, and 6 ml/kg of isotonic bicarbonate over 4 hours following the procedure at an infusion rate of not less than 1 mL/kg per hour and not more than 1.5 mL/kg per hour. Providers will retain discretion to administer larger volumes of isotonic bicarbonate (up to a maximum of 12 mL/kg) over durations of up to 12 hours pre and 12 hours post-procedure.
Treatment: Drugs: N-acetylcysteine
NAC will be administered at a dose of 1200mg orally 1 hour prior to angiography, 1 hour following the procedure, and then twice daily for the next 4 days.
Treatment: Drugs: Placebo
A placebo study drug capsule will be administered orally 1 hour prior to angiography, 1 hour following the procedure, and then twice daily for the next 4 days.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Number of Participants With Serious, Adverse, Patient-Centered Events, Including Death, Need for Acute Dialysis, or Persistent Decline in Kidney Function, Comparing Intravenous Sodium Bicarbonate With Intravenous Sodium Chloride.
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Assessment method [1]
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Death will be based on medical record and/or vital status registry documentation Need for acute dialysis will be defined as the initiation of any modality of renal replacement (intermittent hemodialysis, peritoneal dialysis, continuous renal replacement therapy, or sustained low-efficiency dialysis) Persistent decline in kidney function will be defined as an increase in serum creatinine of at least 50% from the baseline value collected pre-angiography to the measurement taken 90 days following the angiography.
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Timepoint [1]
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Within 90 days following angiography
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Primary outcome [2]
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Number of Participants With Serious, Adverse, Patient-Centered Events, Including Death, Need for Acute Dialysis, or Persistent Decline in Kidney Function, Comparing Oral N-Acetylcysteine With Oral Placebo.
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Assessment method [2]
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Death will be based on medical record and/or vital status registry documentation Need for acute dialysis will be defined as the initiation of any modality of renal replacement (intermittent hemodialysis, peritoneal dialysis, continuous renal replacement therapy, or sustained low-efficiency dialysis) Persistent decline in kidney function will be defined as an increase in serum creatinine of at least 50% from the baseline value collected pre-angiography to the measurement taken 90 days following the angiography.
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Timepoint [2]
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Within 90 days following angiography
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Eligibility
Key inclusion criteria
* Planned elective or urgent coronary or non-coronary angiography with iodinated contrast media in which it is anticipated that there will be an interval of 3 hours between the identification of the indication for angiography and the time of the planned procedure.
* Pre-angiography eGFR <60 ml/min/1.73 m2 with diabetes mellitus or pre-angiography eGFR <45 ml/min/1.73 m2 with or without diabetes mellitus
* Ability to provide informed consent
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Minimum age
18
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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
* Stage 5 chronic kidney disease (CKD) (eGFR <15 mL/min/1.73 m2)
* Currently receiving hemodialysis, peritoneal dialysis, continuous renal replacement therapy, or sustained low efficiency dialysis (SLED)
* Unstable baseline serum creatinine (SCr) (if known) at the time of angiography defined by an increase in SCr of 25% over the 3 days prior to angiography
* Decompensated heart failure requiring any of the following therapies at the time of angiography:
* IV milrinone, amrinone, dobutamine, or nesiritide
* Isolated ultrafiltration therapy
* Intra-aortic balloon pump
* Emergent angiography procedures defined as an anticipated duration of <3 hours between the identification of the indication for angiography and the time of the planned procedure.
* Receipt of intravascular iodinated contrast within the 5 days preceding angiography
* Receipt of oral or IV NAC within the 48 hours preceding angiography
* Known allergy to N-acetylcysteine (NAC)
* Known anaphylactic allergy to iodinated contrast media
* Prisoner
* Age <18 years
* Pregnancy
* Ongoing participation in an unapproved concurrent interventional study
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Study design
Purpose of the study
Prevention
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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 analysing the results/data
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Intervention assignment
Factorial
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
7/10/2013
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
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Actual
17/10/2017
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Sample size
Target
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Accrual to date
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Final
5177
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,SA,VIC,WA
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Recruitment hospital [1]
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Canberra Hospital - Canberra
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Concord Hospital - Concord
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Gosford Hospital - Gosford
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Nepean Hospital - Kingswood
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St. George Hospital - Kogarah
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Liverpool Hospital - Liverpool
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Royal North Shore Hospital - St. Leonards
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Flinders Medical Centre - Bedford Park
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Northern Health - Epping
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Austin Health - Heidelberg
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Fremantle Hospital - Fremantle
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Sir Charles Gairdner Hospital - Nedlands
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Royal Perth Hospital - Perth
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2606 - Canberra
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2139 - Concord
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2250 - Gosford
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2747 - Kingswood
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2217 - Kogarah
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2170 - Liverpool
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2065 - St. Leonards
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5042 - Bedford Park
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3076 - Epping
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3084 - Heidelberg
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6160 - Fremantle
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6009 - Nedlands
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Recruitment postcode(s) [13]
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6000 - Perth
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Recruitment outside Australia
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United States of America
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Arizona
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Malaysia
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Penang
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Malaysia
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Selangor
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Malaysia
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Kuala Lumpur
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New Plymouth
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Wellington
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New Zealand
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Auckland
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Funding & Sponsors
Primary sponsor type
Government body
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Name
VA Office of Research and Development
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Address
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Other collaborator category [1]
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Other
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Name [1]
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The George Institute
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Ethics approval
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Summary
Brief summary
The purpose of this research study is to compare the effectiveness of intravenous isotonic sodium bicarbonate with intravenous isotonic sodium chloride and oral N-acetylcysteine (NAC) with oral placebo for the prevention of serious adverse outcomes following angiographic procedures in high-risk patients.
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Trial website
https://clinicaltrials.gov/study/NCT01467466
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Trial related presentations / publications
Garcia S, Bhatt DL, Gallagher M, Jneid H, Kaufman J, Palevsky PM, Wu H, Weisbord SD; PRESERVE Trial Group. Strategies to Reduce Acute Kidney Injury and Improve Clinical Outcomes Following Percutaneous Coronary Intervention: A Subgroup Analysis of the PRESERVE Trial. JACC Cardiovasc Interv. 2018 Nov 26;11(22):2254-2261. doi: 10.1016/j.jcin.2018.07.044. Parikh CR, Liu C, Mor MK, Palevsky PM, Kaufman JS, Thiessen Philbrook H, Weisbord SD. Kidney Biomarkers of Injury and Repair as Predictors of Contrast-Associated AKI: A Substudy of the PRESERVE Trial. Am J Kidney Dis. 2020 Feb;75(2):187-194. doi: 10.1053/j.ajkd.2019.06.011. Epub 2019 Sep 20. Weisbord SD, Palevsky PM, Kaufman JS, Wu H, Androsenko M, Ferguson RE, Parikh CR, Bhatt DL, Gallagher M; PRESERVE Trial Investigators. Contrast-Associated Acute Kidney Injury and Serious Adverse Outcomes Following Angiography. J Am Coll Cardiol. 2020 Mar 24;75(11):1311-1320. doi: 10.1016/j.jacc.2020.01.023. Bullen AL, Cashion W, Webster L, Palevsky PM, Weisbord SD, Ix JH. Estimated Urinary Flow Rate and Contrast-Associated Acute Kidney Injury Risk: The PRESERVE (Prevention of Serious Adverse Events Following Angiography) Trial. Kidney Med. 2021 Feb 27;3(3):461-463. doi: 10.1016/j.xkme.2020.12.014. eCollection 2021 May-Jun. No abstract available. Soomro QH, Anand ST, Weisbord SD, Gallagher MP, Ferguson RE, Palevsky PM, Bhatt DL, Parikh CR, Kaufman JS; PRESERVE Trial Investigators; PRESERVE Trial Group. The Relationship between Rate and Volume of Intravenous Fluid Administration and Kidney Outcomes after Angiography. Clin J Am Soc Nephrol. 2022 Oct;17(10):1446-1456. doi: 10.2215/CJN.02160222. Epub 2022 Aug 25. Weisbord SD, Gallagher M, Jneid H, Garcia S, Cass A, Thwin SS, Conner TA, Chertow GM, Bhatt DL, Shunk K, Parikh CR, McFalls EO, Brophy M, Ferguson R, Wu H, Androsenko M, Myles J, Kaufman J, Palevsky PM; PRESERVE Trial Group. Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine. N Engl J Med. 2018 Feb 15;378(7):603-614. doi: 10.1056/NEJMoa1710933. Epub 2017 Nov 12.
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Public notes
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Contacts
Principal investigator
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Steven D. Weisbord, MD MSc
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Address
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VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA
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Contact person for scientific queries
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
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/66/NCT01467466/Prot_002.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/66/NCT01467466/SAP_001.pdf
Results publications and other study-related documents
Type
Citations or Other Details
Journal
Garcia S, Bhatt DL, Gallagher M, Jneid H, Kaufman ...
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Journal
Parikh CR, Liu C, Mor MK, Palevsky PM, Kaufman JS,...
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Weisbord SD, Palevsky PM, Kaufman JS, Wu H, Andros...
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Bullen AL, Cashion W, Webster L, Palevsky PM, Weis...
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Soomro QH, Anand ST, Weisbord SD, Gallagher MP, Fe...
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Results are available at
https://clinicaltrials.gov/study/NCT01467466